Abstract

Clinical Outcome Assessments (COAs) use names of mealtimes to refer to specific periods of the day, without specifying a given hour(s); this could lead to the intended timeframe being interpreted differently depending on country of origin. This study aims to assess how national differences in eating habits impact on respondent interpretation of these time periods. 49 participants across 22 countries were asked to identify when they typically eat their morning, midday and evening meal. The responses were assessed to ascertain similarities and differences between countries, and whether an indication of a set time is preferable alongside the meal name in COAs to ensure more consistent interpretations and responses. The responses indicate the variance in timings: Morning meal: range 0600 – 1200. 42% of these responses indicated it would be eaten between 0800 and 0900; 12% of all responses indicating 0600, and <1% indicating 1200. Midday meal: range 1100 – 1700. 83% of these responses indicated it would be eaten between 1200 and 1400; 3% of all responses indicating 1100, and 2% indicating 1400 – 1500. Evening meal: range 1700 – 2300. 25% of these responses indicated it would be eaten at 1900; 10% of all responses indicating 1700, and 5% indicating 2300. Meal times vary greatly across countries, indicating trends due to national and cultural differences. Participants from hotter climes, e.g. Greece, Italy and India typically stated the evening meal would take place between 2000 and 2200; whereas colder countries e.g. Denmark, the UK and Canada stated typically the same meal would be between 1700 and 1900. Respondents interpret meals to occur at different times, spanning a range of 6 hours per meal, depending on country of origin. To enable accurate data pooling, it is optimal to include a reference to the meal alongside a specific time range in COAs.

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