Energy and Macronutrient Intakes With Eating Occasions Consumed by European Children From Ages 3 to 8 Years: The EU Childhood Obesity Project Study

Abstract

Abstract Objectives We characterized the distribution of energy and macronutrient intakes across eating occasions (EO) in a longitudinal study in children from 3 to 8 yrs in 5 European countries. Methods In the Childhood Obesity Project Study, 3-day weighed food records were collected at 3, 4, 5, 6 and 8 yrs of age for children from Belgium, Germany, Italy, Poland and Spain. Food intakes were assigned to EO based on country-specific times of the day and EO size. A consistent pattern with 3 meals (breakfast, lunch, supper) and 2 snacks (morning, afternoon) was identified. We analyzed longitudinal changes in diurnal energy and nutrient intake with age and estimated mixed effects models with child-specific intercept and slope for age. Age was analysed as quadratic term. Results The analyzed food intakes of 740 children showed the proportion of energy consumed within the day as follows: lunch (30.3%±8.3, M ± SD), supper (25.3%±8.0), breakfast (18.6%±6.6) and snacks (afternoon (16.3%±7.2); morning (10.1%±6.7)). Italian children had the lowest intake during morning (5.4%± 3.8) and the highest proportion of skipping morning snack (49%). The portion of fat and protein (as % total energy intake per EO) was high at lunch (fat 36.3%±9.1; protein 18.1%±5.2) and supper (fat 39.1%±10.9; protein 17.7%±5.6) and for carbohydrates at snacks (61.6%±11.6) and breakfast (53.7%±11.7), respectively. In Spain, fat and protein intakes were above study average at all EO. Energy intakes at snacks varied significantly with age (morning βage = -36.22kcal, βage2 = 3.29kcal; afternoon βage = 28.37 kcal, βage2 = −3.21kcal; P >0.001). There were no diurnal energy and nutrient differences between sexes. Conclusions The studied children consumed the major portions of dietary energy, protein and fat at lunch and supper, while most carbohydrates were provided with snacks and breakfast. With increasing age, energy intakes varied with morning and afternoon snacks. Further studies should explore whether diurnal variation of dietary intakes is associated with health outcomes. Funding Sources Partial financial support was received from the Commission of the European Community, the EU Seventh Framework Programme, project EarlyNutrition, the EU H2020 project PHC-2014-DynaHealth and the European Research Council Advanced Grant META-GROWTH.