The Effect Of Eating Frequency On Total Energy Intake, Bmi Z-Score And Diet Quality In Children And Adolescents

To determine if eating frequency is associated with total energy intake, BMI z‐score and diet quality, measured by the Healthy Eating Index 2005 (HEI), in a nationally representative cross‐sectional sample of children and adolescents, we assessed the associations in 9,713 children, ages 2–18, studied in the National Health and Nutrition Examination Survey, 2005–2010. Eating frequency was determined using one in‐person 24‐hour recall. Multiple linear regression models were stratified by pediatric life stage group given statistically significant effect modification. Eating frequency was significantly and positively associated with total energy intake in each group without adjustment and after controlling for sex, race/ethnicity, poverty to income ratio and physical activity. Each additional eating occasion was associated with a 5.2% increase in total energy intake for preschool‐age children, a 6.5% increase in elementary school‐age children, and a 12% increase in adolescents (all p<.0001). The relationship between eating frequency and BMI z‐score was inverse and seen only in adolescents (β=−.10; p<.0001). Similarly, total HEI scores were related to eating frequency only in adolescents (β=0.74; p=.0002). Findings suggest that eating frequency is positively associated with energy intake and diet quality and inversely associated with BMI z‐score in adolescents, but not in young children.