Randomised controlled trialindependent cross-checkabstract checked★ key study I-FAST-115 standard review
One meal a day versus three
A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults.
Overview
Stote KS et al.. Am J Clin Nutr 2007 · PMID 17413096 · DOI 10.1093/ajcn/85.4.981
Eating the same calories in one meal reduced body fat slightly but raised blood pressure, LDL cholesterol and hunger.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Test reduced meal frequency without calorie cut.
- How was the study done?
Crossover trial, 8 weeks each pattern.
- How many people, animals or samples were studied?
Healthy middle-aged adults (pilot).
- What was actually found?
Fat mass down; BP and LDL up; hunger up.
- How large was the observed effect?
Not given in abstract.
- What do the results mean in everyday life?
One meal a day has mixed effects.
- What are the study's limitations?
Small, short.
- What does it say about Elawady's specific claim?
Mixed; no evidence of superiority.
- Do the results apply to Germany and Europe?
Applies; same physiology.
- What can explicitly not be concluded from this study?
Long-term effects.
Scientific in-depth review
1. Full reference
- Authors
- Stote KS et al.
- Journal
- Am J Clin Nutr
- Year
- 2007
- Identifier
- PMID 17413096 DOI 10.1093/ajcn/85.4.981
- Verification
- verified – PubMed efetch 2026-10-26; Crossref update-to/updated-by check
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
NIH/USDA funded (record).
2. Research question
What are the effects of one meal/day vs three meals/day at equal calories?
3. Study design and population
- Study design
- Randomised controlled trial – Randomised crossover trial, two 8-week periods
- Population
Healthy normal-weight middle-aged adults
- Country
USA
- Period
not stated in abstract
- Sample size
not stated in abstract (pilot)
- Inclusion and exclusion criteria
not stated in abstract
4. Methods and endpoints
- Exposure / intervention
1 meal/day (all maintenance calories)
- Comparator
3 meals/day, same calories
- Endpoints
Body composition, BP, lipids, hunger, cortisol, haematology
- Statistical methods
Crossover comparisons
5. Actual results
- Results
With 1 meal/day: significant increase in hunger; reduced fat mass; significant increases in blood pressure and in total, LDL and HDL cholesterol; decreased cortisol. Body weight stayed within 2 kg; no effect on most blood variables.
- Absolute risks
not reported
- Authors' conclusion
Normal-weight subjects can comply with 1 meal/day; modest changes in body composition and some cardiovascular risk factors; diurnal variations may affect outcomes.
6. Strengths
- Randomised crossover, energy-matched
- Directly tests one meal a day
7. Weaknesses
- Small pilot; short
- Evening meal timing may confound lipid/BP measurements
8. Risk of bias
- Orienting tool
- RoB 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Pilot; dropouts; measurement timing.
9. Assessment of the statistical interpretation
Mixed: fat mass fell but BP and LDL rose; direction of net cardiovascular effect unclear.
10. Relevance to the specific claim
Direct test of one meal a day: some favourable (fat mass) and some unfavourable (BP, LDL, hunger) effects.
11. Independent contrary findings
12. Transferability to Germany and Europe
Universal biology; applies in Europe and Egypt.
13. Overall methodological judgement
Does not support one meal a day as clearly healthier.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | low |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Long daily intermittent fasting with one meal a day as the default eating pattern (and sometimes eating once every two days) is the healthy way to eat. – Studies with mixed or unclear results