What does meal pattern mean

The assumption that difference in food choice should be because of smoking or nonsmoking seems as farfetched as an assumption that all differences in food intake shown in the current study were related to the meal pattern only. Both smoking and meal pattern are markers of a lifestyle including different food habits. Compared with a physical activity level of 1. However, those who had fewer breakfasts also had lower energy intake.

Breakfast omission was related to a higher BMI in the boys but not in the girls. To find out if irregularity in main meals was related to an intention to lose weight, we included the students' perception of own body weight as well as BMI in the multiple logistic regression analyses.

For those with irregular breakfast consumption, concerns about body weight were significant independent of BMI, but not for irregular consumption of the other main meals. The school lunch was important and what was offered seemed to affect eating patterns in the different schools. However, for comparison of girls with irregular and regular meal patterns, school did not influence the difference in intakes between the groups. They had a less healthy food choice with type of milk and bread and a lower intake of meat.

The intake of fibre, iron and zinc was even lower than the marginal intake for the rest of the girls in this study. Vitamin C intake was also lower because of a markedly lower intake of vegetables and fruits.

They had higher intake of sweets and soft drinks resulting in a higher intake of sucrose. In isolation, a difference in each of these variables might not have any importance, but together they form a pattern of a less healthy dietary intake that is of concern also accentuated by the markedly higher alcohol intake in this group.

Their less healthy food habits were combined with a cluster of less healthy lifestyle factors. The girls with irregular intake of breakfast as well as lunch had matured earlier than the rest of the girls and in the girls with irregular breakfast intake there was also a tendency of earlier maturation. Breakfast habits remained unchanged. An interesting finding in the current study was that the girls with irregular breakfast and lunch intake were shorter, lighter but had matured earlier than the rest of the girls in the study.

The difference in maturation is probably larger than reported since 21 girls had not yet reached menarche, but none of these were in the irregular breakfast and lunch group. The difference in maturation remained also when ethnicity was adjusted for. Food habits with poorer nutrient intake may have negatively affected growth in these girls. In the Nordic countries, the tradition is to eat a substantial breakfast.

The energy not consumed during breakfast in the current study was not compensated for with higher energy intake from lunch or dinner, but rather higher intake of in-between meals and from snack food. The girls having three main meals with two prepared meals daily had the highest intake of micronutrients both in absolute values and adjusted for energy intake. They had also a higher intake of sucrose and alcohol. In conclusion, the majority of the adolescents in this study had relatively good food habits.

Many of them, both boys and girls, consumed three main meals daily and often two of these were prepared meals. Omitting breakfast was an important indicator of less healthy lifestyle and a food choice leading to a poorer nutrient intake.

This study also showed that omitting breakfast and lunch was an even stronger indicator of lifestyle that may also have effects on future health. Article Google Scholar. Berg-Kelly K : Normative developmental behaviour with implications for health and health promotion among adolescents: a Swedish cross-sectional survey. Acta Paediatr. BMJ , 1—6. Crawley H : Dietary and lifestyle differences between Scottish teenagers and those living in England and Wales.

Google Scholar. Technical Report Series World Health Organization: Geneva. Derivation of cut-off limits to identify under-recording. CAS Google Scholar. Jarman B : Identification of underprivileged areas. BMJ , — Schofield WN : Predicting basal metabolic rate, new standards and review of previous work.

Stockholm: Reports in Statistical Coordination. Download references. All investigators participated in the writing and revision of the paper. You can also search for this author in PubMed Google Scholar. Reprints and Permissions.

Eur J Clin Nutr 57, — Download citation. Received : 30 April Revised : 03 January Accepted : 06 January Published : 28 November Issue Date : 01 December Anyone you share the following link with will be able to read this content:. As eating frequency is positively related to EI, it may be that those who under-report EI also under-report their eating frequency 45 , There is also some evidence that snacks are more prone to being under-reported To advance the area of meal pattern research, the methods used to collect meal pattern data require further development.

Measures that are inexpensive to administer and have low participant burden for example, questionnaire items need to be developed and tested for reliability and validity. Contextual information is not always collected as part of a 24 h recall, yet additional questions about eating location and activities while eating could be considered in order to better understand the contextual factors that influence associations between meal patterns and diet quality.

While specific food records have been adapted to collect contextual information for example, the Weekly Food Diary method 58 , this method also involves a high participant burden. Dietary assessment methods that utilise new technology for example, smartphones may assist in the development of meal pattern research. A major advantage of such technology would be that researchers could collect information allowing examination of all three meal pattern constructs: patterning, format and context.

Furthermore, rich contextual data collected in real time could provide insight into the factors that influence participants' decisions to classify an EO as a meal or snack and therefore help in refining existing meal definitions.

Currently little research has examined meal format; however, understanding how different combinations of foods in a meal influence overall diet quality could be an important step in developing a meals-based framework for dietary guidelines. Further work is also required in developing and applying innovative statistical techniques to examining meal patterns, with few applications tested in the literature. However, it is important to acknowledge that developing new methods to collect and analyse meal patterns data will take considerable time.

A major issue still remains of the different definitions available to researchers when conducting meal patterns research. Further analysis for example, sensitivity analysis that examines more than one definition from the current literature would facilitate understanding of how the choice of definition makes an impact on the characterisation of meal patterns and associations with outcomes such as nutrient intake and diet quality.

Overall, there are a number of gaps and limitations in meal pattern research that need to be addressed to further our understanding of how meal definitions influence the characterisation of meal patterns, and the contribution of different meal patterns to nutrient intake and overall diet quality.

While current evidence suggests breakfast skipping may be detrimental to diet quality, the nutritional impact of eating frequency, skipping meals other than breakfast and meal timing is inconclusive and warrants further investigation.

Future studies should consider how different contexts, beverage-only occasions and energy misreporting affect the relationship between meal patterns and diet quality. The heterogeneity of meal definitions is a major impediment to the interpretation of findings across studies in this field of research.

Future research that examines the influence of different meal definitions on the characterisation of meal patterns will facilitate the interpretation of the existing literature, and provide recommendations on the most appropriate methods to advance the field.

All authors contributed to and approved the final version of the manuscript. National Center for Biotechnology Information , U. Nutrition Research Reviews. Cambridge University Press. Nutr Res Rev. Rebecca M. Sarah A. Author information Copyright and License information Disclaimer.

This article has been cited by other articles in PMC. Abstract Traditionally, nutrition research has focused on individual nutrients, and more recently dietary patterns. Keywords: Meal patterns, Diet quality, Nutrient intake, Diet quality indicators. Introduction It is widely recognised that a nutritionally sound diet is fundamental to human health and wellbeing across the lifespan 1.

Table 1 Overview of the three meal pattern constructs, and examples of variables currently assessed in the literature and the assessment methods that have been used to collect the meal pattern data. Open in a separate window. Meal definitions To date, a variety of approaches has been used in the literature to define EO meals and snacks. Table 2 Summary of different approaches used to define different eating occasions EO.

Meal labels may be influenced by the researcher's existing understanding of eating patterns and introduce researcher bias Food-based classification Foods are firstly categorised into food categories based on their nutritional profile. Food category combinations determine the type of EO Six EO types ranging from a complete meal high nutrient density; contains both animal and plant foods to a low-quality snack low nutrient density Time-of-day As the name implies, this approach defines meals according to the time-of-day in which food was consumed.

Measurement of meals There have been a number of different approaches to the measurement of meals. Associations between meal patterns, nutrient intakes and overall diet quality Due to the current limited methods available to collect meal pattern data, most research to date has examined meal patterning 5 , 61 , with relatively little focus on meal format 29 and context Characteristics of studies which examined associations between meal patterns and nutrient intakes A total of thirty-four studies Table 3 were identified which examined the nutritional contribution of different meal patterns, in adults.

EI and macronutrient intake highest during CHO and protein intake at night among men and afternoon among women was higher in than in the morning. Sensitivity analysis excluding energy under-reporters Intakes per meal of energy as CHO, fat, protein and alcohol were significantly higher in the evening period Percentage energy from fat women only , protein and fibre density decreased. Among older adults, breakfast was higher in fibre density Kant 76 USA Prospective mean follow-up There were no differences in protein or fat intakes between more frequent snackers v.

Stratified by sex There were 5-year increases in the contributions of snacks to vitamin C and fibre intakes per unit of energy among men and fibre only among women. Macronutrient intake was contributed mostly by meals and alcohol was mostly drunk at dinner. Meals v. Eating frequency and nutrient intakes Of eighteen studies that examined eating frequency including snacking frequency , fourteen found that eating frequency was associated with higher EI 40 , 41 , 45 — 47 , 52 , 57 , 67 , 72 , 77 , 78 , 80 , 82 , Meal skipping and nutrient intakes A total of six studies 23 , 64 , 66 , 68 , 69 , 71 were identified that examined the influence of breakfast skipping on nutrient intakes and only one study 71 was identified that examined the nutritional impact of omitting the lunch or dinner meal.

Meal timing and nutrient intakes Only three studies were identified that examined associations between meal timing and EI 76 , 79 , 84 or macronutrient intake Studies examining meal patterns and overall diet quality A total of fourteen studies were identified that examined associations between meal patterns and measures of overall diet quality Table 4.

Table 4 Characteristics of studies that have examined associations between meal patterns and overall diet quality. Meal timing and diet quality Studies examining associations between meal timing and diet quality are rare.

Potential impact of different meal definitions on the characterisation of meal patterns and associations with nutrient intakes and diet quality Clear and objective definitions of what is a meal and what is a snack are critical for determining the energy and nutrient contributions of meals v. Discussion Meal patterns are multidimensional and can be described according to their patterning, format and context. Recommendations to advance the field To advance the area of meal pattern research, the methods used to collect meal pattern data require further development.

Conclusion Overall, there are a number of gaps and limitations in meal pattern research that need to be addressed to further our understanding of how meal definitions influence the characterisation of meal patterns, and the contribution of different meal patterns to nutrient intake and overall diet quality. Acknowledgements R. All authors declare no conflicts of interest. References 1. Geneva: WHO. Hu FB Dietary pattern analysis: a new direction in nutritional epidemiology.

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J Adolesc Health 22 , 29— Appetite 32 , 53— Eur J Clin Nutr 63 , — Am J Epidemiol , 85— Eur J Clin Nutr 67 , — Gatenby SJ Eating frequency: methodological and dietary aspects. Br J Nutr 77 , Suppl. Int J Obes Lond 29 , — J Hum Nutr Diet 16 , 3— Addressing these methodological issues will advance the field of meal pattern research so that we can better understand meal pattern behaviours and their role in health.

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Understanding meal patterns: definitions, methodology and impact on nutrient intake. No more than half of the fruit provided by schools in juice form.

Vegetable serving increases: Grades K-8 should offer three-quarter cups per day, grades should offer 1 cup per day. Schools should offer starchy vegetables i.

For lunch, students should be offered two ounces on most days for all grades, with more flexibility for higher grades. Online resources for meal planning, meal patterns, and school food programs There are many online resources where you can learn more about programs like the National School Lunch Program and the School Breakfast program, as well as meal patterns and menu planning. Bookmark the permalink.