Meal patterns and frequencies: do they affect body weight in children and adolescents?

Some previous studies reported a higher meal frequency associated with a lower body weight both in obese and in normal weight adults. We review recent studies addressing the relation between meal frequency and obesity risk in children and adolescents. In a Medline search, we identified 5 observational studies published between 2004 and 2009 that reviewed data on a total of 13,998 children and adolescents from the United States, Germany, and Portugal. Three of the five studies found a significant reduction of obesity risk with increasing number of meals, which persisted after adjustment for confounders, while the two other studies found a non-significant trend in the same direction. Given the consistent association of skipping meals with an increased obesity risk in children, it appears prudent to promote a regular meal pattern with 5 meals per day with adequate composition to children and their families. Prospective controlled trials to assess the protective potential of promoting regular and frequent meals in children and their families are highly desirable to strengthen the evidence base for such preventive approaches, which should explore the feasibility and effects of interventions.