Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Regular Eating Patterns May Aid in CVD Prevention

Circulation; ePub 2017 Jan 30; St-Onge, et al

Regular eating patterns may help protect against cardiovascular disease, according to a new scientific statement from the American Heart Association (AHA). The statement reviews the cardiometabolic health effects of specific eating patterns such as skipping breakfast, intermittent fasting, meal frequency, and timing of eating occasions. Findings in the statement indicate:

  • Irregular eating patterns appear less favorable for achieving a healthy cardiometabolic profile.
  • Intentional eating with mindful attention to the timing and frequency of eating occasions could lead to healthier lifestyle and cardiometabolic risk factor management.
  • There is evidence that both alternate-day fasting and periodic fasting may be effective for weight loss, although there are no data that indicate whether the weight loss can be sustained long term.
  • Daily breakfast consumption may be helpful in promoting healthy dietary habits throughout the day.


St-Onge MP, Ard J, Baskin ML, et al. Meal timing and frequency: Implications for cardiovascular disease prevention. [Publishing online ahead of print January 30, 2017]. Circulation. doi:10.1161/CIR.0000000000000476.


We are familiar with the relationship between the amount of calories consumed and its effects on weight loss and health, and also familiar with the debate regarding the macronutrient composition of a diet (the amount of fat, carbohydrate, and protein) and whether it affects weight loss. This review looks at another aspect of diet that is of emerging importance in both health and weight loss strategies: nutrient timing and eating patterns. For instance, skipping breakfast has been associated with an increase in A1c as well as post-prandial hyperglycemia later in the day.1,2 Intermittent fasting appears to facilitate short- and medium-term weight loss. Our patients are certainly reading about the effect of eating patterns on weight loss, so it is important for us to recognize that nutrient timing is now part of the conversation and appears to have an effect on metabolic parameters and weight. —Neil Skolnik, MD

  1. Reutrakul S, Hood MM, Crowley SJ, Morgan MK, Teodori M, Knutson KL. The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes. Chronobiol Int. 2014;31:64–71. doi:10.3109/07420528.2013.821614.
  2. Bi H, Gan Y, Yang C, Chen Y, Tong X, Lu Z. Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies. Public Health Nutr. 2015;18:3013–3019. doi:10.1017/S1368980015000257.