Abstract
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.
Highlights
Larger serving sizes and more frequent eating episodes have been implicated in the rising prevalence of obesity at a population level
Meal frequency was not associated with weight gain (ß = 0.3, p = 0.20)
In the model that included both meal parameters, higher meal frequency was associated with greater weight gain (ß = 1.0; p = 0.001); such that supposing meal sizes were held fixed, each extra meal increased a child’s growth rate by 1 g/week or 2.9%
Summary
Larger serving sizes and more frequent eating episodes have been implicated in the rising prevalence of obesity at a population level. 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). Obesity rates have risen dramatically over the past 30 years, with increases in childhood obesity provoking particular concern[1] The causes of this secular trend are likely to be multiple and complex; evidence indicates that, children are consuming food more often, and in larger amounts at each occasion[2]. No study has examined meal size (energy consumed) and meal frequency in the same sample over the same recording period, making it difficult to determine their relative contribution to excess weight gain or obesity risk. We examined differences in meal parameters by weight status at baseline to provide insights into differences in eating patterns between overweight and healthy weight children
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