Ep. 82 - Meal Frequency & Body Composition | Should we eat smaller meals to boost metabolism? | One Meal a Day (OMAD) vs. Six Meals a Day (6MAD) | Free Intermittent Fasting Plan

Uncategorized Jul 20, 2021

In this episode, Dr. Scott and Tommy discuss a recent literature review looking at the very popular idea that eating smaller, more frequent meals is the best way to raise your metabolic rate. They go over actionable takeaways from the data, as well as how fasting can play a powerful role in optimizing your results. 

Schwingshackl L, Nitschke K, Zähringer J, et al. Impact of Meal Frequency on Anthropometric Outcomes: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Adv Nutr. 2020;11(5):1108-1122. doi:10.1093/advances/nmaa056

Fasting For Life Ep. 82

Dr. Scott Watier: [00:00:01] Hello, I'm Dr. Scott Watier,

Tommy Welling: [00:00:03] And I'm Tommy Welling, and you're listening to the Fasting for Life podcast, and

Dr. Scott Watier: [00:00:08] This podcast is about using fasting as a tool to regain your health, achieve ultimate wellness and live the life you truly deserve. Each episode is a short conversation on a single

Tommy Welling: [00:00:18] Topic with immediate, actionable steps. We cover everything from fat loss on health and wellness to the science of lifestyle design.

Dr. Scott Watier: [00:00:25] We started fasting for life because of how fasting has transformed our lives, and we hope to share the tools that we have learned

[00:00:30] Along the way.

Dr. Scott Watier: [00:00:40] And Ron, welcome to the Fasting for Life podcast. My name is Dr. Scott Watier, and I'm here, as always, am a good friend and colleague, Tommy Welling. Good afternoon to you, sir. Hey, Scott. How are you doing? Awesome, man. Looking forward to today's conversation today. We are going to dive into a quite robust a little bit of a heavy lift in terms of a research article review and hopefully give you guys some nuanced kind of thoughts and outcomes, but more importantly, some action. So before I before we go into that article, if you're new to the podcast or if you're looking for some fasting help or how to put fasting into your day to day life, you can head over to our website de fasting for life. Dotcom, if you've been with us for a while, then today's conversation will probably be something you've become accustomed to, where we're going to take a research article and this is a, like I mentioned, a robust one. And it's on the impact of meal frequency on anthropos metrick outcomes, a systemic review and network meta analysis of randomized controlled trials. Sounds sounds like a like like a family game night. Right. Lots of fun. Here we go. So, yeah. Yeah, there's going to be there's going to be some good stuff today. So be sure. Before we dive into that, I want to mention that our next challenge registration link is live.

Dr. Scott Watier: [00:02:09] The challenge starts on July twenty fifth and runs through the thirty first. You can go to the show notes. Click the link for more information. That's going to be July twenty fifth through the thirty first. I am super excited about this new seven day format, Tommy. We have been able to get the same results that we were doing in our ten day challenges with our seven day. The delivery has been leveled up. The results have been maintained or even improved. We've got a new format, daily check ins, more accountability. We've got more time and availability to answer questions. We've streamlined the delivery. I mean, I could just keep going on and on and on. We've got a new couple new recipe packs that are dropping. OK, I'm going to stop. I don't want to give it all away, but have you guys been listening for a while? You know that we do these challenges every six to eight weeks and we're super excited about this one because of all the changes I just mentioned. So if you're looking for more information, go ahead and head over to the show notes. You can click the link or head over to the website. And before we jump into the impact of meal frequency on anthropos metric outcomes, Tommy, gun land the plane on the challenge coming up here for us.

Tommy Welling: [00:03:28] Yeah, we we see some absolutely incredible results during these challenges. So I'm super excited. I'm excited about this format. And like you mentioned, some of the ways that we've leveled it up from from all the great ones in the past. And we took several thousand people through these challenges last year with just some amazing, amazing results. And what I thought was cool about this article is I think it I think it's going to speak to a lot of people who are who are considering doing a challenge or who who may be ready for a challenge, even if they don't quite realize it just yet, because depending on where you are in your in your fasting journey, you may be stuck at a plateau or maybe you've never really, like, pushed the boundaries because you didn't know how to do it or didn't have the confidence to do it or didn't know how to quote unquote, safely do it or in a way that you could really feel good about and really hit the gas and and get some long term, some amazing transformational results. And that's what this process is about. And today's article really kind of speaks to that, because a lot of folks who may be listening have done a 12 hour fast or maybe stuck at a 14 or a 16 hour fast, but never really pushed the boundaries. Or maybe you've done a longer fast here or there, but you kind of gave it all back. You didn't know how to maintain those results or how to accelerate them and how to really get the ball rolling. And that's that's what we talk about. That's where we get to and how we develop the long term results within the challenge. We start within the challenge. And then we have a great continuity group that those those folks have been with us for a while after we get done with the challenge so we can continue the momentum. And so it's just it's really cool to see that structure in play. And I think that's why this article really kind of spoke to us here and felt timely to do.

Dr. Scott Watier: [00:05:19] Yeah, it's interesting, too, because you just mentioned something and I didn't know you were going to bring that up. So I love when there's alignment like that. But the article is kind of a dud, even though it's a it's a heavy lift. Yeah. In the fact that it's looked at. Forty two different entries ended up. Landing on twenty two different random controlled trials, a decent number of participants between six hundred and a thousand, there was some secondary analysis, there was some strengths and weaknesses of the studies. But it really looks at this, the comparison of the old, I should say, old, but the commonly accepted thought process that four to six small meals a day is going to be beneficial for long term weight loss or weight management, which then results in increased longevity, health outcomes, etc.. So if you've been in the weight loss journey, like much of us have, and if you haven't heard Tommy, nice story, you can go back to the first couple of episodes. Give us a little bit of grace, but go ahead and listen to episode one here, how we got started all the way back when we turned the microphones on in January of twenty twenty. And, you know, one of the things that both of our journeys included was this, OK, I'm going to track, I'm going to count, I'm going to make sure I have my stats with me. I'm going to have breakfast. I'm going to have my mid-morning snack, I'll have lunch, I'll have my mid-afternoon snack club dinner and then maybe I'll have a high protein dessert type protein packed snack before bed maybe. And then shake

Tommy Welling: [00:06:55] After after the gym, too, right? Yeah. Yeah.

Dr. Scott Watier: [00:06:58] So a lot of commonly accepted thought processes in the weight loss and dieting world. So I love the study because it's going to look at the difference in meal frequency and the relationship between meal frequency and measures of obesity. And right in the abstract, it says and we know up until this point it's pretty inconclusive. Right. So they were looking at the systemic review of the network meta analysis. And they were looking at situations where the calories were the same, there were also caloric and they wanted to look at the anthropos metric categories or outcomes of body weight, waist circumference, fat, mass and energy intake. And when they started breaking down the different studies and we're not going to go through all the nitty gritty details, one, because we probably couldn't land the plane on that and make it make sense in a 30 minute podcast. Or you might fall asleep if you're listening to this. So we don't we're not going to do that. We want to take the nuanced kind of action steps out of the conversation. But looking at those help, those those those enter parametric outcomes or those measurements of body weight, waist circumference, fat, mass and energy intake on the comparison between one meal all the way up to six to eight meals per day, all with the same caloric intake, meaning the situation was I'm going to eat the same amount of food regardless of how many meals I have eaten.

Tommy Welling: [00:08:39] Yeah, and with with no specific outcome, looking for looking for a calorie deficit, like just just looking to have a maintenance type of meal. Your normal calorie amounts just split up into different different segments through the day, whether that's one or that's six or eight.

Dr. Scott Watier: [00:09:01] Right, and it's interesting because when you start reading, I'm like, oh, man, this is a really cool article and that's why I love how you framed it in relationship to the fasting journey. Right. So it will well go into a couple of the big differences between why we think the results of this were so inconclusive. But it really goes through just in the introduction talking about, you know, the dietary habits of the consumption of foods or snacking and calorie containing beverages. You know, it's been hypothesized that eating small frequent meals instead of larger meals enhances fat loss and better weight maintenance. We mentioned a few of those things. Some studies they mentioned provide support for that hypothesis of the smaller meals and snacks throughout the day. But then there's other diets and cancer studies that lower frequencies so less than three meals a day were associated with higher risk of obesity, but lower waist circumference. And then controversially, there was another cohort study cohort study that indicated that increasing the number of eating occasions beyond three is associated with a higher risk for weight gain. And then a recent meta analysis of 13 random control trial suggests that lowering meal frequency through skipping breakfast and prolonging the fasting times may help to reduce weight in adults. So literally, they just came right out in the introduction said, given these contraindications, we really don't know whether or not increasing or decreasing the meal frequency has an overall benefit on weight and obesity. So that's the introduction. So there's a bunch of a bunch of meat in between.

Tommy Welling: [00:10:37] You're giving me PTSD from when I had these questions, I hadn't stumbled upon fasting. I hadn't done any fasting myself. And I'm looking for answers like in the metabolic journals in in in different research articles just like this. I actually read through some of the ones that they used and reach my own same inconclusive results based on what I was reading.

Dr. Scott Watier: [00:11:03] Yeah, it's it's quite daunting and the relational point here to me was that, like, there's so much information out there, it's like, what do I do with it? And that's why I love fasting, because fasting reggae allowed me to regain control through the simplicity of just simply changing and putting some more time, you know, in between when I ate. So I want to I want to give some of the low certainty outcomes of this study. And that's the terminology of like low certainty, moderate certainty, no effect, low certainty, moderate certainty or like, yeah, this is one hundred percent certain. These two things are related. Right. So when we're looking at these metrics, the body weight, waist circumference, fat, mass and energy intake. The two meals per day slightly reduced body weight compared to the three or six, and it was the best for decreasing waist circumference. So two meals a day, which is your standard, typical beginners, two to three meal beginners starting point for someone that is new to fasting, you skip breakfast, typically intermittent fasting windows or 16 eight. So you eat dinner and then you don't eat until lunch the following day. So 16 hours without food, eight hours with food.

Dr. Scott Watier: [00:12:23] Most people will start there with two to three meals in that eight hour window. It was interesting, though, this is with slightly right here, right. So slightly, two meals per day, reduced body weight compared to three meals. So if you're starting intermittent fasting, just doing the two meals compared to the three is actually going to give you a better reduction in body weight. And it's best for reducing the waist circumference, which is what we found. We did a podcast a few episodes ago about the new emerging field and definitions of metabolic health. And fasting is powerful. It's not all about the scale on the weight loss, but that's a side effect of of using fasting is losing the weight. And that's why most people come to fasting in first place. So the waist circumference, waist circumference ratio ratio in metric is really starting to emerge as a much more potent indicator of overall health and longevity and wellness than like the old BMI chart, for instance. Sure. So I love that right. From the you not low to moderate certainty, the two meals a day is better than three and that it's best for decreasing the waist circumference.

Tommy Welling: [00:13:32] Yeah. With without any. Right. Deliberate caloric deficit there. I'm going to I'm going to keep underlining that point because you know it it also matters too. But yeah, definitely some some promising data there for, for and these studies just to clarify, we're all at least two weeks long. I believe the average was somewhere in the in the four to six week range, but at all at least two weeks in duration.

Dr. Scott Watier: [00:14:02] Yeah, it was interesting. In the body weight Category two, no effects were observed when three, four, six meals per day were compared today per day. So that's a lot of kind of wishy washy. We think this might not really. So when it comes to waist circumference, one meal a day excuse me, when it comes to fat mass, which is another one of the categories, one meal per day, reduced fat mass, the greatest compared to three meals per day. And it was actually also the best for reduction in body weight. So two meals per day, slightly reduced body weight. Right, compared to three or six, one meal per day was actually the best for reduction in body weight. And also secondarily, it was the best for reducing fat mass when compared to the three meal per day. So I love your point that you're going to underline again, insert Tomi's comment here.

Tommy Welling: [00:14:58] Yeah. Without a deliberate effort to have a calorie deficit, but one meal a day is going to typically end up going in the calorie deficit direction much more easily than two or three meals a day. Yeah, and that's why we love the one meal a

Dr. Scott Watier: [00:15:17] Day or the homemade frequency. If you're looking for some some sustainable weight loss, some some some wins under your belt quickly. You've tried intermittent fasting. You've tried the 60 day window and it hasn't really done much. Or maybe you've plateaued. Well, yeah. Then pushing the window a little bit to that twenty, twenty two to twenty four hour mark or the one meal a day even without the restriction. Right. If you're trying to consume your body's complete caloric need in that, in that one meal, that's a really hard thing to do. Yeah. You know, unless of course you're eating the the really caloric dense, rich, processed fast food restaurant food type situations with drinks and desserts and all that kind of stuff you can get there or eating the whole, you know. The two four ten Domino's Pizza, yeah, you can probably get there, too, but you're not going to do that very often because you're going to feel great.

Tommy Welling: [00:16:09] Yeah, it's going to be self limiting or, you know, it probably will be over over time for sure. But I think that's a great point because there is a really big difference in doing one meal a day at home with intentional eating versus being in a restaurant or a fast food situation. It's very easy to consume a day's worth of calories if you if you have dinner at a restaurant with some appetizers, a couple fried things and maybe a drink or two, especially the the sugary stuff that they like to to serve. Right. Like there's a big difference there. And you're going to see big differences in long term outcomes going down those two different paths as well.

Dr. Scott Watier: [00:16:48] For sure. For sure. So as we transition out of the nerdy portion of this and the heavy lifting, don't go to sleep on us portion of today's episode, one meal a day was ranked the best treatment for body weight reduction, followed by two meals a day, whereas two meals a day was actually performed best for waist circumference. The rankings for fat, mass and energy intake were inconclusive, since none of the different meal frequencies investigated were superior when compared with the others. So one of the interesting things that came out of it from a secondary analysis or sensitivity standpoint when they looked at the sensitivity analysis is analysis after is only patients. When they looked at a population of only patients with obesity, both one and two meals per day were slightly more effective than the commonly accepted six meal per day kind of eating plan or or eating schedule. If you ever look at the diabetes, you know, American Diabetes Association recommended food schedule or food plans. Yeah, it's the breakfast snack, lunch, snack, dinner snack. Kind of try to keep those blood sugar levels. Yeah. Steady as possible, which just furthers the insulin resistance portion of it, which is where we're transitioning out of the don't go to sleep on us nerdy portion of where we've been moving into the more nuanced conversation where we're going here the in the population with obesity, which is the and I would surmise I would make an assumption here that those are the people that are less metabolically healthy, that have more insulin resistance, which is the underlying cause of the weight loss issues, or being able to keep the weight off or the the hunger and all the stuff that comes along with trying to lose weight on the diet rollercoaster, both one and two meals a day were more effective than the six meals a day, which goes against in reducing body weight, which goes against that standard operating procedure for people that are already in the category of being overweight or obese. So just simply starting there for you guys who are listening is a great place to be.

Tommy Welling: [00:18:49] Yeah, because there's a big difference in what's going to happen in meal frequency. Between being insulin resistant and not being insulin resistant, and that may be where some of the fuzziness or in conclusions kind of come from, from some of these these groups of the the analyses that they're doing in this study, because this was a bit of a mixed bag of subjects. Right. Some of them, like a minority, had some sort of insulin resistance. A lot of them did not. And we've we've gone through some of those studies in previous episodes where there's definitely a difference and meal frequency. If you're taking in the same number of calories, if you have no insulin resistance, it may not matter if I if I took in half now and half in three hours. But if I have a high level of insulin resistance, my my blood sugar and my insulin are still elevated. Three hours later, if I take in the other half of my day's worth of calories, I'm going to end up storing a lot more of those as long term fat stores versus being able to to burn through those.

Dr. Scott Watier: [00:19:56] Yeah, I really like that that point of of clarity there is that, you know, we looked at this article, we're like, oh, this is really cool. There's some good talking points here. But the main takeaway is going to be the additional benefit that you're going to be gaining from, never mind just the decreasing the frequency, but also decreasing the overall in excuse me, intake, which is going to be addressing the underlying issue of being able to get the weight off and keep it off, which is that resistance component that you were just kind of explaining there.

Tommy Welling: [00:20:31] Yeah, yeah. Great point, because if you if you're just, you know, if you're just eating regularly and again, not so much at a restaurant that can kind of give us false false signals and kind of bypass some of our our own our own body's mechanisms for how much should we be eating. But if we're just doing standard eating at home and we do one meal a day versus two meals a day versus three meals a day, if we're focused on one meal a day, for example, we are typically going to not consume a whole day's worth of calories. Like we're typically going to have a built in calorie deficit there, which which is a good portion of of the insulin control and of the ultimate weight loss that a lot of folks see with with one meal a day. And so that's that's very different from some of these experimental conditions here that we saw

Dr. Scott Watier: [00:21:26] In one of the cool things at the end of the article, they had a section on the relevance of our findings, and they mentioned that research shows that in adults with overweight and obesity, a reduction in body weight simply of five to 10 percent of initial body weight was associated with improvements in the majority of overall health risk factors. So they they even mentioned that in this analysis, the weight loss wasn't significant or so of sufficient magnitude to be associated with those. But some of the studies were as short as two weeks. And we know we've looked at some of those low carb studies with diabetics over the course of six months, 12 months, 18 months and twenty four months. And that a lot of the times the weight comes back following the standardized eating meal planning schedules. That is one of the things that we liked about this conversation, is that the commonly accepted thing is, you know, low, low caloric deficit, making sure you're getting like we mentioned and we opened the episode with, you know, the the meal snack protein shake meal snack kind of framework. Right. And I just like the the the kind of the takeaway. That there's so much information out there and you've most of us like you and I, Tommy, when we came to fasting, there was a lot of like, well, screw it, I've tried everything else. We're like, why not just do it right? So if you do the fasting, if you've been fasting, you've kind of hit a plateau. I really want to encourage you guys to head over to the show notes or the website and jump in. It's time, especially if you're on one episode, eighty eighty one eighty two somewhere in there, I'm not sure which one this is when it'll be released, full transparency.

Dr. Scott Watier: [00:23:14] We do a lot of recordings, but I know specifically for this one, the challenge is coming up next week. So it's like in in on July twenty fifth like we're here, we've got seven days. If you've been on the fence, if you've been like I, you know, I've been it's been working, but maybe you just need like that boost of energy and that little extra push, you know, to, to kind of get the momentum moving in the right direction. Again, we can kind of contrast the the inconclusively of this article and the wishy washy results and the low certainty comparing that with the old weight loss journey of suffering through low, low and slow light. Eat less, move more, take six weeks to lose four pounds and then one life event or celebration or weekend warrior, our birthday event or weekend away order. And one Friday night and the track done right. So it is time to really kick things into high gear. It is the middle of summer before we know what the holidays are going to be here. Yep, I just said it. Go to Hobby Lobby. There's a store here locally. You're going to see Christmas decorations being put up in the middle of summer because they know what they're doing. So I want to compare that old energy of the old journey with what we have coming up on June 20 excuse me, July twenty fifth. I'm super excited, Tommy. Let's land the plane here with a couple of final thoughts and takeaways are action steps just to make sure that we didn't lull people to sleep today?

Tommy Welling: [00:24:59] So I just kept I just kept looking through the article, like waiting for the evidence to hit me, waiting for the conclusion that more meals a day was going to be better, that it was somehow going to to show itself that it was it was revving up metabolism like I had always heard. Like it it was it was the magic behind, you know, dropping the fat and getting the results and losing the weight. Right. And but that's exactly how I felt years ago. I was so confused. I was scouring the research myself, looking for like what was what wasn't working, why wasn't it working? And like it was it was so frustrating and so confusing. And that's when I found fasting. It was like what you mentioned earlier, like that frustration, desperation point. So if you're if you're listening to this and you're you're thinking, why why isn't fasting working right now for me or why can't I lose the weight? Why isn't this working? I'm just going to encourage you. Go over, check out the the challenge page register for it. It's a it's there's no time like the present. We we took all of those confusing pieces, everything that that frustrated us and the questions that we had, we put those into the challenge so we could answer those and get the results that that we'd been looking for for so long.

Dr. Scott Watier: [00:26:14] And I will make one final promise here, Tommy, as we wrap up today's episode. And I love that perspective, I promise you that we will not have this conversation during those seven days, OK? Because the fact that, you know, the conclusion of the article is there's no significant findings on either side. But I'll tell you where we do have findings. That's in our community group. That's in our continuity group. And that is most definitely in our challenges. So I promise, here it is. I'm saying it to all of our hundreds of thousands of people that listen to this. We promise that this these this conversation will not come up. It'll be in those seven days. OK, so with that, I encourage you to head on over to Tommy. Thank you for your time, sir. Great conversation. And we'll talk soon.

Tommy Welling: [00:26:57] Thank you. Bye. So you've heard today's episode and you may be wondering where do I start? Head on over to the Fasting for Life Dotcom and sign up for our newsletter. Or you'll receive fasting tips and strategies to maximize results and fit fasting into your day to day life.

Dr. Scott Watier: [00:27:13] Why are you there? Download your free Fast Start guide to get started today. Don't forget to subscribe on iTunes, Spotify or wherever you get your podcasts. Make sure to leave us a five star review and we'll be back next week with another episode of Fasting for Life.

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