Meal size is a critical driver of weight gain in early childhood.
Larger serving sizes and more frequent eating episodes have been implicated in the rising prevalence of obesity at a population level. This study examines the relative contributions of meal size and frequency to weight gain in a large sample of British children. Using 3-day diet diaries from 1939 children aged 21 months from the Gemini twin cohort, we assessed prospective associations between meal size, meal frequency and weight gain from two to five years. Separate longitudinal analyses demonstrated that every 10 kcal increase in meal size was associated with 1.5 g/wk or 4% (p = 0.005) faster growth rate, while meal frequency was not independently associated with growth (β = 0.3 g/wk p = 0.20). Including both meal parameters in the model strengthened associations (meal size: β = 2.6 g/wk, p < 0.001; meal frequency: β = 1.0 g/wk, p = 0.001). Taken together, the implication is that meal size promotes faster growth regardless of frequency, but meal frequency has a significant effect only if meal size is assumed to be held constant. Clearer advice on meal size and frequency, especially advice on appropriate meal size, may help prevent excess weight gain.
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK.
Hayley
H
Syrad
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK.
Clare H
CH
Llewellyn
Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Rd, Bristol BS8 1TZ.
Laura
L
Johnson
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK.
David
D
Boniface
Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK.
Susan A
SA
Jebb
Department for Health Evidence &Department of Primary and Community Care, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Cornelia H M
CH
van Jaarsveld
Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK.
Jane
J
Wardle
D000886:Anthropometry; D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D002149:Energy Intake; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D062407:Meals; D009765:Obesity / Q000453:epidemiology* / Q000503:physiopathology*; D064787:Portion Size; D011446:Prospective Studies; D006113:United Kingdom; D015430:Weight Gain