title: Eating frequency and overweight and obesity in children and adolescents: a meta-analysis.
abstract: OBJECTIVE
  To determine the effect of eating frequency on body weight status in children and adolescents.
  
  
  METHODS
  In this meta-analysis, original observational studies published to October 2011 were selected through a literature search in the PubMed database. The reference list of the retrieved articles was also used to identify relevant articles; researchers were contacted when needed. Selected studies were published in English, and they reported on the effect of eating frequency on overweight/obesity in children and adolescents. Pooled effect sizes were calculated using a random effects model.
  
  
  RESULTS
  Ten cross-sectional studies and 1 case-control study (21 substudies in total), comprising 18 849 participants (aged 2-19 years), were included in the analysis. Their combined effect revealed that the highest category of eating frequency, as compared with the lowest, was associated with a beneficial effect regarding body weight status in children and adolescents (odds ratio [OR] = 0.78, log OR = -0.24, 95% confidence interval [CI] -0.41 to -0.06). The observed beneficial effect remained significant in boys (OR = 0.76, log OR = -0.27, 95% CI -0.47 to -0.06), but not in girls (OR = 0.96, log OR = -0.04, 95% CI -0.40 to 0.32) (P for sex differences = 0.14).
  
  
  CONCLUSIONS
  Higher eating frequency was associated with lower body weight status in children and adolescents, mainly in boys. Clinical trials are warranted to confirm this inverse association, evaluate its clinical applicability, and support a public health recommendation; more studies are also needed to further investigate any sex-related differences, and most importantly, the biological mechanisms.
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens 17671, Greece.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Kaisari
authors.forename: Mary
authors.initials: M
authors.lastname: Yannakoulia
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004734:Energy Metabolism / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D017678:Sex Distribution
keywords: children; eating frequency; obesity