Planning meals and snacks in advance and eating breakfast every day may help lower the risk of cardiovascular disease, new guidelines from US doctors say.
Eating more calories earlier in the day and consuming less food at night may also reduce the odds of a heart attack, stroke or other cardiac or blood vessel diseases, according to the scientific statement from the American Heart Association.
"When we eat may be important to consider, in addition to what we eat," said Marie-Pierre St-Onge, chair of the group that wrote the guidelines and a nutrition researcher at Columbia University Medical Center in New York.
As many as 30 per cent of US adults may routinely skip breakfast, a habit that has become more common in recent years as more people snack throughout the day instead of sitting down for three traditional meals, St-Onge and colleagues note in the journal Circulation.
When people do eat breakfast daily, they're less likely to have risk factors for cardiovascular disease like high cholesterol and elevated blood pressure. And people who skip this morning meal are more likely to have risk factors like obesity, poor nutrition and diabetes or high blood sugar.
That's because meal timing may affect health by impacting the body's internal clock. We may not process sugars as well at night as we do during the day, and studies of shift workers have linked this schedule with a greater risk of obesity and heart disease than a typical day job, St-Onge said by email.
"We know from population studies that eating breakfast is related to lower weight and healthier diet, along with lower risk of cardiovascular disease," St-Onge said.
"However, interventions to increase breakfast consumption in those who typically skip breakfast do not support a strong causal role of this meal for weight management, in particular," St-Onge cautioned. "Adding breakfast, for some, leads to an additional meal and weight gain."
It's possible that some people who add breakfast aren't eating the right things or cutting back on what they eat later in the day, resulting in more calories but not necessarily good nutrition.
A healthy diet is heavy on fruits and vegetables, whole grains, low-fat dairy, poultry and fish, according to the guidelines. Eating well also means limiting red meat, salt and foods high in added sugars.
Plotting out what to eat ahead of time, especially for busy people who eat on the go, can help create a diet that's better for heart health, St-Onge said.
"Planning ahead and making healthy, carry-on foods is important," St-Onge suggested. "This could be a homemade smoothie or whole grain muffin or cereal bar for breakfast; packing a sandwich or leftovers for those times when time is tight."
Advance thought can also help people eat the right amount of food throughout the day and eat at the right time, said Samantha Heller, a nutritionist at New York University Langone Medical Center who wasn't involved in the guidelines.
"The 'eating several small meals' during the day advice that we commonly hear is unrealistic for most people because the 'small' meals often turn into meal-sized meals and weight gain is inevitable," Heller said by email.
"Another booby trap for overeating is after dinner," Heller added. "Night time eating is quite common and an easy way to add unnecessary calories and pack on the pounds over time because people snack when in front of TV, computer and tablet screens."
Heller's advice: "Once dinner is finished, the kitchen should be closed. If your schedule is crazy and you cannot get to dinner until later in the evening, then eat light at night."