The Relationship between Eating Occasions and BMI Percentile in School Children

Abstract

The relationship between meal frequency and BMI percentile in school-children by Savannah J. Goldsbury. Dietetics & Nutrition; University of Kansas Medical Center, Kansas City, KS

Purpose: To identify the relationship between meal frequency and BMI in children. Methods: This was a cross-sectional study involving 1,004 children in grades 3-5 (age 7-12 y) from 12 elementary schools within the Kansas City, KS Public School District. Each child completed one testing day of height and weight measurements to determine BMI percentiles (BMI%). Number of eating occasions per day (EO), and total energy intake (EI) were identified using a multiple pass 24-hr diet recall administered by trained nutrition staff. Correlation analyses were performed to determine relationships between BMI%, EO, and EI. BMI% was also examined according to EO categorized as >3, 3 - 4, and ≥5 using ANOVA. Regression analysis was used to determine the best predictors of BMI%. Results: BMI% was 73 ± 27% ; EO was 4 ± 1 (range: 1-8); EI was 1,674± 784 kcals (range: 104-7,273). A lower BMI% was associated with a greater number of EO(r= -0.089; p<0.01). A greater number of EO was also associated with a higher EI(r= 0.543; p<0.001). Main effects of categorized EO were observed for BMI% (p<0.05). Children that had >3 EO had higher BMI% (80± 23%) compared to those who had 3-4 (73± 27; p< 0.01), and those who had >5 (72± 28; p< 0.01). The best fit model for predicting BMI% included EI, gender, and race/ethnicity (R2= 0.27). A higher BMI% was predicted by a lower EI (β= -0.102; p<0.001), being male (β= -0.093; p<0.01), and by being white Hispanic (β= 0.079; p<0.05). Conclusion: Increased EO in combination with increased EI is associated with a lower BMI% in children. Gender and race/ethnicity also play a role in BMI%. The relationship between BMI% and EI may be a result of underreporting, but it is unknown whether this translates to EO. The strong correlation between EI and EO may be masking the influence of EO on BMI%. The results suggest that increasing EO may be a beneficial strategy in combating obesity.