title: Should snacks be recommended in obesity treatment? A 1-year randomized clinical trial.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  In total 140 patients (36 men, 104 women), aged 18-60 years and body mass index>30 kg/m(2) 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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Recommending snacks or not between meals does not influence 1-year weight loss.
authors: Department of Metabolism and Cardiovascular Research, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden. helene.berteus.forslund@medfak.gu.se
authors: H
authors: H
authors: Bertéus Forslund
authors: S
authors: S
authors: Klingström
authors: H
authors: H
authors: Hagberg
authors: M
authors: M
authors: Löndahl
authors: J S
authors: JS
authors: Torgerson
authors: A K
authors: AK
authors: Lindroos
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D004038:Diet, Reducing; D004435:Eating / Q000502:physiology*; D002149:Energy Intake / Q000502:physiology*; D005247:Feeding Behavior / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D010349:Patient Compliance; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult