Skipping meals and alcohol consumption

Abstract

Research suggests that specific eating patterns (e.g., eating breakfast) may be related to favorable weight status. This investigation examined the relationship between eating patterns (i.e., skipping meals; consuming alcohol) and weight loss treatment outcomes (weight loss, energy intake, energy expenditure, and duration of exercise). Fifty-four overweight or obese adults (BMI ≥ 27 kg/m²) participated in a self-help or therapist-assisted weight loss program. Daily energy intake from breakfast, lunch, dinner, and alcoholic beverages, total daily energy intake, total daily energy expenditure, physical activity, and weekly weight loss were assessed. On days that breakfast or dinner was skipped, or alcoholic beverages were not consumed, less total daily energy was consumed compared to days that breakfast, dinner, or alcoholic beverages were consumed. On days that breakfast or alcohol was consumed, daily energy expenditure (breakfast only) and duration of exercise were higher compared to days that breakfast or alcohol was not consumed. Individuals who skipped dinner or lunch more often had lower energy expenditure and exercise duration than individuals who skipped dinner or lunch less often. Individuals who consumed alcohol more often had high daily energy expenditure than individuals who consumed alcohol less often. Skipping meals or consuming alcoholic beverages was not associated with weekly weight loss. In this investigation, weight loss program participants may have compensated for excess energy intake from alcoholic beverages and meals with greater daily energy expenditure and longer exercise duration.

Introduction

Whether reading print media, listening to the radio, watching television, or surfing the Internet, there is no shortage of advice on eating patterns that “will” lead to weight loss. For example, despite a preponderance of research indicating that meal frequency is not related to energy utilization or balance (Bellisle, McDevitt, & Prentice, 1997), participants in our weight loss classes commonly ask whether they need to eat every 3 h to prevent triggering the body's starvation response, thus impeding weight loss.

While some research does suggest that specific eating patterns (e.g., eating breakfast every day), may be related to success at maintaining weight loss or associated with favorable weight status (Boutelle, Neumark-Sztainer, Story, & Resnick, 2002; Choo, Dietrich, Brown, Clark, & Block, 2003; Masheb & Grilo, 2006; Timlin & Pereira, 2007; Wyatt et al., 2002), the mechanisms by which eating patterns influence weight status are poorly understood. For example, there is evidence that daily energy intake is lower on days that breakfast is skipped than days when breakfast is consumed (Berkey, Rockett, Gillman, & Coldtiz, 2003; Choo et al., 2003). Paradoxically, however, several studies suggest that skipping breakfast is associated with poor weight loss maintenance, weight gain, and higher body mass index (Boutelle et al., 2002, Choo et al., 2003; Masheb & Grilo, 2006; van der Heijden, Hu, Rimm, & van Dam, 2007; Wyatt et al., 2002). While an assessment of daily energy expenditure in studies examining skipping breakfast might help to clarify these discrepant findings, daily energy expenditure is not commonly examined. People who eat breakfast every day could be qualitatively different than individuals who do not eat breakfast every day. For example, people who regularly eat breakfast might maintain a more active lifestyle through regular exercise or lifestyle activities than people who do not eat breakfast. Although total daily energy expenditure resulting from lifestyle activity and exercise has not been examined directly in prior studies, at least a couple studies suggest that individuals who regularly consume breakfast may also be more physically active (Berkey et al., 2003, Wyatt et al., 2002). Additionally, some people, such as dieters, may consciously regulate energy expenditure through activities and exercise based on their energy intake. However, to our knowledge, the relationship between skipping breakfast, daily energy expenditure, and active weight loss (not maintenance) has not been examined. Additionally, little is known about the relationship between eating patterns and weight loss among free living adults attempting to lose weight on their own or with minimal professional assistance from a therapist.

Large-scale surveys indicate that skipping meals is often a common weight loss strategy (Kruger, Galuska, Serdula, & Jones, 2004; Levy & Heaton, 1993). In one study, one in five dieters engaged in skipping meals as a specific weight loss practice (Levy & Heaton, 1993). Despite these reports, there is virtually no empirical evidence that skipping meals is an efficacious weight loss strategy.

Approximately 56% of Americans consume alcoholic beverages (National Center for Health Statistics, 2007) and alcohol provides approximately 6–10% of the total energy intake of adults in the U.S. (Block, Dresser, Hartman, & Carroll, 1985). Given alcohol's high energy content (7.1 g/kcal) and its prior association with greater daily energy intake (e.g., Colditz et al., 1990), it is surprising that alcohol consumption, like breakfast consumption, is often paradoxically associated with lower BMI (Gruchow, Sobocinski, Barboriak, & Scheller, 1985). However, once again, the relationship between alcohol consumption and energy expenditure has not been regularly examined.

This investigation examined the relationship between eating patterns (i.e., skipping meals; consuming alcohol) and weight loss treatment outcomes (weight loss, energy intake, energy expenditure, and duration of exercise) among overweight/obese dieters taking part in a multiphase behavioral weight loss program (BWLP). During the first phase of the program, individuals participated in a 14-week self-help (SH) or therapist-assisted self-help (TASH) BWLP. This investigation uses data from this phase. Participants were instructed to self-monitor and electronically record energy intake from meals and beverages (including total energy intake), physical activity (type and duration), and energy expenditure (assessed through accelerometry). Participants reported their weight at least once per week. While previous research has commonly relied on between-subject comparisons of eating patterns and weight status (Boutelle et al., 2002, Choo et al., 2003; Hill, Wyatt, Phelan, & Wing, 2005; Masheb & Grilo, 2006), daily records of eating patterns, energy intake and expenditure, and the weekly assessment of weight allow for a detailed examination of both within- and between-subject associations among these variables.