To study the effect to recommend no snacks vs three snacks per day on 1-year weight loss. The hypothesis was that it is easier to control energy intake and lose weight if snacks in between meals are omitted.
In total 140 patients (36 men, 104 women), aged 18–60 years and body mass index>30 kg/m2 were randomized and 93 patients (27 men, 66 women) completed the study. A 1-year randomized intervention trial was conducted with two treatment arms with different eating frequencies; 3 meals/day (3M) or 3 meals and 3 snacks/day (3+3M). The patients received regular and individualized counseling by dieticians. Information on eating patterns, dietary intake, weight and metabolic variables was collected at baseline and after 1 year.
Over 1 year the 3M group reported a decrease in the number of snacks whereas the 3+3M group reported an increase (−1.1 vs +0.4 snacks/day, respectively, P<0.0001). Both groups decreased energy intake and E% (energy percent) fat and increased E% protein and fiber intake but there was no differences between the groups. Both groups lost weight, but there was no significant difference in weight loss after 1 year of treatment (3M vs 3+3M=−4.1±6.1 vs −5.9±9.4 kg; P=0.31). Changes in metabolic variables did not differ between the groups, except for high-density lipoprotein that increased in the 3M group but not in 3+3M group (P<0.033 for group difference).
Recommending snacks or not between meals does not influence 1-year weight loss.
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We thank Ted Lystig for statistical advice. This study was supported by a grant from Västra Götalandsregionen.
Contributors: HBF initiated, designed and conducted the study, collected the data, did the statistical analysis and wrote the paper. SK, HH and ML collected the data, participated in the discussion of results and reviewed the paper. JT and AKL participated in the study design, the discussion of the results and reviewed the paper.
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Bertéus Forslund, H., Klingström, S., Hagberg, H. et al. Should snacks be recommended in obesity treatment? a 1-year randomized clinical trial. Eur J Clin Nutr 62, 1308–1317 (2008). https://doi.org/10.1038/sj.ejcn.1602860
- eating patterns
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