It’s commonly believed that consuming small, frequent meals optimizes fat loss. According to theory, go without eating for more than a few hours and your body shifts into “starvation mode.” Part of the starvation response is to slow down metabolism in an effort to conserve energy. Pretty hard to get lean when your metabolic rate isn’t cooperating. Conceivably, providing your body with a constant stream of nutrients prevents the starvation response by “stoking the metabolic furnace,” thereby enhancing the ability to burn stubborn body fat.
Or so the theory goes…
Despite a seemingly logical basis, however, the evidence generally doesn’t support metabolic benefits of increased meal frequency. A study in dogs did show that consuming four small meals doubled the thermogenic response compared to eating an energy-equated amount of food as a large single meal.9 A follow-up study by the same group of researchers found similarly beneficial thermogenic effects in humans from a greater feeding frequency.10 On the other hand, a number of other tightly controlled human and animal trials have failed to show increases in metabolism as a result of spreading nutrient intake over multiple meals.5,7,13,18,19
While acute studies on metabolism provide interesting mechanistic insight into the body’s immediate response to different feeding frequencies, the only thing that really counts is whether a strategy of eating more frequently enhances fat loss. And the only way to determine actual fat loss is through randomized controlled trials (RCTs) that study this outcome directly.
My lab carried out a meta-analysis to gain greater clarity on the topic. We searched back to the early 1960s to find any and all RCTs that compared feeding frequencies of less than or equal to three meals a day with greater than three meals a day. Studies had to last a minimum of two weeks, involve healthy adult men and/or women, and equate the number of calories consumed between conditions. A total of 15 studies were determined to meet inclusion criteria. The results of these studies were then pooled for analysis to determine what, if any, effects on body composition can be attributed to how often you eat.
Feeding frequency had no effect on overall bodyweight. This seems in line with the findings of the acute studies mentioned earlier. Interestingly, however, our initial analysis did reveal a positive correlation between fat loss and the number of daily meals consumed. Here’s the rub: A sensitivity analysis found that these results were almost exclusively attributed to a single study6— the effects all but disappeared when this study was selectively removed from analysis. A positive association also was initially found between meal frequency and reductions in body fat percentage, but again these results were unduly biased by one study1 whose deletion rendered the results inconsequential.
So what can we glean from our research? Contrary to popular belief, it doesn’t appear that eating small, frequent meals provides any meaningful benefits to fat loss. This was particularly apparent from the metabolic ward trials included in our analysis. As opposed to “free living” studies that allow subjects to self-report dietary habits (and thus have been shown to be quite unreliable), research carried out in a metabolic ward meticulously controls these variables; every morsel of food and every step of activity is carefully monitored by the investigators. Without exception, these studies showed no benefit to fat loss from higher meal frequencies.
Now a caveat to our meta-analysis is that we only included studies that matched caloric intake between feeding frequencies. This was necessary to rule out the potential for confounding from unequal energy consumption. However, some claim that the true benefit of an increased meal frequency is a better control over hunger, conceivably by regulating blood sugar and hormonal levels. If true, this in itself would promote a beneficial effect on fat loss given that weight management is basically a function of energy balance: take in more calories than you expend and you'll gain weight; create a caloric deficit and you'll lose weight.4 Thing is, research is conflicting on the topic. Although some studies have found that spacing out meals over the course of a day reduces hunger,14-17 others show no differences in satiety regardless of feeding frequency.3,12 Several studies have even found greater feelings of fullness from consuming three as opposed to six daily meals.11,13 Considering the body of literature as a whole, evidence remains weak that eating frequent meals helps to control hunger; any beneficial effects are likely specific to the individual.
The take-home message here is that eating small, frequent meals appears to have little if any effect on reducing body fat. From this standpoint, meal frequency should therefore come down to personal preference: choose whatever frequency fits your lifestyle. Focus on what’s important to achieving fat loss: creating a negative energy balance and consuming adequate dietary protein.
Aside from fat loss, there is a compelling reason why feeding frequency may have important implications on body composition. Namely, the anabolic effects of a meal have been estimated to last approximately five to six hours based on the rate of postprandial amino acid metabolism.8 Given that you’ll generally spend at least 16 hours of the day awake, you thus need at least three protein feedings to maximize anabolism. Indeed, recent research indicates that spreading protein intake out over four daily servings increases muscle protein synthesis to a greater extent than consuming the same amount of protein in two larger servings.2 So eating a minimum of three daily meals spaced out no more than every five to six hours is a prudent strategy to promote lean muscle.
1. Arciero, PJ, Ormsbee, MJ, Gentile, CL, Nindl, BC, Brestoff, JR, and Ruby, M. Increased protein intake and meal frequency reduces abdominal fat during energy balance and energy deficit. Obesity (Silver Spring) 21: 1357-1366, 2013.
2. Areta, JL, Burke, LM, Ross, ML, Camera, DM, West, DW, Broad, EM, Jeacocke, NA, Moore, DR, Stellingwerff, T, Phillips, SM, Hawley, JA, and Coffey, VG. Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis. J. Physiol. 591: 2319-2331, 2013.
3. Cameron, JD, Cyr, MJ, and Doucet, E. Increased meal frequency does not promote greater weight loss in subjects who were prescribed an 8-week equi-energetic energy-restricted diet. Br. J. Nutr. 103: 1098-1101, 2010.
4. Hall, KD, Heymsfield, SB, Kemnitz, JW, Klein, S, Schoeller, DA, and Speakman, JR. Energy balance and its components: implications for body weight regulation. Am. J. Clin. Nutr. 95: 989-994, 2012.
5. Hill, JO, Anderson, JC, Lin, D, and Yakubu, F. Effects of meal frequency on energy utilization in rats. Am. J. Physiol. 255: R616-21, 1988.
6. Iwao, S, Mori, K, and Sato, Y. Effects of meal frequency on body composition during weight control in boxers. Scand. J. Med. Sci. Sports 6: 265-272, 1996.
7. Kinabo, JL, and Durnin, JV. Effect of meal frequency on the thermic effect of food in women. Eur. J. Clin. Nutr. 44: 389-395, 1990.
8. Layman, DK. Protein quantity and quality at levels above the RDA improves adult weight loss. J. Am. Coll. Nutr. 23: 631S-636S, 2004.
9. LeBlanc, J, and Diamond, P. Effect of meal size and frequency on postprandial thermogenesis in dogs. Am. J. Physiol. 250: E144-7, 1986.
10. LeBlanc, J, Mercier, I, and Nadeau, A. Components of postprandial thermogenesis in relation to meal frequency in humans. Can. J. Physiol. Pharmacol. 71: 879-883, 1993.
11. Leidy, HJ, Armstrong, CL, Tang, M, Mattes, RD, and Campbell, WW. The influence of higher protein intake and greater eating frequency on appetite control in overweight and obese men. Obesity (Silver Spring) 18: 1725-1732, 2010.
12. Leidy, HJ, Tang, M, Armstrong, CL, Martin, CB, and Campbell, WW. The effects of consuming frequent, higher protein meals on appetite and satiety during weight loss in overweight/obese men. Obesity (Silver Spring) 19: 818-824, 2011.
13. Ohkawara, K, Cornier, MA, Kohrt, WM, and Melanson, EL. Effects of increased meal frequency on fat oxidation and perceived hunger. Obesity (Silver Spring) 21: 336-343, 2013.
14. Smeets, AJ, and Westerterp-Plantenga, MS. Acute effects on metabolism and appetite profile of one meal difference in the lower range of meal frequency. Br. J. Nutr. 99: 1316-1321, 2008.
15. Speechly, DP, and Buffenstein, R. Greater appetite control associated with an increased frequency of eating in lean males. Appetite 33: 285-297, 1999.
16. Speechly, DP, Rogers, GG, and Buffenstein, R. Acute appetite reduction associated with an increased frequency of eating in obese males. Int. J. Obes. Relat. Metab. Disord. 23: 1151-1159, 1999.
17. Stote, KS, Baer, DJ, Spears, K, Paul, DR, Harris, GK, Rumpler, WV, Strycula, P, Najjar, SS, Ferrucci, L, Ingram, DK, Longo, DL, and Mattson, MP. A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults. Am. J. Clin. Nutr. 85: 981-988, 2007.
18. Taylor, MA, and Garrow, JS. Compared with nibbling, neither gorging nor a morning fast affect short-term energy balance in obese patients in a chamber calorimeter. Int. J. Obes. Relat. Metab. Disord. 25: 519-528, 2001.
19. Verboeket-van de Venne, WP, and Westerterp, KR. Influence of the feeding frequency on nutrient utilization in man: consequences for energy metabolism. Eur. J. Clin. Nutr. 45: 161-169, 1991.
Have you tried this NEW workout plan that everyone is talking about?
Fitness Testing 2.0
When many of us think of fitness assessments, memories of school-day Presidential Fitness Tests come to mind. While these annual measurements didn’t offer much in the way of real insights, testing our fitness capacities as adults does have its place.
“Fitness testing allows someone to assess where they fall on the training continuum so they begin in a [training] phase that is challenging and safe but not physically or emotionally overwhelming,” says Life Time personal trainer Billy Anderson, NASM. “Assessments provide validation and feedback that the program is creating measurable, positive change.”
To really assess your strength, conditioning, power, and mobility, it’s important to shift the focus from performance on the test to analysis of the results. The goal of testing isn’t to make anyone feel inferior but to offer guidance on how to move the dial.
The payoff is a heightened awareness of how you move — and knowledge of the steps you can take to improve.
“Testing helps keep us motivated,” says physical therapist and trainer Erika Mundinger, DPT. “It helps keep us honest, and it helps us understand our benchmarks for what we need to achieve. It shows us the barriers that might be holding us back, or the progress we’re making toward those goals.”
Mundinger offers three tests — one each for muscular endurance, power, and mobility — that you can use to assess without judgment, repeat as part of your training, and progress over time.
Perform one or more of the tests (depending on your goals) once a month. Record the results and spend the time in between tests working toward improving.
Muscular Endurance Test
This fundamental move calls for more than just arm strength; it requires strength in the chest, back, core, glutes, and quads, as well as stability in the wrists and shoulders. All of these parts must work together to maintain what is recognized as ideal pushup form — a straight line from head to heels — throughout the exercise.
How to Test: Assume a plank position. Bend your elbows to lower yourself with control until your arms bend to 90 degrees or deeper. Press through your hands to rise back up.
Perform as many pushups as you can without sacrificing form. If you can’t do one great-form pushup with your hands on the floor, elevate your hands on a bench, table, countertop, or wall. Avoid berating yourself for elevating your hands and focus instead on the task at hand: getting stronger.
How to Assess: Record the number of reps and the pushup variation you performed. Over time, you will see improvements in both of these. Let’s say the first time you test you are able to do 10 great-form pushups with your hands elevated on a weight bench. Eventually, you might be able to perform more reps with your hands elevated, or you might find that you can maintain the same great form and rep count with your hands on a lower box or on the floor. These are both signs of improved strength.
How to Improve: Perform three sets of a challenging 10 repetitions, three times each week. On nonpushup days, hold a plank position for 30 seconds.
For more pushup tips, variations, and progressions, visit “BREAK IT DOWN: The Pushup“.
In fitness, “power” refers to explosiveness — the ability to move weight with speed. The box jump is a great way to test and train lower-body power. It requires the ability to use power from your legs to jump up; to achieve triple-extension of your hips, knees, and ankles; and to land softly and with control.
How to Test: Stand with your feet at hip width about a foot behind a sturdy elevated surface, such as a weight plate or plyo box. Hinge your hips and lower into a mini squat.
Explosively reverse the motion — swing your arms forward for added momentum to jump up and forward with a powerful hip drive. Land gently with knees soft, then straighten your legs and drive through your hips to stand tall.
Step down and repeat for as many controlled, great-form reps as possible in one minute. If you feel your form eroding — or miss a rep — before the minute is complete, stop there.
How to Assess: Record the height of the platform — whether it’s 4 inches, 12 inches, or 36 inches. As with elevating your hands in a pushup, selecting an appropriate height ensures safety and the opportunity to measure progress.
Additionally, record how many reps you completed. Over time, you likely will be able to complete more repetitions, jump to a higher platform, or both.
How to Improve: Practice box jumps a couple of times a week, performing two or three sets of eight reps. Pay particular attention to fully extending the hips as you jump and to landing with control on each repetition.
For more tips on improving box-jump prowess, including alternatives to the move, visit “BREAK IT DOWN: The Box Jump“.
This full-body move requires mobility in your shoulders, hips, and ankles, and stability through your upper back, core, glutes, and adductors. It is useful for assessing weakness, immobility, and muscular imbalance — and for improving overall mobility.
Strive to avoid leaning too far forward or letting your knees move inward or heels rise from the floor. Don’t let the weight track behind your body as a counterbalance. For the purpose of testing mobility, use a light implement (a dowel rod, PVC pipe, or empty barbell) and focus on form, not how much weight you can lift.
How to Test: Stand with feet at shoulder width, toes pointed slightly out, and take a wide, shoulder-width-and-a-half grip on the rod, pipe, or barbell. Press or snatch the weight overhead with chest proud, arms locked out, and shoulders engaged.
Brace your core and squat down as far as you can with control. Continue to engage your core, glutes, and shoulders as you return to standing.
How to Assess: The number of reps you can perform and the weight you carry isn’t as important as improving your form. Consider recording a video of yourself and look for the following: If your chest drops, it may signal a weak core. If you can’t keep your arms overhead and in line with your torso, it could mean limited shoulder mobility. If your heels lift, ankle immobility may be the culprit. If your knees collapse inward, hip strength is a likely issue.
How to Improve: Depending on the results of the test, you may want to incorporate shoulder- or ankle-mobility work, core- or hip-strengtheners, or some combination of these efforts. You can also add variations of the overhead squat into your warm-up or workout.
Trainers often recommend ditching tools that hold the hands in a fixed relative position in favor of dumbbells or kettlebells that unlink the hands — or simply perform the move with just body weight, one arm extended overhead at a time.
For more tips on improving your overhead squat, see “BREAK IT DOWN: The Overhead Squat“.
Have you tried this NEW workout plan that everyone is talking about?
In Training, Consistency Is the Key to Your Fitness Goals
Consistency is arguably the most important component when working to accomplish goals, in or out of the gym. Without consistency, programs are unorganized, the body has a harder time adapting, and forming habits may be more challenging.
Build and Follow Workout Programming
Whatever your goals may be, they require a consistent level of training for you to reach them. One way to ensure consistency within the scope of your goals is to build a program. Programs make it much easier to stay on track because you won’t have to think about what you’re going to do at the gym today—it’s already written out. Most programs are designed to be followed for a set amount of time, typically about 4 weeks. Depending on the desired goal, the program will have a different focus—hypertrophy, endurance, strength, and so on. Each day is designed with the goal in mind, while ensuring that you are training in a way that minimizes imbalances within the body. If you aren’t following the program consistently, the chance of it working is reduced.
Theoretically, if you have a program and you don’t follow it, the body is not going to be able to adapt to the program because there isn’t an opportunity for progressive overload, which is when the amount of stress on the body is gradually increased over time, leading to increased strength and performance.
Work Toward Adaptations
Biologically, a lot of things happen in the body during exercise. Over time these reactions change the body to become stronger, grow, or run more efficiently. Different factors affect adaptations in everyone, so it’s impossible to predict when these changes will occur. But being consistent with training will increase the likelihood of seeing adaptations sooner.
Different modes of exercise elicit different adaptations. Endurance training will produce different changes than resistance training. While there are far too many adaptations to discuss in this blog, a few examples reported by the CDC include the following:
Improved ability of muscles to use fat as energy Stronger ligaments and tendons Increased VO2 max and lactate threshold Increased number of capillaries in muscles Cardiac muscle hypertrophy Increased force production
Each of these changes is beneficial for different scenarios. The body is either becoming more efficient or stronger, or performance is enhanced. However, these long-term benefits are seen only after consistent training over a period of time.
We are creatures of habit. The more we practice something, the more natural it becomes. We experience this when we learn to walk as babies, when we learn to drive, and when we exercise. It’s normal to feel out of your element when you try something new, but the more you do it, the more comfortable you feel.
Current research suggests that to make a habit stick it must be performed for 68 consecutive days. The idea of sticking with something brand new for 68 days may feel overwhelming for some people. When taking on a new challenge, focusing on taking it day by day might be a helpful mindset. Yes, we might be aiming to create a lifelong habit; however, thinking about just starting a habit to last for years could seem daunting. Start by doing it for one day, and then two, and then three, and so on.
Once you feel comfortable with one small change, add another small change, and so on. Small changes are more sustainable over the long term and add up to form new habits. There will likely be days that your plan doesn’t work out how it was supposed to, but that doesn’t mean all progress is lost.
Our bodies adapt gradually to exercise. In the end, consistency will help you reach your goals. Without it, you might not have enough structure to allow for growth. Work first on figuring out your goals, determine the best route to achieve them, and get started with one step. If you’re not sure how to get started, the trainers at NIFS can help you set goals and develop programs tailored to those goals.
This blog was written by Hannah Peters, BS, CPT, Health Fitness Instructor. To learn more about the NIFS bloggers, click here.
Personal Trainers for Diabetics
Get the Basics…
As a diabetic, controlling your blood sugar can prevent diabetic retinopathy and neuropathy. Regular exercise can lower blood glucose levels. A personal trainer can help you find the right balance between aerobic exercise and strength training workouts.
According to the Center for Disease Control, one in three American adults could have diabetes by 2050. Exercise, whether cardiovascular or strength training, is considered one of the most effective lifestyle changes someone can make to ward off diabetes.
If you’re diagnosed with diabetes, it’s important that you remain physically active. If you stay active and maintain a healthy weight, you’ll have better control over your blood sugar.
Having adequate control over your glucose levels can prevent long-term complications, such as kidney failure, diabetic neuropathy, and heart disease. People with diabetes are also more likely to develop blocked arteries, which can lead to a heart attack. Exercise keeps your heart healthy and strong. Regular exercise also helps you maintain good cholesterol.
Furthermore, there are other traditional benefits of exercise:
Lower blood pressure Better weight control Increased good cholesterol Strong bones Better sleep habits Improved mood Lower stress levels Before You Begin Exercising
Unfortunately, many people diagnosed with diabetes are overweight, so the idea of starting an exercise program can be daunting. Before starting any type of exercise program, you must have clearance from your family physician.
Your physician will examine your cardiovascular function, which is especially important if you already have high blood pressure or signs of heart disease. You also need to take into consideration any other diabetes-related complications, such as diabetic retinopathy or neuropathy.
When you begin a fitness program, your doctor can refer you to a dietician and personal trainer to help create an exercise program that is best for you. In addition to obtaining medical clearance, you also need to set realistic goals.
Benefits of a Personal Trainer
If you’re new to exercise or haven’t exercised for a long time, you need to start slowly and gradually increase the frequency and intensity. If unsure of how to proceed, meeting with a personal trainer may be beneficial.
A personal trainer can pave the way to fitness success. Choose one that has experience working with diabetic clients. You can find certified personal trainers through the American College of Sports Medicine or the American Council on Exercise.
You should think of your personal trainer as an educator and a friend. Not only will he or she walk you through different exercise sequences, but they will also show you how to lift weights safely and effectively. Depending on your fitness goals, you’ll probably meet with your trainer two to three times a week. Based on your fitness capacity, your trainer will create a workout plan that’s specifically for you.
Making the Most of Your Training Sessions
Set up a plan – Before you start, have an action plan in place in case your blood sugar drops. If you find that your blood sugar is too low when working out, let your doctor know. Be present – Give your training sessions 100 percent of your attention. Leave your phone in the locker room and focus on your workout. Be consistent – A training session here and there won’t deliver the results you want. Consistency is key. Create a training schedule that fits into your weekly routine. Be open – If something doesn’t feel right or is too difficult, tell your trainer immediately. Never push yourself to the point of exhaustion. Be aware of your physical limits – Always keep an eye on your blood sugar while working out. You may have to avoid intense workouts or even stop and eat a snack to keep your glucose levels in check. Exercising with Diabetes
Going to the gym is only part of the equation. Even under the supervision of a personal trainer, you need to make sure you are prepared in case your blood sugar drops.
It’s important to check your blood sugar before, during, and after you finish your training session. You may see a drop in your blood sugar while working out or immediately after a workout. Your glucose levels may also spike during an intense workout session.
Make a point of testing your blood sugar to learn how your body reacts to different types of exercise. Know where to draw the line. Even if you’re intent on finishing your workout, pushing yourself too hard can have serious repercussions. If your blood sugar is high before you start exercising, stop halfway through and check for ketones. If still present, it’s a good idea to stick to lower-intensity activities.
Types of Exercises
Whether you’re working out with your trainer or on your own, there are three specific types of exercises you need to do, which includes cardiovascular exercise, flexibility exercises, and strength training. Your goal should be to have an equal balance of all three.
– Aerobic Exercise
There are many different exercises you can choose from. Shoot for at least 30 minutes of cardiovascular exercise to boost your metabolism.
Find an activity that you enjoy, such as:
Brisk walking Jogging Spinning classes Zumba Using the elliptical Swimming Biking
Don’t be discouraged if you can’t go for the entire 30 minutes at first. Your personal trainer can help you build your endurance gradually over time. And remember, exercise is cumulative, so making small changes in your daily routine will carry over even when you’re not working out. For instance, you can park your car farther away when you go to the market, or take the stairs instead of the elevator.
Make sure you enjoy the exercise you’re doing. If it’s not fun, you probably won’t stick with it.
In between sessions with your personal trainer, why not take a group class with friends? Exercising with friends is a great source of motivation!
– Strength Training
Once you’ve built up your endurance, your trainer will probably get you started with strength training. You’ll develop lean muscles and also maintain strong, healthy bones. If you’ve been diagnosed with diabetes, strength training is a must. Since muscles need glucose to function properly, strengthen training will give you control of your blood sugar.
Make a commitment to get in shape. Your future health depends on it, so as difficult as it may seem, motivate yourself to go to the gym. It will help you lose excess weight and help your body use its insulin and glucose more efficiently.
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