Tendon Thickness and Meal Frequency

An article published last month in the International Journal of Environmental Research and Public Health explored the association between thickness of the patellar and Achilles tendons in runners and the number of meals ingested per day. Researchers hypothesized the number of meals per day may explain the morphological changes in tendons in addition to being the trigger for metabolic disorders. The rationale was a lower meal frequency (3 meals/day) versus a higher meal frequency (4 or 5 meals/day) would influence several immunological and metabolic pathways. For example, the postprandial inflammatory response, the polyol pathway, and a down regulation of glucose transporters at the level of the muscle tissue. Researchers surmised their study showed preliminary evidence that runners with higher meals per day presented thinning changes in the patellar and Achilles tendon thicknesses (Navarro-Ledesma et al., 2022).

 Some of the standard limitations are obvious with this type of research. It was an observational cross-sectional study on a small group (n=36) of males. What this may look like in a larger cohort including females would be interesting. In addition, for example, without controlling for the composition of the dietary intake or entire training loads makes it difficult to provide recommendations of limiting meals. While sagacious to evaluate musculoskeletal integrity and the potential etiology of injury holistically, until further work is done to justify the rationale for reducing frequency of meals, runners are best to focus on fuelling themselves to optimize the quality of their workouts however that may theoretically appear.