Meals and Grazing Study

Observational studies have demonstrated an inverse relationship between eating frequency
(EF), obesity, and other markers for disease risk. It has been suggested that consumption of
several small, frequent meals may influence physiological mechanisms, reducing the risk for
disease and lowering appetite. Participants in this randomized crossover study completed two
intervention phases lasting three weeks each: one of low eating frequency ("low-EF"; 3
eating occasions/day) and one of high eating frequency ("high-EF"; 8 eating occasions/day).
Fasting C-reactive protein, insulin-like growth factor, and leptin were measured at baseline
and endpoint of each phase and an optional subjective appetite testing session lasting four
hours was offered at the endpoint of each phase. During appetite testing sessions,
participants consumed an amount of food equal in total energy and macronutrient content at
either one occasion at 8:00 am ("low-EF" condition) or spread evenly over two smaller eating
occasions at 8:00 am and 10:30 am ("high-EF" condition). Ratings of hunger, desire to eat,
fullness, thirst, and nausea were made every 30 minutes using paper-and-pencil semi-anchored
100-mm Visual Analog Scales. A composite appetite score was calculated as the mean of
hunger, desire to eat, and 100-fullness. The generalized estimating equation modification of
linear regression was used to compare fasting plasma biomarkers and mean ratings of
subjective appetite.

Inclusion Criteria:

- Participants will be overweight and obese (BMI 25 and over) males and females ages
18-50 years.

- Participants must be willing to report to FHCRC on 5 occasions (initial screening
appointment + 4 testing sessions)

- Participants must be willing to provide a 7-day food record for analysis prior to
Phase 1 and Phase 2 of the study

- Participants must be willing to follow diet protocol during Phase 1 of the study

- Participants must be willing to undergo 4 blood draws

Exclusion Criteria:

- Non-diabetic (self-report)

- Non-smokers (self-report)

- Not following a diet to gain or lose weight (self-report)

- Normal cholesterol (self-report)

- Normal blood pressure (self-report)

- Not currently taking any medication (self-report)

- Not pregnant or nursing (self-report and verification by DEXA)

- Not athletes in training (self-report)