Monday, April 4, 2011

A Critique of the ISSN Position Stand on Meal Frequency

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When International Society of Sports Nutrition (ISSN) released their position stand on the topic of meal frequency, two things stood out to me.

First of all, a number of questionable conclusions are made in the abstract. With my last article in mind, the claim that "...increasing meal frequency during periods of hypoenergetic dieting may preserve lean body mass in athletic populations" seems a bit presumptuous, wouldn't you say? An inquiring mind would like to know what conclusive data these gentlemen are sitting on.

Furthermore, given yesteryear's study on meal frequency and appetite control, the claim that "Increasing meal frequency appears to help decrease hunger and improve appetite control" is also rather interesting.

I could go on and on and give you numerous examples to counter some of the statements made in the abstract. But that is not the role I'm going to play today.

What was the second thing that stood out to me? You may recognize some names amongst the authors; the more notable ones are John Berardi - author of several diet books and articles - and Jose Antonio, CEO and co-founder of ISSN.

Is John Berardi - who, aside from making numerous scientifically unsound claims, has been one of the strongest proponents of high-meal frequency eating - unbiased enough to be allowed to participate in this publication? Berardi considers HMB a worthwhile supplement for athletes and wholeheartedly recommends it on his site. For those of you who don't know, HMB is damn near worthless. Buying it is as close to throwing your money away as you can possibly get (just like Glutamine - which Berardi also recommends). What does this say about his credibility as a scientist?

Jose Antonio? He's been the nutritional consultant to several supplement companies, among them Met-Rx, the king of meal replacements. What position do you think is most beneficial to maintain in order to keep the supplement industry spinning - that high-frequency eating is superior or that there's no difference between 3 and 6 meals a day? When people feel that the need to eat every other hour or so, what is it that they add to their diet? Protein shakes, protein bars, recovery drinks and meal replacements.

There's more here if you do some digging. Suffice to say, I was not convinced that this was the best team for an unbiased "position stand" on meal frequency. And the greatest joke of all? At the end of the paper, you'll find this: "Competing interests: The authors declare that they have no competing interests." When pigs fly, perhaps.

But never mind that for now. Let's judge this paper on its own merits and forget everything else. But I've talked myself blue in the face about the topic of meal frequency and it would be refreshing to have someone else dissect this paper for us. For that purpose, there is no one more fitting than Alan Aragon.




I've been a subscriber to Alan Aragon's Research Review since the first issue. AARR provides unbiased and critical analyses of the latest research on nutrition, exercise and supplementation. Adding to that, it also contains commentaries and analyses on the latest "hot topics" in the fitness industry and blogosphere. I'm giving it two thumbs up and recommend anyone interested in nutrition and exercise science to check it out. Download a free issue here. 



A Critique of the ISSN Position Stand on Meal Frequency
By Alan Aragon 
Originally Presented at Leangains.com, April 4th, 2011


Introduction

The International Society of Sports Nutrition (ISSN) is a forerunner in the movement toward providing reliable nutrition information for sports and fitness professionals. By virtue of its academically decorated staff and peer-reviewed research journal (JISSN), the ISSN is in a justifiable position to consider itself one of the world’s top authorities on sports nutrition. Thus, when they issue a position statement on any given topic, it’s frequently cited as solid evidence, and not taken lightly. For example, along with other literature reviews, I regularly cite their position paper on protein requirements for athletes [1]. However, I typically follow that up with what I do in personal practice, which isn’t always research-backed. It’s important to keep an eye on both the research and the trenches, since field knowledge can take years and sometimes decades to make it into academic publication.

It’s clear that the focus of their latest position stand is meal frequency’s effect on body composition. Right from the start, the authors illustrate the importance of this topic by citing the obesity epidemic in the United States. Setting the tone as such implies that weight/fat loss is the most pressing concern of the position stand, more so than other aspects such as muscle gain and exercise performance. This focus is justified, given the prevalence of obesity in industrialized nations, not just the United States. This justification is bolstered by the myriad health complications that accompany a chronic state of excess body fat. The next question becomes, how well does the ISSN support their meal frequency assertions to this end? I encourage you to have the ISSN’s position stand open while you read through this critique of the evidence used to support their key claims. The full text of the paper is freely available, see the reference list [2].  


Body Weight & Body Composition

The authors begin the above-titled section by discussing uncontrolled/observational studies, including animal data. We can safely skip those, since the threats to their validity are numerous & obvious. They then move on to discuss experimental studies in humans. They correctly note that on the whole, the evidence in this area fails to indicate the superiority of increased meal frequency for improving weight loss. An interesting and important detail is the authors’ point that the minority of studies that did show improvements as a result of increased meal frequency happened to be in athletic subjects, whereas the ones that did not examined overweight/obese subjects. Three studies were provided to support this, which I’ll discuss next.

First up is Benardot et al, who compared the effects of three 250 kcal between-meal snacks with a noncaloric placebo [3]. A significant increase in anaerobic power and lean mass was seen in the snacking group, with no such improvements seen in the placebo group. Obviously, it’s impossible to credit the superior results to a higher meal frequency since this was also accompanied by a higher overall energy intake. The next study cited was by Deutz et al, which was not a controlled comparison of the isolated effects of different meal frequencies [4]. Instead, it merely drew correlations between body composition and the results of a 24-hour recall of diet and physical activity variables. The final study was by Iwao et al, who found that boxers consuming 6 meals a day lost less lean body mass (LBM) and showed lower molecular measures of muscle catabolism than the same diet consumed in 2 meals per day [5].

Of the three aforementioned studies, one was correlational. Of these two studies that demonstrated causation, only one of them (the boxer study) equally matched the intakes of each group. However, its design flaws compromise its relevance. Aside from flaws common to studies on both sides of the fence (short trial duration, subpar assessment methods, small sample size), the total energy intake at 1200 kcal was artificially low compared to what this population would typically carry out in the long-term. It’s also important to note that the protein intake, at 20% of total kcals, amounted to a paltry 60g/day. This translated to slightly under 1.0g/kg. To illustrate the inadequacy of this dose, recent research by Mettler et al showing that protein as high as 2.3g/kg and energy intake averaging 2022 kcal was still not enough to completely prevent LBM loss in athletes under hypocaloric conditions [6]. Therefore, the ISSN’s claim that increased meal frequency in athletic populations may improve body composition is based on a single study with questionable applicability.

Missing Research on Body Composition 

In addition to the aforementioned limitation, the authors failed to mention research that runs contrary to their assertion that, Interestingly, when improvements in body composition are reported as a result of increasing meal frequency, the population studied was an athletic cohort. Introducing the topic of comparative drops in LBM opens up a can of worms that does not support the ISSN’s claims. A recent review by Farady concluded that although daily caloric restriction (DCR) and intermittent calorie restriction (ICR) have similar effects on total bodyweight reduction, ICR has thus far been more effective for retaining lean mass [7]. The results of 11 DCR studies 7 ICR studies were clearly laid out. Here are a couple of key stats that contributed to Farady’s conclusion:

  • 3 of the ICR studies showed no significant decrease in LBM, while all of the DCR studies showed decreases in LBM.
  • In studies lasting 8-12 weeks, average LBM loss was 1.25% in ICR and 4% in DCR.

Adding to the body of contrary data to the ISSN’s position, there are two more studies showing the superior effects on LBM status via lower meal frequency. An 8-week trial by Stote et al found the group consuming one meal per day gained lean mass and lost body fat, while the group consuming 3 meals per day showed no improvements in body composition [8]. It should be noted that just like the study by Iwao et al, Stote et al’s results are limited by the use of BIA to assess body composition. Oyvind et al compared the 12-week effects of eating 3 versus 6 meals per day in subjects on a resistance training program, and the lower-frequency group gained significantly more LBM [9].

Collectively, this body of research refutes the ISSN’s claim that superior effects on body composition have only been seen in athletic subjects with higher meal frequencies.


Blood Markers of Health

As an obligatory introduction, the authors begin their above-titled section by discussing observational/uncontrolled studies. Again, there’s no need to wade through this, given the availability of controlled studies. The first controlled intervention discussed is by Stote et al, where blood pressure and total cholesterol (both HDL & LDL) were higher in the group consuming 1 meal per day compared to the 3-a-day group [8]. However, Stote et al noted that the difference in blood pressure may have been due to differences in circadian rhythm since it was measured in the late afternoon in the 1-meal group, and in the early morning in the 3-meal group. No speculations were made over what might have caused the cholesterol increase in the 1-meal group.

Another concern of the ISSN was the potentially adverse effect of lower meal frequency on glucose homeostasis. In support, they cited work published in the 1960’s. They also cited subsequent work done in the same proximity with contrary outcomes. Notably, they discussed a study by Jenkins et al, which compared 3 versus 17 feedings per day and found no difference in mean blood glucose levels [10]. Although the latter failed to show improvements in blood glucose levels, benefits from the (unrealistically) high meal frequency improved insulin levels and blood lipid profile. Although the data in this area is equivocal, the ISSN recommends increasing meal frequency for the purpose of improving health markers.

Missing Research on Glucose Control

An 8-week trial by Carlson et al found that subjects consuming 3 meals instead of 1 meal per day had more favorable results on an oral glucose tolerance test (OGTT) [11]. However, the authors of this study acknowledge that this may have been due to a much larger consumption of food in closer proximity to the OGTT in the single-meal group. Testing was first thing in the morning, and the single-meal group consumed their day’s intake in a 4-hour window before bed.

A very recent study adds to the evidence contrary to this idea, and was likely unavailable at the time of the ISSN position stand was written. Holmstrup et al found that glucose levels remained elevated throughout the day with frequent 6 meals compared to 3 meals, and no differences in insulin levels were seen [12]. The key design strengths this study has over predecessors were the frequent sampling used to track blood glucose and insulin levels, and the use of healthy non-obese subjects with normal glucose tolerance. These aspects make it more relevant to active & athletic populations, to whom the ISSN’s position stand is directed in the first place. Another trial too recently published to make it into the position stand was by Harvie et al, who found that intermittent energy restriction was as effective as continuous energy restriction for decreasing bodyweight and increasing insulin sensitivity [13].

In sum, due to the inconsistency of the data, it appears that increasing meal frequency for the purpose of improving health-related biomarkers is a premature recommendation.     


Metabolism

The aspects of metabolism discussed in this section are diet-induced thermogenesis (DIT – also called the thermic effect of food), resting metabolic rate, and protein metabolism. As for DIT, differences between varying meal distributions across several studies are negligible. The same lack of difference was also seen in several studies, including tightly controlled designs involving metabolic chambers to measure resting metabolic rate and total energy expenditure. These data further serve to invalidate the dying cliché of stoking the metabolic fire with frequent small feedings.

The discussion of protein metabolism mainly involved the effects of meal frequency on nitrogen retention. The ISSN duly notes that most studies discussed in this section used nitrogen status as a proxy for muscle protein status, which is not always reliable. The nitrogen balance technique measures whole-body (systemic) nitrogen flux, rather than directly measuring protein turnover within skeletal muscle. Although the nitrogen balance method has limited applicability, it provides clues & hypotheses to test through more rigorous & direct means. The literature on meal frequency and nitrogen retention is reviewed, and the bulk of the data shows no differences despite meal frequencies ranging from one to six meals per day.

The discussion of effects on protein metabolism begins by citing work by Garrow et al, who saw less nitrogen loss in obese subjects in hypocaloric conditions consuming 5 meals per day, compared to consuming 1 meal per day, and lean mass preservation was more pronounced in the higher protein treatments [14]. However, the extrapolability of this research to real-world scenarios in non-sedentary & athletic populations is highly questionable. Total energy of the diets was 800 kcal, and the protein levels tested ranged from 10-15% of total kcals, amounting to 20-30g of protein per day. This amount represents about a tenth of the protein typically consumed by adult male athletes. The limitations of this study’s design are obvious.

The authors then proceed down a slippery slope by discussing the potential benefit of maximizing muscle protein synthesis (MPS) on a per-meal basis. In acute (short-term or immediate-effect) studies on individuals of average body weight, the protein dose that tops out MPS is roughly 20-30g of high-quality protein, or about 10-15g of essential amino acids (EAA). Given this, the authors make a logical leap by presuming that more frequent occasions of maxing-out MPS would ultimately lead to faster rates of muscle gain. To support this idea, they cite rodent research by Wilson et al [15] and short-term human research by Paddon-Jones et al [16]. I’ll comment on the latter since rat data pales in relevance when there’s human data available to examine.  

Paddon Jones et al found that MPS was greater when an EAA + carbohydrate liquid supplement was consumed between the 3 regular-sized solid meals [16]. As a result, this study is often cited to support both the idea of increasing protein feedings as well as the benefits of dosing EAA between meals. The problem is, the group receiving the inter-meal supplementation ended up with 45g EAA + 90g carbs more than the control group by the end of the 16-hour test period. This treatment imbalance in both total calories and macronutrition is compounded by low protein intakes, averaging 23g per meal, totaling 64g per day. The experimental group’s supplemental intake boosted protein intake to 109g. So, not only was there the confounding element of unmatched macronutrition between groups, it essentially was a comparison of insufficient protein intake versus barely adequate intake.

After examining the literature on protein metabolism/nitrogen retention, the ISSN concluded that, “…it appears as if the protein content provided in each meal may be more important than the frequency of the meals ingested, particularly during hypoenergetic intakes.”  Still, this statement is collectively based on the Garrow study involving 20-30g protein per day, the Wilson rodent study, and the Paddon-Jones study, all of whose limitations are critical. Nevertheless, the ISSN made the redeeming point that increasing meal frequency isn’t likely to increase metabolic rate. To their credit, they repeatedly acknowledged that there’s a lack of research on the effect of meal frequency on various aspects of metabolism in athletic & physically active subjects.  

Missing Research on Markers of Protein Metabolism

Missing from this section of the paper was any mention of recent work by Soeters et al, who saw no difference in glucose, lipid, or protein metabolism between an intermittent fasting treatment (involving 20-hour fasting cycles) and a standard diet [17]. Similarly, Arnal et al saw no significant difference in body composition & nitrogen retention in subjects consuming most of their daily calories in 1 meal versus 4 evenly-spread meals throughout the day [18].  In older subjects, the same research team actually found better nitrogen retention with most of the day’s calories from 1 meal instead of 4 meals [19].

Although the ISSN isn’t firm with it, there’s an underlying implication that increasing the frequency of protein dosing at the threshold known to max-out MPS (20-30g protein or 10-15g EAA) would optimize the rate of net muscle protein gains. If this were true, then more muscle would be lost in lower-frequency treatments. Conversely, greater gains would be seen in higher-frequency treatments over time. The majority of the research thus far has simply not supported either one of these phenomena [7-9, 17-19, 21, 22].

   
Hunger and Satiety

This section begins by discussing short-term (within-day) effects of meal frequency on hunger and satiety. These designs involved the pre-loads of varying meal distributions, and measuring subsequent ad libitum food intake. Unanimously, the higher-frequency meal preloads resulted in better appetite control, evidenced by lesser subsequent intakes. Additionally, a study by Smeets et al found higher satiety ratings over a 24-hour period in subjects consuming 3 meals instead of 2 [20].

The important question is whether the hunger-controlling effects of higher meal frequency persist beyond a single day. The ISSN only mentions 2 such studies, and they happen to have conflicting outcomes. Stote et al’s 8-week trial reported greater hunger levels in subjects consuming 1 versus 3 meals per day [8]. A more recent trial by Cameron et al compared 6 meals per day (technically 3 meals + 3 snacks) with 3 meals per day, and found no significant differences in appetite ratings [21]. Additionally, there were no trends suggesting a significant effect of increased meal frequency on the levels of the appetite-regulating peptides ghrelin and peptide YY (PYY). As seen consistently in other research, there were no differences bodyweight decrease or body composition change. Curiously, despite the equivocal results of these two trials, the ISSN concluded that increasing meal frequency is likely to decrease hunger and control intake in subsequent meals. But as we’ll see, more recent data continues to challenge this idea.  

Missing Longer-Term Research on Hunger & Satiety

An important study is missing from the ISSN’s review. In fairness, it’s likely because it wasn’t yet available at the time it was written. Leidy et al compared varying protein levels consumed across either 3 or 6 meals per day [22]. Predictably, the higher-protein level (25% vs. 14%) promoted greater satiety. Interestingly, the higher meal frequency led to lower daily fullness ratings regardless of protein level. Meal frequency had no significant impact on ghrelin levels, regardless of protein intake. PYY, which is associated with satiety, was 9% lower in the higher meal frequency.

When focusing mainly on the short-term (within-day) studies, increasing meal frequency appears to have beneficial effects on appetite control. However, these results for the most part have not been supported by longer-term research. Thus, the blanket recommendation to increase meal frequency in order to decrease hunger is not based on the weight of the evidence.


Athletic Populations

This section of the position paper was basically a reiteration of the outcomes of 3 studies discussed earlier, in attempt to emphasize the point that more is potentially better when it comes to meal frequency. In response, I’ll briefly review my contentions with the applicability of this data. Deutz et al was a retrospective correlational study, not a controlled intervention capable of demonstrating causation [4]. Iwao et al’s study on boxers used a protocol that was artificially low in total kcals and unrealistically low in protein compared to what athletes typically consume [5]. Benardot et al’s design did not match total energy and macronutrition between groups, so it’s not surprising that the greater performance and lean mass gains occurred in the group with the higher fuel consumption [6]. In addition to the crucial limitations of these studies, research with contrary results (and equal or better design quality) is missing from this position stand [7-9].

The authors go on to assert that data on the eating habits of competitive athletes (in primarily endurance-based sports) shows a range of roughly 5-10 eating occasions per day. They suggest that this is optimal because it enables athletes to consume a culturally normal meal pattern in addition to meals proximal to the training bout. In response to this, I’d say that this range of frequencies is fine for this population. But, I’d also contend that the energy needs of competitive athletes in endurance-based sports can be 2-4 times greater than that of recreationally active individuals (who make up the bulk of the nonsedentary adult population). Therefore, applying the meal frequency of competitive athletes to less active populations is unnecessary & impractical, at best. In my private practice, I’ve seen recreational athletes succeed long-term with as little as 2 meals per day. The most common meal frequency range I’ve observed in physically active clients with long-term success is rather broad (3-6 meals per day). Whether individuals choose the higher or lower end of that range is based solely on personal preference and tolerance.   


Boiling Things Down: The Position Statements

Credit is due to the ISSN for preemptively stressing that the research on physiological & morphological effects of meal frequency in physically active and athletic populations is scarce. They responsibly state that this prevents definitive conclusions from being made. The following are the exact statements that comprise the ISSN position stand on meal frequency, which I’ll follow with my comments & conclusion.

  1. Increasing meal frequency does not appear to favorably change body composition in sedentary populations.
  2. If protein levels are adequate, increasing meal frequency during periods of hypoenergetic dieting may preserve lean body mass in athletic populations.
  3. Increased meal frequency appears to have a positive effect on various blood markers of health, particularly LDL cholesterol, total cholesterol, and insulin.
  4. Increased meal frequency does not appear to significantly enhance diet induced thermogenesis, total energy expenditure or resting metabolic rate.
  5. Increasing meal frequency appears to help decrease hunger and improve appetite control.

When examining the above points, 1 & 4 have a substantive, cohesive, and adequately-designed body of research backing them. Thus, they possess the strongest evidence basis of the bunch. Number 3 sits right on the fence, since it’s a particularly complex and delicate area with much conflicting data. It’s my hunch that the differential effects of varying meal frequencies on blood markers of health would greatly diminish in the presence of a formal exercise program. Again, the potentially profound impact of training that’s missing from the current meal frequency research leaves big questions unanswered. Points 2 & 5 have the least scientific support, and the largest leaps of faith and bias from the ISSN.

In Closing

I’d advise everyone with enough motivation to dig into the references and question the conclusions of all parties involved. It’s clear that position stands of authoritative organizations are far from being completely accurate, complete, and bias-free. With that said, the ISSN provides plenty of food for thought. Again, read the full text of their paper in order to get the most out of my critique of it [2]. Meal frequency research is becoming increasingly more active, so it’s safe to predict that in the coming years, more relevant designs will narrow the gap between the questions and answers. Something I can wholeheartedly agree with is the paper’s closing quote: Nonetheless, more well-designed research studies involving various meal frequencies, particularly in physically active/athletic populations are warranted.”


References

1.      Campbell B, et al. International Society of Sports Nutrition position stand: protein and exercise. J Int Soc Sports Nutr. 2007 Sep 26;4:8. [Medline]
2.      La Bounty PM, et al. International Society of Sports Nutrition position stand: meal frequency. J Int Soc Sports Nutr. 2011 Mar 16;8(1):4. [Epub ahead of print] [Medline] [JISSN]
3.      Benardot D, et al. Between-meal energy intake effects on body composition, performance, and total caloric consumption in athletes. Med Sci Sports Exerc. 2005;37(5):S339. [MSSE]
4.      Deutz RC. et al. Relationship between energy deficits and body composition in elite female gymnasts and runners. Med Sci Sports Exerc. 2000 Mar;32(3):659-68. [Medline]
5.      Iwao S, et al. Effects of meal frequency on body composition during weight control in boxers. Scand J Med Sci Sports. 1996 Oct;6(5):265-72. [Medline]
6.      Mettler S, et al. Increased protein intake reduces lean body mass loss during weight loss in athletes. Med Sci Sports Exerc. 2010 Feb;42(2):326-37. [Medline]
7.      Varady KA. Intermittent versus daily calorie restriction: which diet regimen is more effective for weight loss? Obes Rev. 2011 Mar 17. [Epub ahead of print] [Medline]
8.      Stote KS, et al. A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults. Am J Clin Nutr. 2007 Apr;85(4):981-8. [Medline]
9.      Oyvind H, et al. The effect of meal frequency on body composition during 12 weeks of strength training. 12th Annual congress of the European College of Sport Science, 2007. [ECSS]
10.  Jenkins DJ, et al. Nibbling versus gorging: metabolic advantages of increased meal frequency. N Engl J Med. 1989 Oct 5;321(14):929-34. [Medline]
11.  Carlson O, et al. Impact of reduced meal frequency without caloric restriction on glucose regulation in healthy, normal-weight middle-aged men and women. Metabolism. 2007 Dec;56(12):1729-34. [Medline]
12.  Holmstrup ME, et al. Effect of meal frequency on glucose and insulin excursions over the course of a day. Eur e-J Clin Nutr Metab. 2010 Dec;5(6):277-80. [e-SPEN]
13.  Harvie MN, et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women. Int J Obes (Lond). 2010 Oct 5. [Epub ahead of print] [Medline]
14.  Garrow JS, et al. The effect of meal frequency and protein concentration on the composition of the weight lost by obese subjects. Br J Nutr. 1981 Jan;45(1):5-15. [Medline]
15.  Wilson GJ, et al. Equal distributions of dietary protein throughout the day maximizes rat skeletal muscle mass. The FASEB Journal, 2010. 24(740.17). [FASEB J]
16.  Paddon-Jones D, et al. Exogenous amino acids stimulate human muscle anabolism without interfering with the response to mixed meal ingestion. Am J Physiol Endocrinol Metab. 2005 Apr;288(4):E761-7 [Medline]
17.  Soeters MR, et al. Intermittent fasting does not affect whole-body glucose, lipid, or protein metabolism. Am J Clin Nutr. 2009 Nov;90(5):1244-51. [Medline]
18.  Arnal MA, et al. Protein feeding pattern does not affect protein retention in young women. J Nutr. 2000 Jul;130(7):1700-4. [Medline]
19.  Arnal MA, et al. Protein pulse feeding improves protein retention in elderly women. Am J Clin Nutr. 1999 Jun;69(6):1202-8. [Medline]
20.  Smeets AJ,  Westerterp-Plantenga MS. Acute effects on metabolism and appetite profile of one meal difference in the lower range of meal frequency. Br J Nutr, 2008. 99(6): p. 1316-21. [Medline]
21.  Cameron JD, et al. 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. 2010 Apr;103(8):1098-101. [Medline]
22.  Leidy HJ, et al. The influence of higher protein intake and greater eating frequency on appetite control in overweight and obese men. Obesity (Silver Spring). 2010 Mar 25. [Epub ahead of print] [Medline]

50 comments:

Bojan said...

Brilliant.

Anonymous said...

Martin, Alan, & the Rebel Freedom Forces: 1

Berardi, the ISSN, & the Supplement Empire: 0

josh said...

I've been suspicious of Berardi for a while, now. His stuff, as he presents it, is a little too much of "the magic is in the dosage" and "pay no attention to the man behind the curtain".

Either way, I love IF and my life is profoundly different from what it was a year ago- it is profoundly mine. Thanks, Martin!

Nick Efthimiou said...

You can't argue that Berardi hasn't got the results on the board, but then again, so have many "brofessors".

This isn't a knock on Berardi, it is more a comment to say that sometimes you can get results in spite of what you do, not because of, and that looking objectively at the evidence can result in you getting the same results with less effort, or better results with the same effort.

Elfling said...

I love a well-cut jib in the morning. <3 Alan.

Mr X said...

excellent write up! On another note also teaches me how to reference like a god lol

Maod said...

Reps!

Anonymous said...

Kinda sad that they bring out such information to the masses. IF is the best thing that happend to me since i started training 15 years ago. Dieting is even fun and easy now.

/Patrick, Sweden/Halmstad

said...

Good review. Unfortunately pointing out the flaws in methodology in the experiments that showed a benefit to frequent meals doesn't mean IF is 'better', either.

Ahmed said...

Can't deny IFs success with the wide range of anecdotal evidence (although that doesn't seem to hold up). Great article with great references.

Jena said...

Hi Martin,

I would like to invite you to the ISSN conference in Las Vegas (complimentary)Please contact jenavieve.autumn.issn@gmail.com

Thx :)

Alan said...

Thanks for the feedback, everyone. And thanks to Martin for hosting the melee.

Anonymous said...

I sent you an email, would love to work with you.. can you email me back for a consultation.. thanks.

Low Class said...

glad to see Alan has changed his viewpoint on meal frequency. Seems as if DIF is really starting to change the whole bodybuilding game.

Anonymous said...

Oh so this proves IF is better right? Uhh..wait. Imagine if that was the claim, and the onslaught of dissection and criticism Alan could come up with as well. This basically only covers one single counter-argument of IF. I'd like to see some more POSITIVE support for IF discussed.

Kujo said...

Great work Alan. Top notch as usual. Very interesting stuff.

Thank you Martin for asking Alan to do this review for your site.

I like John Berardi, but I don't like how he continues to push the eating every 2-3 hours agenda. I use to swear by this, but as I've increased my knowledge about nutrition, and meal frequency, I came to release how unnecessary it is.

CosmicKeys said...

@the Anonymous above - "Oh so this proves IF is better right?"

Well no, clearly this article is as the title of the damn thing so clearly puts, "A Critique of the ISSN Position Stand on Meal Frequency".

You want more positive discussion of IF try, well I don't know, the whole rest of leangains.com?

muhammad akram said...

Great article!

I am an IF follower and this suits my lifestyle so much better.

Just one LunchBox. yeaaaaaaaah

Simon said...

Hi Martin. Discovering your blog at the beginning of last year has done more for my training results than any other factor. Your articles on training and diet have been exceedingly useful, and I was wondering if you intend to write more about sleep, since this is considered an integral part of both body recomposition and general health?

You mentioned in the interview with Leigh Peele that catecholamine levels rise during fasting - could this have detrimental effects on sleep? I have personally noticed that I tend to wake up more often during the night and find it harder to fall asleep again now than I did a year ago, before I started intermittent fasting. I do not know if this is related to IF, or if it is due to some other factor.

Regardless of whether you answer this or not - thanks for the great work you do.

Simon from Lund

Bill Pairaktaridis said...

What a brilliant break down for the layman! I love it! Are all the articles in the AARR like this? If so, I'm gonna have to subscribe...

Alan said...

Bill -- More or less, yes. The material fluctuates in its lay-friendliness, but I'd say this here is a fair representation of the majority of the opening articles of each issue.

Martin Bernardino said...

Enormous work you've put into this, Alan. Now, time to look at all the references before re-reading this. Keep up the great work!

Alan said...

Martin -- I appreciate it, bro.

Anonymous said...

I had the chance to talk to John Berardi at a conference last weekend about his opinion on IF. He fasts once a week for 24 hours. He definitely is not against IF. He also supports meal frequency. I don't see why the two can't compliment each other as part of a good diet.

Variety is the key.

Alan said...

Anonymous - Did JB have his peanutbutter and fish & rice cakes in separate tupperware containers? Just curious.

nondual said...

I was a follower of Berardi before I did IF. It's a 'go around your ass to get to your elbow' approach to fitness and diet. High volume routines, frequent meals, high carb only after lifting, ZERO emphasis on caloric intake, etc.

I lost some fat doing it, but it was a lot of work and hard to stick to. It really messes up your social life, and it has you obsessing over those 10% cheat meals - but considers even eating a meal sans complete protein as a cheat on par with an ACTUAL cheat meal. It's total up-your-ass focus on arcane rules.

I got the leanest of my life using IF - dropping 145lbs in 4.5 months. I later went on Berardi's inappropriately named 'Precision Nutrition' forums and pretty much blasted him.

nondual said...

45 lbs, NOT 145 lbs. iPhone keyboard...

Nils said...

Looks like your Feeds are broken, I always get the error "[..] is not a valid feed" in thunderbird and when opening the URL in the Browser I only get a redirect site from feedburner.

Anonymous said...

Alan -- Haha. I never noticed any containers or anything at the conference. He was a good speaker and very personable. His nutrition advice was hardly ground-breaking though, and almost identical to Dr. Sears' Zone Diet, but with less specificity. I think it's definitely worth questioning his studies, so I appreciate the article.

One thing that stands out though, is that during the conference he seemed to look at meal frequency/fasting as a non-factor. That neither approach was better than the other. It's surprising that he is attached to a study promoting meal frequency considering this.

Alan said...

Anonymous -- this is part of the challenge with putting yourself out there, but not necessarily staying in the game in which you sowed your wild oats. JB was once a posterboy fot T-Nation (a site with a lot of potential, but a lot of human error. During that time, he espoused stuff that was questionable. This has stuck with him, mainly because he has never formally updated or adequately renounced his former incorrect beliefs (ie - carbs + fats = bad). In contrast, Tom Venuto has directly faced the music & addressed the issue of meal frequency with full candor.

JB may no longer be connected with the 'internet cummunity' but it would be a pleasant surprise for him to show up & offer his nickel's worth. After all, if you do a google search on "issn position stand on meal frequency", this article here at leangains is the 2nd link behind the ISSN article itself.

Anonymous said...

Another study I found with preliminary results showing health benefits from monthly day-long fast. Google translate link from a Finnish newspaper:

http://translate.googleusercontent.com/translate_c?hl=en&ie=UTF-8&sl=auto&tl=en&u=http://www.hs.fi/tulosta/1135265363243&prev=_t&rurl=translate.google.com&twu=1&usg=ALkJrhgz3CB8ZxQoWHleFxUKC0rr76iSmQ

Daniel said...

i disagree somewhat...

Imo 4 meals a day spaced out is better than 3 crammed in small window in terms of stimulating MPS...I don't need an exact study to tell me this...

the studies on leucine combined with the studies on spread meal patterns suggest this to be true...

leangains may be great for a hypocaloric diet, but i think there are better options when it comes to acheiving maximal anabolism...

Jahed Momand said...

Just wanted to let you know that my RSS feed to your site did not update with this post for some reason.

Anonymous said...

Incredible post Alan, glad you made it very clear.
Imo, all along, most nutrition gurus have been pushing this nonsense of 6-meals a day just to get people to go for supplements.
It's what happened to me when I first started bodybuilding, I may have wasted over 1000$ in my 1st year (yes yes I was stupid) but I didn't even think I had a choice, almost all of the gurus I followed were saying "6 meals a day = faster metabolism, missing one meal = more fast less muscle".
These people are too far deep to now say openly that It was all a lie. (exception maybe Tom Venuto)
Been doing IF for 5 months now, never felt and looked better.
I'm also glad to read that the "deadly combo" of carbs + fat isn't bad at all (I didn't follow it since I started IF but it's good to know it was wrong all along).
Thanks a lot!

Alan said...

Daniel,

You said:

"Imo 4 meals a day spaced out is better than 3 crammed in small window in terms of stimulating MPS...I don't need an exact study to tell me this...

the studies on leucine combined with the studies on spread meal patterns suggest this to be true..."

First off, that's contradictory. But nevermind. Since you mentioned that leucine research & studies on spread meal patterns support your stance, I'd like to see what exactly you're talking about. By the way, take some time to actually read my article, I may have covered some of the research you're hanging your hopes on.

Dexter said...

Alan, thank you for sharing this. Very insightful. It always surprises me that blogs/websites like this one, yours and Lyle's seem to provide the best sources of information on nutrition and physical training out there. At least, information that is both scientifically sound and comprehending for those who are not academically schooled in this material.

Keep up the good work.

daniel said...

Alan,

I'm not paticuarlly intrested in debating you on this interface, but I will tell you why i believe 4 meals spread out is better than 2-3 meals. I'm fairly certain you eat at least 4 meals anyway, so it is a silly arguement....but i'll explain my thoughts regardless

The tipton studies showed that 4.4g of leucine resulted in the same mps response as 8g of leucine...the paddon jones study showed similar MPS with only 2.6g of leucine...

This suggest there is a limit to how much leucine can stimulate MPS, and extremely high protein servings will lead to diminishing returns...

This same research suggests there is a refractory response to elevated amino acid levels...which suggests that constant elevations are not optimal, but bouts of hyperaminoacidemia are ideal in terms of stimulating MPS response...

Now, if one is consuming 60-80g of protein in 3 meals(which would be what is required to hit 200g+ protein in 3 meals), they will be missing out on anabolism...as they could shift some of their protein grams for a 4th meal in which they could maxmimally stimulate protein synthesis again....

I will admit there is no exact studies showing this, but it is just a matter of time before one is done...

now as far as the spread meal pattern and nitrogen retention...I read the arnal study you posted on spread vs pulse meal patterns, and it's not comparable to a bodybuilder's diet...as they didn't eat a high enough protein intake in the pulse meal to show diminishing returns...i guarentee you if they bumped the overall protein intake up to 2g+/kg of bw, it would change the results...

again, i can't provide exact studies showing this...

Maybe all of this BS theorizing...However, I sleep better at night knowing I'm getting an extra bout of increased protein synthesis everyday...

Chad said...

Great post! Having spent years eating 6 small meals a day I can tell you that I rarely felt satiated. All I thought about was eating all day long - when was my next meal? Could I make it another half hour?

With IF - I eat large, satisfying meals and often remind myself it is time to eat again. Love it!

Anonymous said...

Offtopic: This entry don't show in the RSS feed...

Alan said...

Daniel - You're hope-pothesizing. And I'm admitting to making up a word in your honor.

All - Thank you for the comments.

Cole said...

Martin, I have a quick question, hopefully you can answer it for me...it'd help alot.
I've been using intermitten fasting, for about 8 weeks to diet, i've lost 13 pounds including the water i've lost, been staying at a weekly 20% calorie deficit, and have been carb/calorie cycling training days and off days. Even on the days where calories are below maitnence, I have never felt hunger once.
My question is,today for the 1st time in 8 weeks, My strength on one of my main lifts has gone down by 5lbs. What should I do here? Is this normal? I know it's not much, but I'm an athlete, therefore strength is pretty important for me.
Thanks so much

Cole said...

my question above goes to anyone else that can help as well. I'd appreciate any feedback from anyone

Bay said...

@ Nondual,

I don't know when you were a follower of Berardi, but I'm familiar with the Precision Nutrition system and there is definitely an emphasis on caloric intake. In fact, I come to the roughly the same caloric intake recommendations if I use the formulas in Alan's book and in the Precision Nutrition packet. (That's not to say the two manuals are equal. I thought Alan's book was the best I've ever read. I would rather buy his twice than the PN system.) Like most other reputable nutrition coaches, he recommends picking a sensible calorie level, sticking with it for 2-4 weeks, and making adjustments depending on your rate of weight gain or loss.

Further, I've seen numerous times on the PN boards where people say they just don't like eating 6 meals a day, or get better results with 3. The response from the PN team, as far as I've seen, has always been "If it works for you, then keep doing it."

With that said, he does still advocate a higher meal frequency and I'm glad Alan took him to task for it. I don't recommend his product to anyone unless they just really enjoy eating smaller meals throughout the day, but at the same time, I think it's unfair to say Berardi's current work is still largely very sensible and responsible. His Lean Eating coaching program is mainly focused on something I think a lot of others miss, and that's proper goal setting and then slowly modifying behavior to reach those goals. In the end, I'm sure Alan and John agree on more things than they disagree on.

Anonymous said...

Your RSS feed URL is borked

Fredrik Gyllensten said...

Great article, Alan! :)

Elizabeth Moore said...

Wow Martin, you've done it again.
You've been a fond inspiration to my new lifestyle, and I'm never going back.

Don't allow these primates to bother you, they're simply not worth it.

Thanks again, I'll throw support your way!

LoyalQ (http://loyalq.blogspot.com)
Elizabeth

Mutualist Punk said...

Martin, i have a question. There is some research which states that insulin stimulates muscle synthesis. So isnt it bad that we keep it most at low levels during the daytime?

http://jcem.endojournals.org/cgi/content/abstract/95/8/3848

http://www.ncbi.nlm.nih.gov/pubmed/16545079


How would you refer to this ? I have little knowledge in the subject, just someone posted me some statement and links.

Reka said...

I really don't get it why they waste so much money and preparation and work on studies with so unrealistic conditions (like the 20-30 g protein per day, yeah, that is really relevant to athletes, lol).
So many experts keep stating that the solution is frequent small meals, and I used to buy it completely, and it really worked for me, obviously because I controlled my calories anyway. I was convincing myself that this was the way to make the diet easy, by eating frequently and keeping my insulin and blood sugar in control, eating most of the carbs early and no carbs later, etcetera. I even figured there was something wrong with me, since I always felt hungrier on the frequent small meals diet, and felt much more comfortable and less hungry when I skipped breakfast.
After having great success with my diet, recently I found that my willpower has sort of gone, and, after having the appropriate amounts of small meals, in the evenings I often felt I could kill for a satisfying meal, just one per day. Your approach makes it possible to have that satisfying meal (right in the evening like I naturally prefer), and still have the calorie deficit, and this is really a genius work.
I'm very grateful that I found this site, just the right time. Started to follow your approach about a week ago, and it suits me perfectly, so if the results are as good as good I feel, I will definitely follow this lifestyle.

JP said...

Great article Martin! I've been slacking on my fishoil dosage and I recently did the math... I was only getting ~.800 mg EPA/DHA.
----
FYI, bb.com has NOW Super EPA on sale with a buy two get one free deal.

Martin recommended NOW ultra which is more concentrated, but is more costly than the NOW super EPA.

http://www.bodybuilding.com/store/now/epa.html

Anonymous said...

http://www.precisionnutrition.com/intermittent-fasting

Interesting read. Looks like some people are open to the "multiple paths" mentality.




My name is Martin Berkhan and I work as a nutritional consultant, magazine writer and personal trainer.

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