• A new study finds that meeting our daily energy needs through three relatively similar meals may be the best way to avoid cognitive decline.
• Skipping breakfast, according to the study, is associated with a decline in cognitive health.
• The study also finds that tilting your energy intake toward one meal or another is not associated with a rapid cognitive decline, but it does not benefit your cognition as well as a balanced three meals.

Food is fuel. It provides us the energy our bodies need to function and also to remain healthy.

Previous research has focused on how the quality of the energy — the food — we consume can affect our health, and experts have investigated cardiovascular and metabolic health outcomes associated with when we eat.

However, there has been little research exploring the ways in which the distribution of our daily energy intake may influence long-term cognitive health, and whether it has any impact on the risk of developing dementia.

According to the World Health Organization (WHO), around 55 million people worldwide have dementia, with 10 million new cases being diagnosed each year. As the world’s population is aging — the proportion of older people is rising steadily — the WHO estimates 78 million people will have dementia by 2030, and 139 million by 2050.

To better understand the effects that energy intake and meal timing have on cognition, a new study takes a look at the potential effect on cognitive decline of different meal schedules, or temporal patterns of energy intake (TPEI).

The results show that consuming three balanced meals each is associated with better cognitive function, compared to other, less evenly distributed ways of consuming one’s total energy intake, or TEI.

“To our knowledge, this study is one of the few population-based studies that explore the association of TPEI and cognitive decline, although accumulating studies have linked TPEI to health outcomes, including obesity, hypertension, and cardiovascular health,” the authors wrote.

The study also demonstrates that skipping breakfast is associated with worse cognitive function and faster cognitive decline.

The study was recently published in Life Metabolism.

Studying nearly a decade of meal habits

The researchers drew their conclusions from an analysis of data from the 1997–2006 China Health and Nutrition Survey.

Included in that data were the meal habits of 3,342 people in China for whom the survey had collected up to four repeat entries over 10 years. Individuals were at least 55 years of age, with the average age being 62.2.

The authors note that 61.2% lived in rural areas, and 13.6% had high school or higher degrees.

People with severe cognitive decline were excluded from the study.

At the start of the study period, each participant received both a dietary assessment and a phone-based cognitive test in which they were rated for their immediate and delayed word recall, backward counting, and their agility at subtracting 7 from supplied figures.

Cognitive scores ran from 0 points to 27 points, with 27 points representing the highest level of cognitive health.

Effects of different energy intakes on meal schedules

The researchers categorized individuals’ meal timing into six eating patterns:

• Evenly distributed: People balanced their energy intake across three roughly equivalent meals per day. They consumed 28.5% of their daily energy at breakfast, 36.3% at lunch, and 33.8% at dinner.
• Breakfast-dominant: People ate three meals, but consumed the greatest share of energy, 49.5% at breakfast.
• Lunch-dominant: People ate three meals, but consumed the greatest share of energy, 64.3% at lunch.
• Dinner-dominant: People ate three meals, but consumed the greatest share of energy, 64.5% at dinner.
• Snack-rich: People consumed 36.8% of their TEI from snacks.
• Breakfast-skipping: People ate little or no breakfast, consuming just 5.9% of their TEI.

The breakfast-skipping pattern was linked to a cognitive decline of 0.14 cognitive-test points a year, compared to the evenly distributed pattern.

No other similar declines were seen for other patterns.

Dr. Clifford Segil, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA, not involved in the study, described this finding to Medical News Today as “fascinating.”

“I think the take-home would be that skipping a meal is worse if you choose to skip the meal at breakfast,” he said.

However, when the researchers modified the possible TPEIs into just four patterns — evenly distributed, breakfast-dominant, lunch-dominant, and dinner-dominant — all of them except for the first were linked to lower cognitive function.

None of them were associated, however, with an accelerated loss of function.

Possible underlying mechanisms

According to Dr. Segil, the study might “unintentionally support that we have excess calories, and assuming we have excess calories, we have obesity. And I think that’s where most of this kind of research has been done, on excess calories in general health.”

Still, he noted, the study generally aligns with other research indicating that “dividing your energy and taking it in even meals improves short-term cognitive function.”

“That’s supportive of what we’ve heard for other medical conditions.”

Previous research has indicated that meal timing affects the body’s circadian clock. In mammals, the circadian clock resides in two clusters of nerve cells called the suprachiasmatic nuclei (SCN), which are located in a region at the base of the brain called the anterior hypothalamus.

Dr. Hoon-Ki Sung, Ph.D., associate professor in the Department of Laboratory Medicine & Pathobiology at the University of Toronto, explained to MNT:

“We have two different kinds of internal clock (circadian rhythm). One is located in the brain (central clock or central circadian clock), and the other clock in some peripheral tissues, including fat, liver, intestine, and retina (peripheral circadian clock). While the central clock is mainly regulated by light, the peripheral clock can be regulated by multiple factors, including central clock and feeding.”

Dr. Sung suggests circadian nutrition may refer “to a circadian rhythm diet or circadian diet.”

He said this means “you are keeping the feeding rhythms synchronized with your internal clock.” He noted that eating this way can include three meals, “as well as meal [or] energy intake between meal times.”

Other studies have linked meal timing to short-term cognitive function improvement.

The Western three-meals-a-day schedule grew out of the needs of employers and workers during the Industrial Revolution. Before that, two large meals a day, based on household and farming tasks, were more common.

“I think common sense says you should eat a meal before the time of the day that you’re going to be the busiest,” added Dr. Segil. “Some people are busy in the morning, and that’s why a big breakfast [is often] advised, especially for school-age kids.”

Be that as it may, more research on the long-term benefits of meal timing on cognitive health is still needed.

“Cognitive issues are multifactorial, and there’s still a very limited understanding,” Dr. Segil concluded.

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