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The Impact of Late-Night Meals and Fast Eating on Your Health

April 11, 2024 From Medscape

Emerging research highlights that how fast and when we eat can significantly influence our health. This growing body of evidence points to the risk factors associated with rapid eating and late-night meals, particularly concerning gastrointestinal issues, obesity, and type 2 diabetes (T2D).

Speedy Eating: Risks and Consequences

Eating too quickly is known to cause immediate gastrointestinal discomfort, such as indigestion, gas, bloating, and nausea. However, the long-term effects can be more severe. Regularly eating too fast can lead to overeating, as it takes about 20 minutes for the stomach to signal fullness to the brain. This delay often results in consuming more calories than necessary, which is linked to weight gain and gastrointestinal diseases.

One study involving 10,893 adults in Korea found that those who ate their meals in less than 5 minutes were 1.7 times more likely to develop endoscopic erosive gastritis compared to those who took 15 minutes or longer. Similarly, a study of young female military cadets in Korea showed that faster eating increased the risk of functional dyspepsia.

In extreme cases, competitive speed eaters may experience severe conditions such as morbid obesity, gastroparesis, and intractable nausea due to the physiological demands of their eating habits. Researchers noted that the “observed physiological accommodation required for the role (expanding the stomach to form a large flaccid sac) makes speed eaters vulnerable to morbid obesity, gastroparesis, intractable nausea and vomiting, and the need for gastrectomy.”

Clinical studies in Japan and a case-control study in Lithuania have identified a strong association between faster eating and increased risk for T2D and insulin resistance. A cross-sectional study in China of 7,972 adults further supports this, showing that fast eating is linked to a higher risk of metabolic syndrome, elevated blood pressure, and central obesity.

Several hypotheses explain these associations, including delayed fullness leading to higher caloric intake, insufficient mastication resulting in higher glucose levels, and the triggering of specific cytokines that cause insulin resistance. These findings suggest that slowing down the pace of eating can be a preventive strategy for these health issues. According to Dr. Michael Camilleri from the Mayo Clinic, “About 20%-25% of people with obesity actually have rapid gastric emptying. As a result, they don’t feel full after they eat a meal and that might impact the total volume of food that they eat before they really feel full.”

The Timing of Meals: Aligning with Circadian Rhythms

The timing of meals is equally crucial. Research indicates that aligning meals with the body’s circadian rhythms can have substantial health benefits. Eating earlier in the day is more beneficial, as the body’s metabolism is more active during daylight hours.

A study involving 2,050 participants found that having the largest meal at lunch reduced the risk of obesity (odds ratio [OR], 0.71), while having it at dinner increased the risk (OR, 1.67). Furthermore, a 2015 randomized controlled trial showed that a high-energy breakfast and a low-energy dinner helped reduce hyperglycemia in adults with obesity and T2D.

Time-restricted eating (TRE), a form of intermittent fasting, has shown promise in improving metabolic health, particularly when practiced earlier in the day. A 2023 meta-analysis and a 2022 study confirmed that early TRE is more effective at improving insulin sensitivity and reducing body mass compared to mid-day TRE. Dr. Beverly Tchang, an endocrinologist at Weill Cornell Medicine, noted, “Better insulin resistance when the window of food consumption was earlier in the day.”

Behavioral Interventions for Patients

Patients who eat too quickly or late at night can benefit from behavioral interventions. Healthcare providers can start by discussing patients’ eating habits and recommending changes based on individual lifestyles and needs. Dr. Collin Popp from the NYU Grossman School of Medicine suggests, “When I first meet patients, I always ask them to describe to me a typical day for how they eat — when they’re eating, what they’re eating, the food quality, who are they with — to see if there’s social aspects to it. Then try and make the recommendations based on that.”

Encouraging mindfulness about hunger and fullness cues, as well as adjusting diet composition, can be beneficial. For instance, a high-fiber or high-fat diet can slow gastric emptying, providing a longer-lasting sensation of fullness. Dr. Camilleri adds, “We know that a high-fiber diet or a diet that has a large amount of fat in it tends to empty from the stomach slower. That might give a sensation of fullness that lasts longer and that might prevent, for instance, the ingestion of the next meal.”

For those struggling to slow down their eating pace, choosing hard, minimally processed foods and using technology-based self-monitoring devices can be effective strategies. Studies have shown that these methods can help reduce eating speed and lower energy intake.

While meal timing and speed are important, they should be considered alongside other factors like total caloric intake, food quality, sleep, alcohol use, smoking, and physical activity for a holistic approach to health. Dr. Popp emphasizes, “We also have to consider total caloric intake, food quality, sleep, alcohol use, smoking, and physical activity. Meal timing should be considered as under the umbrella of health that is important for a lot of folks.”

Modifying how fast and when we eat presents an opportunity to improve health outcomes and prevent chronic diseases. By incorporating these strategies, healthcare providers can offer practical advice to patients looking to enhance their overall well-being.


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