Frequency of eating and concentrations of serum cholesterol in the Norfolk population of the European Prospective Investigation into Cancer (EPIC-Norfolk): cross sectional study. (Primary Care).(Norfolk, England)

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.

Introduction

Small, time limited trials in humans and some case-control studies have indicated that people who eat frequently tend to have lower concentrations of total cholesterol and low density lipoprotein cholesterol than people who eat a gorging diet. (1-6) Results have been less conclusive with respect to concentrations of high density lipoprotein cholesterol, apolipoproteins, and serum glucose and secretion of insulin. (1 3 7)

Data from free living populations are limited, and it is not clear whether the effects observed in trials pertain only at the extremes of eating frequency or are continuous over the whole distribution of eating frequency. To investigate this we examined the relation between frequency of eating and concentrations of total cholesterol, low density lipoprotein cholesterol, and high density lipoprotein cholesterol in middle aged men and women in a British population based study.

Methods

We used data from the Norfolk cohort of the European prospective investigation into cancer. (8) This is an ongoing prospective cohort of approximately 25000 people aged 45-75, resident in Norfolk, and recruited from general practice registers between 1993 and 1997. All participants gave informed consent. At the baseline survey participants completed a detailed…