Eating patterns and portion size associated with obesity in a Swedish population

Objective: To examine how different definitions of meals and snacks can affect the associations of meal frequency (MF) and snack frequency (SF) with dietary intake and adiposity measures. Design: Based on 7 d weighed dietary record data, all eating occasions providing ≥210 kJ of energy were divided into meals or snacks based on contribution to energy intake (≥15 % or <15 %) or time (06.00-10.00, 12.00-15.00 and 18.00-21.00 hours; other). Diet quality was assessed using the Healthy Diet Indicator (HDI) and Mediterranean Diet Score (MDS). Setting: Great Britain. Subjects: British adults aged 19-64 years (n 1487). Results: MF based on energy contribution was associated with higher intake of dietary fibre, lower intakes of non-milk extrinsic sugars and alcohol, and higher HDI (only men) and MDS. MF based on time was associated with higher HDI and MDS in women only. Conversely, irrespective of the definition of snacks, SF was associated with higher intakes of confectionery and alcohol, lower intakes of cereals, protein, fat and dietary fibre, and lower HDI (except for SF based on energy contribution in women) and MDS. After adjustment for potential confounders, MF based on time, but not MF based on energy contribution, was positively associated with BMI and waist circumference in men only. SF was positively associated with BMI and waist circumference, irrespective of the definition of snacks. Conclusions: Higher SF was consistently associated with lower diet quality and higher adiposity measures, while associations with MF varied depending on the definition of meals and sex.

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confidence: 99%

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confidence: 99%

Associations between meal and snack frequency and diet quality and adiposity measures in British adults: findings from the National Diet and Nutrition Survey

Murakami¹,

Livingstone²

2015

“…'Eating slowly' has been advocated for control of food intake and thus body weight (12) . Overeating, eating until full or having larger portion size of food also led to increase in energy intake and thus overweight or obesity (6,(13)(14)(15) . However, previous studies on the relationship between these eating behaviours and overweight were focused on parent-reported behaviours (8)(9)(10) or conducted in standardized laboratory settings or clinical research facilities (11,12,15) , and no information has yet been available on observed meal duration and excess energy intake of commonly consumed foods in daily life in pre-school children.…”

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confidence: 99%

Association of eating speed and energy intake of main meals with overweight in Chinese pre-school children

Lin

Pan

Tang

et al. 2013

Objective: To investigate the association between eating behaviours (eating speed and energy intake of main meals) and overweight in pre-school children. Design: Cross-sectional study. Data consisted of measurements (height and weight), questionnaire information (eating behaviours of eating speed and overeating) and on-site observation data (meal duration and energy intake of main meals). Setting: Seven kindergartens in Beijing, China. Subjects: Pre-school children (n 1138; age range 3?1-6?7 years old) from seven kindergartens participated in the study. Results: The multivariate-adjusted odds ratio of overweight in participants with parent-reported 'more than needed food intake' was 3?02 (95 % CI 2?06, 4?44) compared with the 'medium food intake' participants, and higher eating speed was associated with childhood overweight. For the two observed eating behaviours, each 418?7 kJ (100 kcal) increase of lunch energy intake significantly increased the likelihood for overweight by a factor of 1?445, and each 5-min increase in meal duration significantly decreased the likelihood for overweight by a factor of 0?861. Increased portions of rice and cooked dishes were significantly associated with overweight status (OR 5 2?274; 95 % CI 1?360, 3?804 and OR 5 1?378; 95 % CI 1?010, 1?881, respectively). Conclusions: Eating speed and excess energy intake of main meals are associated with overweight in pre-school children.

“…However, several methodological limitations make it difficult to interpret these studies. First, EF has often been estimated using a series of self-report questions (8)(9)(10)(11)(15)(16)(17)(18)(19) , the validity of which has not been examined or reported. Only a limited number of studies have estimated EF with the use of information on actual dietary behaviours (based on dietary record or 24 h recall) (20)(21)(22)(23)(24) .…”

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confidence: 99%

“…Second, there is no consensus about what constitutes a snack, a meal or an eating occasion. While some studies have relied on respondents' self-identification of meals, snacks or eating occasions (8)(9)(10)(11)(15)(16)(17)(18)25,26) , others have tried to apply more objective criteria (19)(20)(21)(22)(23)(24)(27)(28)(29)(30) . Third, the associations between EF and dietary intake may be confounded by the under-reporting of EF accompanied by the under-reporting of energy intake (EI), particularly by obese or overweight individuals (12,13) .…”

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confidence: 99%

Meal and snack frequency in relation to diet quality in US children and adolescents: the National Health and Nutrition Examination Survey 2003–2012

Murakami

Livingstone

2016

Objective: To examine the associations of meal frequency (MF) and snack frequency (SF) with diet quality. Design: Dietary intake was assessed using two 24 h dietary recalls. All eating occasions providing ≥210 kJ of energy were divided into meals or snacks on the basis of contribution to energy intake (≥15 % or <15 %), self-report and time (06.00-09.00, 12.00-14.00 and 17.00-20.00 hours, or others). Diet quality was assessed using the Healthy Eating Index (HEI)-2010. Setting: Nationally representative sample of the US population. Subjects: Children aged 6-11 years (n 4269) and adolescents aged 12-19 years (n 6193) in the National Health and Nutrition Examination Survey 2003-2012. Results: Irrespective of the definition of meals, higher MF was associated with higher HEI-2010 in both children and adolescents. One additional meal per day increased HEI-2010 by 1·45-3·59 points (all P < 0·005). Conversely, the associations for SF were inconsistent. While SF based on energy contribution was positively associated with HEI-2010 in both children and adolescents (0·70 (P = 0·001) and 1·00 (P < 0·0001) point increase by one additional snack, respectively), there were no associations for SF based on self-report or time. In analyses in which only plausible energy reporters (3425 children and 3753 adolescents) were included, similar results were obtained. Conclusions: In a representative sample of US children and adolescents, MF was associated with better diet quality, while the associations for SF varied depending on the definition of snacks. The findings highlight the importance of applying different definitions of meals and snacks when assessing the impact of dietary patterns on health.