The role of eating frequency on total energy intake and diet quality in a low-income, racially diverse sample of schoolchildren.
OBJECTIVE
The relationship of meal and snacking patterns with overall dietary intake and relative weight in children is unclear. The current study was done to examine how eating, snack and meal frequencies relate to total energy intake and diet quality.


METHODS
The cross-sectional associations of eating, meal and snack frequencies with total energy intake and diet quality, measured by the Healthy Eating Index 2005 (HEI-2005), were examined in separate multivariable mixed models. Differences were examined between elementary school-age participants (9-11 years) and adolescents (12-15 years).


METHODS
Two non-consecutive 24 h diet recalls were collected from children attending four schools in the greater Boston area, MA, USA.


METHODS
One hundred and seventy-six schoolchildren, aged 9-15 years.


RESULTS
Overall, 82% of participants consumed three daily meals. Eating, meal and snack frequencies were statistically significantly and positively associated with total energy intake. Each additional reported meal and snack was associated with an 18·5% and a 9·4% increase in total energy intake, respectively (P<0·001). The relationships of eating, meal and snack frequencies with diet quality differed by age category. In elementary school-age participants, total eating occasions and snacks increased HEI-2005 score. In adolescents, each additional meal increased HEI-2005 score by 5·40 points (P=0·01), whereas each additional snack decreased HEI-2005 score by 2·73 points (P=0·006).


CONCLUSIONS
Findings suggest that snacking increases energy intake in schoolchildren. Snacking is associated with better diet quality in elementary school-age children and lower diet quality in adolescents. Further research is needed to elucidate the role of snacking in excess weight gain in children and adolescents.
1Weight Control and Diabetes Research Center,Brown University School of Medicine,196 Richmond Street,Providence,RI 02903,USA.
E Whitney
EW
Evans
2Friedman School of Nutrition Science and Policy,Tufts University,Boston,MA,USA.
Paul F
PF
Jacques
2Friedman School of Nutrition Science and Policy,Tufts University,Boston,MA,USA.
Gerard E
GE
Dallal
2Friedman School of Nutrition Science and Policy,Tufts University,Boston,MA,USA.
Jennifer
J
Sacheck
2Friedman School of Nutrition Science and Policy,Tufts University,Boston,MA,USA.
Aviva
A
Must
D000293:Adolescent; D000294:Adolescent Behavior; D017195:Adolescent Nutritional Physiological Phenomena; D000375:Aging; D001900:Boston; D002648:Child; D002652:Child Behavior; D002664:Child Nutritional Physiological Phenomena; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000191:economics; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D062407:Meals; D018673:Nutrition Policy; D010349:Patient Compliance; D011203:Poverty; D012574:Schools; D062410:Snacks
Childhood obesity; Diet quality; Energy intake; Meal patterns; Snack patterns