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Frequency of eating and concentrations of serum cholesterol in the Norfolk population of the European prospective investigation into cancer (EPIC-Norfolk): cross sectional study

BMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7324.1286 (Published 01 December 2001) Cite this as: BMJ 2001;323:1286
  1. Silvia M O Titan, visiting research fellowa,
  2. Sheila Bingham, deputy directorb,
  3. Ailsa Welch, research associatea,
  4. Robert Luben, research associatea,
  5. Suzy Oakes, research associatea,
  6. Nicholas Day, MRC professor of epidemiologya,
  7. Kay-Tee Khaw (kk101{at}medschl.cam.ac.uk), professor of clinical gerontologya
  1. a Institute of Public Health, University of Cambridge, Cambridge CB2 2SR
  2. b MRC Dunn Human Nutrition Unit, Cambridge CB2 2XY
  1. Correspondence to: K-T Khaw, Clinical Gerontology Unit, University of Cambridge, Addenbrooke's Hospital Box 251, Cambridge CB2 2QQ
  • Accepted 2 September 2001

Abstract

Objectives: To examine the relation between self reported eating frequency and serum lipid concentrations in a free living population.

Design: Cross sectional population based study.

Setting: Norfolk, England.

Participants: 14 666 men and women aged 45–75 years from the Norfolk cohort of the European prospective investigation into cancer (EPIC-Norfolk).

Main outcome measures: Concentrations of blood lipids.

Results: Mean concentrations of total cholesterol and low density lipoprotein cholesterol decreased in a continuous relation with increasing daily frequency of eating in men and women. No consistent relation was observed for high density lipoprotein cholesterol, body mass index, waist to hip ratio, or blood pressure. Mean cholesterol concentrations differed by about 0.25 mmol/l between people eating more than six times a day and those eating once or twice daily; this difference was reduced to 0.15 mmol/l after adjustment for possible confounding variables, including age, obesity, cigarette smoking, physical activity, and intake of energy and nutrients (alcohol, fat, fatty acids, protein, and carbohydrate).

Conclusions: Concentrations of total cholesterol and low density lipoprotein cholesterol are negatively and consistently associated with frequency of eating in a general population. The effects of eating frequency on lipid concentrations induced in short term trials in animals and human volunteers under controlled laboratory conditions can be observed in a free living general population. We need to consider not just what we eat but how often we eat.

What is already known on this topic

What is already known on this topic Studies in animals and small human trials indicate that eating frequency is inversely related to serum lipid concentrations

Few studies have examined this in a free living population under no dietary restrictions

What this study adds

What this study adds In a free living population increased eating frequency was negatively and significantly associated with concentrations of total cholesterol and low density lipoprotein cholesterol

This association was still present after adjustment for body mass index, physical activity, cigarette smoking, and dietary intake

Mean age adjusted cholesterol concentrations differed by 0.25 mmol/l between people eating more than six times a day and those eating less than twice daily

Footnotes

  • Funding EPIC-Norfolk is supported by research programme grant funding from the Cancer Research Campaign and Medical Research Council with additional support from the Stroke Association, British Heart Foundation, Department of Health, Europe Against Cancer Programme Commission of the European Union, Ministry of Agriculture, Fisheries and Food, and Wellcome Trust.

  • Competing interests None declared.

  • Accepted 2 September 2001
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