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Living Longer and Healthier
One of my favorite patients likes to say, "If I'd known I was going to live this long, I'd have taken better care of myself!" He has a few chronic health conditions, but in many ways he's pretty lucky: he's in his late 70's and still working part time at his family business, taking care of himself at home, and in general still living a very full life.
How to get your kids to eat more fruit
I've written before about how few children and adolescents are eating their recommended five servings of fruit and vegetables per day (Adolescents low in fruits and vegetables, 2/7/07). Researchers at Yale University recently discovered a simple way to get kids to eat more fruit (Int J Beh Nutr Phys Act 2007).
Myth: Eating late at night or just before you go to bed makes you gain weight.
Truth: Calories are calories. Period. If you eat too many and don't exercise enough, you will gain weight. Eating late and going to bed right afterwards simply doesn't matter.
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When I give a talk in my role as Dr. Gourmet, I can count on hearing a few specific questions just about every time:
My standard answer to that last question has been that that for most people, eating late at night is snacking - and it usually represents extra calories they just don't need. No matter what time you snack, if your caloric intake is greater than the calories you burn, you're going to gain weight.
Now I may have to change my answer. Researchers in Spain designed a study to compare the weight loss of those who ate their meals earlier with the weight loss of those who ate later (Int J Obesity 2013;37(4):604-611). They recruited over 400 healthy, adult men and women who were clinically overweight or obese and wanting to lose weight to participate in their study. The participants were enrolled in a weight-loss program based on the Mediterranean Diet and included group behavioral therapy, nutrition instruction, and moderate physical activity. For 20 weeks the participants kept daily food and exercise diaries and noted what time they ate as well. Weekly weigh-ins allowed the researchers to monitor their weight loss progress.
All of the participants lost weight, but after week 5 of the study, those who ate later saw their rate of weight loss slow down. After 20 weeks they had lost significantly less weight than those who ate earlier, even though both groups burned about the same number of calories, ate about the same number of calories, and the percentage of calories from the macronutrients (protein, fat, and carbohydrate) were about the same as well. Other variables that might affect weight loss were also able to be excluded, including appetite hormones, the amount of sleep an individual got, and obesity- and metabolic sydrome-related characteristics. In short, the only scientifically detectable difference between the two group was when they ate.
The problem with this study is that in Spain, the main meal of the day is lunch (the midday meal) - and lunch usually represents about 40% of a person's total caloric intake for the day. This would be like someone on a 1,500-calorie per day diet eating a 600 calorie lunch and only 300 calories each at breakfast and dinner. In the United States, people usually eat their largest meal in the evening. The people in this study were characterized as "early eaters" if they ate their lunch before 3pm. "Late eaters" ate lunch after 3pm. (The average time for dinner meals, however, was around 9:30pm.)
Those who ate later also were more likely to have smaller breakfasts or skip breakfast altogether and tended to eat less protein than early eaters.
This study certainly suggests that when you eat may have a bigger impact on weight loss than we thought, but I still would stop short of saying that you shouldn't eat after a specific time of day. If you are working on your weight, making lunch your big meal of the day might be one strategy for you to pursue. While one might argue that because our culture frowns on the long lunches enjoyed in parts of Europe, it would present a significant challenge here in the United States, you might take a look at what you're eating for lunch. Does your lunch contain more calories than it needs to be? Could you cut back at dinner, making lunch your main meal?
First posted: February 6, 2013