Q:They say meals should be eaten five hours apart, but I can’t get enough food at each meal (three times daily) to get the calories needed for my health. I used to eat four meals a day, didn’t overeat, and did well. Should I return to that? Any long-term health effects? Help!

A:Not everyone is able to fit into guidelines designed for the public in general. Individual variations are real, and circumstances differ even with the same individual during the course of a lifetime. One size rarely fits all; so you can and should consider what will work best for you without causing long-term harm.

Your optimal eating pattern and meal frequency depend on who you are. Do you have any medical conditions? Are you overweight or underweight? Have you had abdominal surgeries? Are you under or over 60? Are you otherwise healthy and following a healthful lifestyle? Consider the following issues as you make your decision:

Weight Management: Reporting on 50,000 participants in the Adventist Health Study-2, researchers observed healthier weight in individuals who ate fewer than three meals per day; regularly had a hearty, healthy breakfast; made breakfast or lunch the largest meal of the day (if they ate more than two meals per day); and had an overnight fast of 18 hours. The two factors associated with higher weight were eating more than three meals—or meals and snacks—per day and making supper the largest meal of the day. Whatever the meal pattern, people tended to increase their weight year by year until they reached 60, then lost weight each year afterward; but both the amount of weight gain and loss were related to eating frequency and pattern. Choice makes a difference over time.

Diabetes: Studies show that fewer meals are associated with better overall blood sugar control, and eating the largest meal early in the day lowers average daily blood sugar levels.

Hunger and Satiety: Improved satiety and reduced hunger accompany less-frequent eating and fewer processed foods. Longer periods of no-calorie ingestion appear to also induce the cellular cleanup process called autophagy, in which your body’s cells remove unnecessary or dysfunctional components for recycling, cell replacement, and rejuvenation. So if you can do well with fewer meals per day, you may have better long-term outcomes.

So here’s a suggestion: try a hearty, whole-food breakfast that has adequate protein and healthy fats, and is low in water content and high in nutritional value and caloric density (i.e., high calories in a small amount of food), as a great day-starter. This ensures enough calories without having to overeat and still stave off hunger for five to six hours. Healthy calorie-dense foods include nuts, avocado, coconut cream, seeds, dried fruit, and whole grains. Get specific advice from your health-care practitioner, and see if this approach suits you given your specific health situation.

Whether you eat or drink, or whatever you do, do it to God’s glory!

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.