title: Associations between meal and snack frequency and overweight and abdominal obesity in US children and adolescents from National Health and Nutrition Examination Survey (NHANES) 2003-2012.
abstract: The association between eating frequency (EF) and adiposity in young populations is inconsistent. This cross-sectional study examined associations of EF, meal frequency (MF) and snack frequency (SF) with adiposity measures in US children aged 6-11 years (n 4346) and adolescents aged 12-19 years (n 6338) participating in the National Health and Nutrition Examination Survey 2003-2012. Using data from two 24-h dietary recalls, all eating occasions providing ≥210 kJ of energy were divided into meals or snacks based on 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). When analysed without adjustment for the ratio of reported energy intake:estimated energy requirement (EI:EER), all measures of EF, MF and SF showed inverse or null associations with overweight (BMI≥85th percentile of BMI-for-age) and abdominal obesity (waist circumference≥90th percentile) in both children and adolescents. After adjustment for EI:EER, however, EF and SF, but not MF, showed positive associations in children, irrespective of the definition of meals and snacks. In adolescents, after adjustment for EI:EER, positive associations were observed for EF (abdominal obesity only), SF based on energy contribution and MF based on self-report, whereas there was an inverse association between MF based on energy contribution and overweight. In conclusion, higher SF and EF, but not MF, were associated with higher risks of overweight and abdominal obesity in children, whereas associations varied in adolescents, depending on the definition of meals and snacks. Prospective studies are needed to establish the associations observed here.
authors.affiliation: 1Department of Nutrition,School of Human Cultures,University of Shiga Prefecture,Shiga 522 8533,Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Murakami
authors.affiliation: 2Northern Ireland Centre for Food and Health,Ulster University,Coleraine BT52 1SA,UK.
authors.forename: M Barbara E
authors.initials: MB
authors.lastname: Livingstone
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D015930:Diet Records; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D062407:Meals; D011939:Mental Recall; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009751:Nutritional Requirements; D056128:Obesity, Abdominal / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000453:epidemiology*; D062410:Snacks; D014481:United States; D055105:Waist Circumference; D055815:Young Adult
keywords: EER estimated energy requirement; EF eating frequency; EI energy intake; EI:EER ratio of EI:EER; MF meal frequency; MFenergy% MF determined based on percentage contribution to total EI; Meal frequency; NHANES National Health and Nutrition Examination Survey; National Health and Nutrition Examination Survey; Obesity; SF snack frequency; SFenergy% SF determined based on percentage contribution to total EI; Snack frequency; WC waist circumference