Systematic Review Question

What is the relationship between the frequency of eating and risk of type 2 diabetes?

Insufficient evidence is available to determine the relationship between the frequency of eating and type 2 diabetes. (Grade: Grade not assignable)

The question is: What is the relationship between the frequency of eating and type 2 diabetes?

Insufficient evidence is available to determine the relationship between the frequency of eating and type 2 diabetes.

This important public health question was identified by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) to be examined by the 2020 Dietary Guidelines Advisory Committee.

The 2020 Dietary Guidelines Advisory Committee, Frequency of Eating Subcommittee conducted a systematic review to answer this question with support from the Nutrition Evidence Systematic Review (NESR) team.
Frequency of eating was defined as the number of daily eating occasions.

The population of interest was generally healthy children through older adults (ages 2 years and older).

This review included 2 articles that met the inclusion criteria.
Inconsistent results from 2 prospective cohort studies with critical limitations, were insufficient to draw conclusions.

This important public health question was identified by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) to be examined by the 2020 Dietary Guidelines Advisory Committee.
The 2020 Dietary Guidelines Advisory Committee, Frequency of Eating Subcommittee conducted a systematic review to answer this question with support from the Nutrition Evidence Systematic Review (NESR) team.
The goal of this systematic review was to examine the following question: What is the relationship between the frequency of eating and type 2 diabetes?

Insufficient evidence is available to determine the relationship between the frequency of eating and type 2 diabetes. (Grade: Grade not assignable)

A literature search was conducted using 4 databases (PubMed, Cochrane, Embase, and CINAHL) to identify articles that evaluated an intervention or exposure of the frequency of eating and the outcome of type 2 diabetes. A manual search was also conducted to identify articles that may not have been included in the electronic databases searched. Articles were screened by two authors independently for inclusion based on pre-determined criteria.
Data extraction and risk of bias assessment were conducted for each included study, and both were checked for accuracy. The Subcommittee qualitatively synthesized the body of evidence to inform development of a conclusion statement(s), and graded the strength of evidence using pre-established criteria for risk of bias, consistency, directness, precision, and generalizability.

This systematic review was undertaken to examine the relationship between the frequency of eating and type 2 diabetes.
This review included 2 PCSs published between January 2000 and September 2019 that met inclusion criteria.
- One included study reported that adult men who reported 1 to 2 eating occasions per day had a higher risk of type 2 diabetes compared to men who reported 3 eating occasions after 16 years of follow-up.
- One included study did not report an association between frequency of eating in adult women and risk of type 2 diabetes after a 6-year follow-up.
Critical limitations were identified within the body of evidence:
- Habitual eating frequency was measured only at baseline, leading to concern that changes in exposure status may have occurred over the follow-up time periods.
- Weak study designs were used to explore this question.
- Beverages and water were not included in assessments of eating occasions.
- The amount of attrition was unknown.
Due to a small, inconsistent body of evidence with critical limitations, the Committee determined that the evidence was insufficient to draw conclusions about the relationship between frequency of eating and type 2 diabetes.