title: Eating Frequency Is Positively Associated with Overweight and Central Obesity in U.S. Adults.
abstract: BACKGROUND
  Evidence of the association between eating frequency (EF) and adiposity is inconsistent.
  
  
  OBJECTIVE
  With the use of data from the NHANES 2003-2012, this cross-sectional study examined the associations between EF, meal frequency (MF), and snack frequency (SF) and overweight/obesity and central obesity.
  
  
  METHODS
  Dietary intake was assessed with the use of two 24-h dietary recalls in 18,696 US adults ≥20 y of age. All eating occasions providing ≥50 kcal of energy were divided into meals or snacks on the basis of contribution to energy intake (≥15% or <15%), self-report, and time (0600-1000, 1200-1500, 1800-2100, or other). Multivariable logistic regression was used to compute ORs and 95% CIs.
  
  
  RESULTS
  When analyzed without adjustment for the ratio of energy intake to estimated energy requirement (EI:EER), all measures of EF, MF, and SF showed inverse or null associations. After adjustment for EI:EER, however, EF was positively associated with overweight/obesity (body mass index ≥25 kg/m2) and central obesity (waist circumference ≥102 cm in men and ≥88 cm in women). Compared with the lowest category (≤3 times/d), the OR (95% CI) for overweight/obesity in the highest category (≥5 times/d) was 1.54 (1.23, 1.93) in men (P-trend = 0.003) and 1.45 (1.17, 1.81) in women (P-trend = 0.001). The corresponding value for central obesity was 1.42 (1.15, 1.75) in men (P-trend = 0.002) and 1.29 (1.05, 1.59) in women (P-trend = 0.03). The self-report-based MF and time-based MF were positively associated with overweight/obesity, central obesity, or both, although MF based on energy contribution showed no associations. There were positive associations for all SF measures in men and for the energy-contribution-based SF in women.
  
  
  CONCLUSIONS
  This cross-sectional study suggests that higher EF, MF, and SF are associated with an increased likelihood of overweight/obesity and central obesity in US adults. Prospective studies are needed to confirm the associations observed in this study.
authors.affiliation: Department of Nutrition, School of Human Cultures, University of Shiga Prefecture, Shiga, Japan; and kenmrkm@m.u-tokyo.ac.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Northern Ireland Centre for Food and Health, Ulster University, Coleraine, United Kingdom.
authors.forename: M Barbara E
authors.initials: MB
authors.lastname: Livingstone
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D002149:Energy Intake; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D062407:Meals; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology / Q000209:etiology; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000209:etiology*; D050177:Overweight / Q000453:epidemiology / Q000209:etiology*; D062410:Snacks; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055105:Waist Circumference
keywords: NHANES; body mass index; eating frequency; epidemiology; meal frequency; misreporting; snack frequency; waist circumference