What Are “Regular Meals”? A Dietary Quality-Driven Definition Supports a Meal-Specific Day-to-Day Consistency Approximating 0–120 Minutes

Abstract

Abstract Objectives Develop a definition of “regular meals” that aligns with optimum dietary quality. Methods Parents of 4th grade youth in an impact assessment of a school-based culinary & physical activity intervention completed three, 24-hour ASA24 dietary assessments. Intervals among the breakfasts, the lunches, and the dinners were arithmetically calculated and values of 3, 2, and 1 were assigned to definitions of “always,” “often/sometimes,” and “rarely/never” respectively for each meal to achieve a mealtime regularity score (MRS) ranging from 3 to 9. Values were assigned using 3 interval-based MRS versions iteratively based on descriptor proportionality. For each version, MRS was divided into groups based on 4 separate categorization strategies, i.e., 3 groups based on extremes and middle scores, 3 groups with more moderate delimiters, breakfast vs non-breakfast eaters, and 2 groups derived from median splits. Linear regression was used to predict HEI scores from MRS. Energy adjusted nutrient values and HEI scores were compared among MRS version categories using one-way ANOVA, independent t-tests, Mann-Whitney U, and Kruskal-Wallis as appropriate. Results Parents (n = 68) were non-Hispanic white (94%), female (88%), college educated (95%), had normal BMI (57%), with little history of SNAP participation (21%). HEI and Kcals were typical (55.8 ± 12.1; 1815 ± 553). No scoring scheme was unequivocally aligned with dietary quality indicators, but the median-driven categorization of 1 MRS version was more consistently correlated. This version assigned “always” to a day-to-day consistency of 60 minutes for breakfast, up to 120 min for lunch/dinner; “often/sometimes” for intervals as high as 90 minutes for breakfast and 120 minutes for lunch/dinner and “rarely/never” for greater intervals. 47%, 55%, and 71% identified with “always” for breakfast, lunch, and dinner respectively. Only the MRS based on these moderate delimiters (mean 7.24 ± 1.42) predicted HEI (ß 2.1, P 0.043), total fruit and whole fruit HEI. With this scoring strategy, regular eaters, i.e., those with scores ≥ median, consumed more dietary fiber and had greater HEI, total fruit and whole fruit HEI scores. Conclusions “Regular meals,” as aligned with dietary quality, were defined as MRS ≥ median that were derived using less stringent interval and meal-skipping parameters. Funding Sources USDA, NIFA