title: Relationship between frequency of eating and cardiovascular disease mortality in U.S. adults: the NHANES III follow-up study.
abstract: This study examined longitudinal relationship between baseline daily eating frequency and all-cause and cardiovascular disease (CVD) mortality among U.S. adults.
  
  
  
  The Third National Health and Nutrition Examination Survey (1988-1992) participants were followed through 2006. Nonpregnant adults >17 years old (n = 6884) whose dietary recall was of good quality and had fasted at least 8 hours before physical examinations were eligible for this analysis. Frequency of eating was derived from 24-hour dietary recalls. Main outcomes included all-cause and CVD mortality during follow-up, based on National Death Index data.
  
  
  
  During follow-up (median time: 176 months), 1280 subjects died, 503 of them from CVD. Adults reporting eating ≥6 times/day had a lower hazard ratio for CVD mortality than those reporting eating 4 times/day (hazard ratio = 0.68; 95% confidence interval, 0.43-1.08; test for trend, P = .011). The gradient of CVD mortality risk by eating frequency was significant for the groups with ≥2500 kcal of total energy intake (test for trend, P = .037).
  
  
  
  Eating frequency was inversely associated with CVD mortality, which was especially marked for people reporting high total energy intake. Nevertheless, public health recommendations should be cautious, as eating frequency was positively associated with total energy intake, which could promote weight gain.
authors.affiliation: Institute and Department of Public Health, National Yang-Ming University, Taipei, Taiwan; Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: hsinjenchen@ym.edu.tw.
authors.forename: Hsin-Jen
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Systems-Oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY.
authors.forename: Youfa
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Global Obesity Prevention Center at Johns Hopkins, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: cheskin@jhu.edu.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Cheskin
mesh_terms: D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality*; D002423:Cause of Death; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors; D014481:United States
keywords: Feeding behavior; Longitudinal studies; Mortality; Nutrition surveys