Introduction: Consuming a daily diet of high glycemic load (GL) carbohydrates has potential long-term effects on obesity and cardiovascular health. However, it is possible that the GL of certain meals (breakfast, lunch and supper) have different effects. Few studies have examined the effect of meal-specific GL and frequency of high GL meals on adiposity and cardiovascular health in children. We hypothesized that the number of high GL meals per day, and secondarily, the meal-specific GL, would predict cardiovascular risk factors in children after two years of follow-up. Methods: We used data from the QUALITY cohort which recruited 630 children, ages 8-10 years at baseline with at least one obese parent. Three separate 24-hour dietary recalls were administered by a dietitian at baseline and individual meal-specific GL scores were calculated using the International table of GI. CV risk factors measured at 2 years of follow-up included continuous values of BMI z-score, percent fat mass, triglycerides, LDL and HDL cholesterol, and systolic (SBP) and diastolic (DBP) blood pressure obtained through direct measurement (blood pressure, blood lipids, anthropometrics) or questionnaires (socio-economic characteristics). Linear regressions between meal-specific GL categorized as high ( 2 33) vs. low (<33) and CV risk factors were estimated, adjusting for important confounders, including underreporting, as well as anthropometric, socio-economic and dietary factors. Secondary analysis consisted of linear regression with number of high GL meals as an ordinal exposure variable. Results: Mean age at baseline was 9.6 years, with 33% of children overweight or obese. Breakfast, lunch and supper glycemic load were positively associated with each other. A higher number of high GL meals was positively associated with BMI z-score (β=0.18, 95%CI: 0.06, 0.30), percent fat mass (β=1.74, 95%CI: 0.52, 2.96) and triglycerides (β=0.08, 95%CI: 0.03, 0.14) and negatively associated with HDL (β=-0.04, 95%CI: -0.07, -0.01). Our secondary analysis revealed that High breakfast GL was positively associated with increased triglycerides (β=0.14, 95%CI: 0.05, 0.23) after 2 years but not adiposity, HDL, LDL and blood pressure. High GL lunch (β=0.27, 95%CI: 0.08, 0.46) and supper (β=0.22, 95%CI: 0.02, 0.41) were associated with higher BMI z-score after 2 years. Conclusion: In conclusion, consuming more than one high GL meal per day is associated with greater BMI and unhealthy lipid profile after 2 years.