Reduced caloric intake, in a variety of insects, worms, rats, and fish, has been shown to have a positive impact on health and lifespan [52–54]. Similarly, reduced caloric intake has been shown to have health promoting benefits in both obese and normal-weight adults as well . Some of the observed health benefits in apparently healthy humans include a reduction in the following parameters: blood pressure, C-reactive protein (CRP), fasting plasma glucose and insulin, total cholesterol, LDL cholesterol, and atherosclerotic plaque formation . However, much less has been published in the scientific literature regarding the effects of varying meal frequencies on markers of health such as serum lipids, serum glucose, blood pressure, hormone levels, and cholesterol.
Gwinup and colleagues [56, 57] performed some of the initial descriptive investigations examining the effects of "nibbling" versus "gorging" on serum lipids and glucose in humans. In one study , five hospitalized adult women and men were instructed to ingest an isocaloric amount of food for 14 days in crossover design in the following manner:
"Gorging" (i.e., one meal per day) led to increases in serum lipids when compared to eating three meals per day. Conversely, 14 days of "nibbling" (i.e., 10 meals per day) led to small decreases in serum lipids such as serum phospholipids, esterified fatty acids, and cholesterol . It is important to point out that this study only descriptively examined changes within the individual and no statistical analyses were made between or amongst the participants . Other studies using obese  and non-obese  subjects also reported significant improvements in total cholesterol when an isocaloric amount of food was ingested in eight meals vs. one meal  and 17 snacks vs. 3 normal meals . In a cross-sectional study which included 6,890 men and 7,776 women between the ages of 45-75 years, it was reported that the mean concentrations of both total cholesterol and LDL cholesterol significantly decreased with increased meal frequency in the general population, even after adjusting for possible confounding variables such as obesity, age, physical activity, and dietary intake . Specifically, after adjusting for confounding variables, the mean total and LDL cholesterol concentrations were ~5% lower in the individuals that ate more than six times a day as opposed to those only eating once or twice per day . Similarly, Edelstein and colleagues  reported that in 2,034 men and women aged 50-89, the individuals that ate greater than or equal to four times per day had significantly lower total cholesterol than those who ate only one to two meals per day. Equally important, LDL concentrations were also lower in those who ate with greater frequency .
A more recent study examined the influence of meal frequency on a variety of health markers in humans . Stote et al.  compared the effects of consuming either three traditional meals (i.e., breakfast, lunch, and dinner) or one large meal on markers of health. The study was a randomized, crossover study in which each participant was subjected to both meal frequency interventions for eight weeks with an 11 week washout period between interventions . All of the study participants ingested an amount of calories needed to maintain body weight, regardless if they consumed the calories in either one or three meals per day. The individuals who consumed only one meal per day had significant increases in blood pressure, and both total and LDL cholesterol .
In addition to improvements with lipoproteins, there is evidence that increasing meal frequency also exerts a positive effect on glucose kinetics. Gwinup et al., [5, 56] along with others , have reported that "nibbling" or increased meal frequency improved glucose tolerance. Specifically, when participants were administered 4 smaller meals, administered in 40 minute intervals, as opposed to one large meal of equal energy density, lower glucose and insulin secretion were observed . Jenkins and colleagues  demonstrated no significant changes in serum glucose concentrations between diets consisting of 17 snacks compared to three isocaloric meals per day. However, those that ate 17 snacks per day significantly decreased their serum insulin levels by 27.9% . Ma et al.  point out that the decrease in serum insulin with increased meal frequency may decrease body fat deposition by decreasing lipase enzyme activity.
Contrary to the aforementioned studies, some investigations using healthy men , healthy women , and overweight women  have reported no benefits in relation to cholesterol and triglycerides. Although not all research agrees regarding blood markers of health such as total cholesterol, LDL cholesterol, and glucose tolerance, it appears that increasing meal frequency may have a beneficial effect. Mann  concluded in his review article that there seems to be no deleterious effects in regard to plasma lipids or lipoproteins by eating a relatively large number of smaller meals. It is noted, however, that the studies where benefits have been observed with increased meal frequency have been relatively short and it is not known whether these positive adaptations would occur in longer duration studies .
Application to Nutritional Practices of Athletes: Although athletic and physically active populations have not been independently studied in this domain, given the beneficial outcomes that increasing meal frequency exerts on a variety of health markers in non-athletic populations, it appears as if increasing meal frequency in athletic populations is warranted in terms of improving blood markers of health.