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Snack Your Way to Lower Cholesterol

Eating many small meals each day is beneficial, British research finds

THURSDAY, Nov. 29, 2001 (HealthDayNews) -- One good way to lower blood cholesterol is to eat many small meals during the day rather than one or two big feasts, a British study finds.

The study of almost 15,000 older people found that those who ate at least six times a day had cholesterol levels about 5 percent lower than those who ate only one or two meals, says a report in the Dec. 1 issue of the British Medical Journal.

That is about the same reduction that can be achieved by dietary changes aimed at lowering intake of fat and cholesterol, and it can reduce the risk of heart disease by 10 percent to more than 20 percent, the researchers say.

"If applied population-wise, such reductions might have a substantial impact, particularly in older people, who have higher absolute rates of heart disease," they write.

It's a finding that has been reported in laboratory tests and smaller human studies, says Dr. Kay-Tee Khaw, professor of clinical gerontology at the University of Cambridge Institute of Public Health and leader of the research group. "Now we show that it occurs in a free-living human population," she adds.

It's not known why having more smaller meals affects blood cholesterol levels, Khaw says. One possibility is that eating big meals triggers a change in body metabolism, activating liver enzymes involved in cholesterol metabolism, she says. It could be a defensive mechanism allowing the body to store fat when a particularly big food source becomes available.

The study used data gathered for a European cancer study. The Cambridge researchers concentrated on residents between the ages of 45 and 75 in the city of Norfolk. They filled out detailed questionnaires on such heart attack risk factors as body weight, smoking, physical activity and diet, and they were also asked about their eating habits.

More than half the participants reported eating three or four meals a day, with a small number saying they ate just once or twice and a larger number reporting at least six meals. There was a steady decrease in blood cholesterol levels as the number of daily meals increased, the researchers say.

That finding is "particularly striking," because the frequent eaters took in more calories and more fat overall than the those who limited themselves to one or two meals, they say.

"We need to consider not just what we eat but how often we eat," they conclude.

The British results are consistent with those of a California study done in the mid-1980s, says Dr. Elizabeth L. Barrett-Connor, professor of epidemiology at the University of California, San Diego, who did the earlier study.

"We have continuing evidence of the value of more frequent meals," she says. "Now, how do we get people's attention?"

One way would be to show that the cholesterol reduction does reduce the risk of cardiovascular disease, and the British study holds promise of doing that, Barrett-Connor says.

"It is large enough so that in time they can see whether the eating pattern goes on to affect death from heart disease," she says. "It's important to show that."

What To Do

"Our advice to people is to first increase their intake of fruits and vegetables; second, to reduce their intake of saturated fats, and in addition spread their food intake out over several meals rather than just one to derive additional benefits," Khaw says. "It would be the usual healthy diet spread out in small meals during the day."

For definitive information on good eating, consult the American Heart Association, the National Heart, Lung and Blood Institute, or the American Dietetic Association.

SOURCES: Interviews with Kay-Tee Khaw, M.D. professor of clinical gerontology, University of Cambridge Institute of Public Health, Cambridge, England; Elizabeth L. Barrett-Connor, M.D., professor of epidemiology, University of California, San Diego; Dec. 1, 2001, British Medical Journal
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