The research, published recently in the Journal of the Academy of Nutrition and Dietetics, assessed the associations of meal frequency, skipping, and intervals with all-cause and cardiovascular disease (CVD) mortality in American adults aged 40 and above.
Scientists, including those from The University of Tennessee in the US, found that eating only one meal per day is associated with an increased risk of mortality in American adults.
They say skipping breakfast is linked to a higher risk of CVD mortality, and missing lunch or dinner associated with all-cause mortality.
Even among those who ate three meals daily in the study, eating two adjacent meals less than or equal to 4.5 hours apart is linked to a higher all-cause death risk, researchers say.
“Our research revealed that individuals eating only one meal a day are more likely to die than those who had more daily meals. Among them, participants who skip breakfast are more likely to develop fatal cardiovascular diseases, while those who skip lunch or dinner increase their risk of death from all causes,” study lead author Yangbo Sun explained.
“At a time when intermittent fasting is widely touted as a solution for weight loss, metabolic health, and disease prevention, our study is important for the large segment of American adults who eat fewer than three meals each day,” Dr Sun said.
In the study, scientists analysed data from a cohort of over 24,000 American adults 40 years of age and older who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2014.
The ongoing survey collects a range of health-related data from participants including, nutritional status, general health, disease history, and health behaviors every two years.
Researchers ascertained the mortality status and the cause behind the 4,175 deaths identified among this group.
They found a number of common characteristics among those eating fewer than three meals per day – around 40 per cent of respondents.
Scientists say they are more likely to be younger, male, non-Hispanic Black, have less education and lower family income, smoke, drink more alcohol, be food insecure, and eat less nutritious food, more snacks, and less energy intake overall.
“Our results are significant even after adjustments for dietary and lifestyle factors (smoking, alcohol use, physical activity levels, energy intake, and diet quality) and food insecurity,” said Wei Bao, another author of the study.
While the findings are observational and do not imply a causal relationship between the factors, scientists say the results make “metabolic sense” nonetheless.
Skipping meals, researchers say, usually leads to ingesting a larger energy load all at once.
This can aggravate the burden of glucose metabolism regulation in the body and lead to subsequent metabolic deterioration, they explain.
The results, according to the scientists, can also explain the link between a shorter meal interval and mortality since a shorter time between meals could lead to a larger energy load in the given period.
“Our research contributes much-needed evidence about the association between eating behaviors and mortality in the context of meal timing and duration of the daily prandial period,” Dr Bao said.