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Cited by 379Nutritional Studies and DietNutrition, Health and Food BehaviorDietary Effects on Health

Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality

Open access
Leech, Rebecca M., Worsley, Anthony, Timperio, Anna, McNaughton, Sarah A.·2015·Nutrition Research Reviews
DOI 10.1017/s0954422414000262PMC PMC4501369
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Abstract

Traditionally, nutrition research has focused on individual nutrients, and more recently dietary patterns. However, there has been relatively little focus on dietary intake at the level of a ‘meal’. The purpose of the present paper was to review the literature on adults' meal patterns, including how meal patterns have previously been defined and their associations with nutrient intakes and diet quality. For this narrative literature review, a comprehensive search of electronic databases was undertaken to identify studies in adults aged ≥ 19 years that have investigated meal patterns and their association with nutrient intakes and/or diet quality. To date, different approaches have been used to define meals with little investigation of how these definitions influence the characterisation of meal patterns. This review identified thirty-four and fourteen studies that have examined associations between adults' meals patterns, nutrient intakes and diet quality, respectively. Most studies defined meals using a participant-identified approach, but varied in the additional criteria used to determine individual meals, snacks and/or eating occasions. Studies also varied in the types of meal patterns, nutrients and diet quality indicators examined. The most consistent finding was an inverse association between skipping breakfast and diet quality. No consistent association was found for other meal patterns, and little research has examined how meal timing is associated with diet quality. In conclusion, an understanding of the influence of different meal definitions on the characterisation of meal patterns will facilitate the interpretation of the existing literature, and may provide guidance on the most appropriate definitions to use.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative review synthesizes adult meal-pattern literature and finds that meal definitions vary widely, limiting comparability across studies. The most consistent finding is that skipping breakfast is inversely associated with diet quality and nutrient intake, while evidence for other meal patterns is inconsistent.

Key findings

  • The review identified 34 studies examining meal patterns and nutrient intakes and 14 studies examining meal patterns and overall diet quality. Most studies defined meals using a participant-identified approach, but varied in additional criteria such as time intervals, minimum energy thresholds, and whether beverages counted as separate eating occasions.
  • Breakfast skipping was consistently associated with lower micronutrient intakes and higher prevalence of not meeting recommended intakes for Ca, vitamin C, folate, vitamin A, and Mg. In diet-quality studies, 6 of 9 found a negative association between breakfast skipping and diet quality, while 3 found no association.
  • Eating frequency was associated with higher energy intake in 14 of 18 studies, but associations with nutrient intake were less consistent. Only 3 studies examined meal timing and energy/macronutrient intake; a higher proportion of energy consumed in the evening was positively associated with overall energy intake.
  • No consistent association was found for other meal patterns, and little research has examined how meal timing is associated with diet quality.

Methods

  • Narrative literature review with searches in PubMed and EMBASE using terms related to meals, snacks, eating frequency, diet quality, and nutrient intake; filters were journal article, humans, adult, and English. Two searches were conducted: February–May 2013 and February–April 2014.
  • Inclusion criteria were original research studies in free-living, healthy men and women aged ≥19 years that examined nutritional contributions of meal patterns or associations between meal patterns and nutrient intakes and/or overall diet quality. Studies in populations with conditions affecting meal patterns and studies examining energy intake only were excluded.
  • Diet quality was defined as overall food intake determined by compliance with national dietary guidelines or an a priori diet quality score. The synthesis was narrative and critical, not a meta-analysis.

Limitations

  • Stated in the paper: heterogeneity in meal definitions and additional criteria (time intervals, energy criteria, beverage inclusion) is a major impediment to interpreting findings across studies. Few studies adjusted for total energy intake and important sociodemographic/lifestyle factors, and meal-pattern questionnaires often had unreported reliability or validity.
  • Stated in the paper: energy misreporting was rarely examined; little research has examined meal format, context, meal timing, skipping meals other than breakfast, or beverage-only occasions.
  • Evident from the text: as a narrative review, it did not use a systematic quality appraisal or quantitative synthesis, and the search was restricted to two databases, English-language articles, and title/abstract fields, which may limit coverage.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1017/s0954422414000262

Cites

114 of 114 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 174 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    Most research in this area has focused on how different meal patterns make an impact on energy balance and weight status.

    “Most of the research in this area, however, has focused on how different meal patterns (also referred to as eating patterns) make an impact on energy balance and weight status( 5 , 6 ).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [5] Mesas AE, Munoz-Pareja M, Lopez-Garcia E, et al (2012) Selected eating behaviours and excess body weight: a systematic review. Obes Rev 13, 106– 135. 21955734 source

      Not checked in the free run.

    • cites [6] Szajewska H & Ruszczynski M (2010) Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Crit Rev Food Sci Nutr 50, 113– 119. 20112153 source

      Not checked in the free run.

  • Findingnone given

    The most consistent finding was an inverse association between skipping breakfast and diet quality.

    “The most consistent finding was an inverse association between skipping breakfast and diet quality.”
    Quote in the paperSubstantial claim
  • Findingcitation

    Previous reviews of the impact of different definitions on the interpretation of meal pattern studies have examined snacking only.

    “However, previous reviews of the impact of different definitions on the interpretation of meal pattern studies have examined snacking only( 7 , 8 ).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [7] Gregori D, Foltran F, Ghidina M, et al (2011) Understanding the influence of the snack definition on the association between snacking and obesity: a review. Int J Food Sci Nutr 62, 270– 275. 21118054 source

      Not checked in the free run.

    • cites [8] Johnson GH & Anderson GH (2010) Snacking definitions: impact on interpretation of the literature and dietary recommendations. Crit Rev Food Sci Nutr 50, 848– 871. 20924867 source

      Not checked in the free run.

  • Findingnone given

    Studies varied in the types of meal patterns, nutrients and diet quality indicators examined.

    “Studies also varied in the types of meal patterns, nutrients and diet quality indicators examined.”
    Quote in the paperNot a substantial claim
  • Findingown data

    This review identified fourteen studies that examined associations between adults' meal patterns and diet quality.

    “This review identified thirty-four and fourteen studies that have examined associations between adults' meals patterns, nutrient intakes and diet quality, respectively.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 26
  • May combine two claims. 45

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Little research has examined how meal timing is associated with diet quality.

    “little research has examined how meal timing is associated with diet quality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Most studies defined meals using a participant-identified approach, but varied in the additional criteria used to determine individual meals, snacks and/or eating occasions.

    “Most studies defined meals using a participant-identified approach, but varied in the additional criteria used to determine individual meals, snacks and/or eating occasions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Different approaches have been used to define meals with little investigation of how these definitions influence the characterisation of meal patterns.

    “To date, different approaches have been used to define meals with little investigation of how these definitions influence the characterisation of meal patterns.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Studies on meal patterning have differed in their approach to defining meals, and even within a given approach, there have been differences in the delineation of individual eating occasions, meals and/or snacks.

    “However, these studies have differed in their approach to defining meals, and even within a given approach, there have been differences in the delineation of individual EO, meals and/or snacks.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Findingnone given

    The time-of-day approach is easy to understand and apply.

    “While this approach is easy to understand and apply”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The time parameters used in the time-of-day approach are not always explicit.

    “the time parameters used are not always explicit”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The time-of-day approach usually restricts the number of meals per day to a maximum of three.

    “the number of meals per d is usually restricted to a maximum of three”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Findingreasoning

    A neutral definition can be standardised and can allow for comparison across different population groups and cultures.

    “The advantage of a neutral definition is that it can be standardised and can allow for comparison across different population groups and cultures.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Much data on meal patterns have been derived from dietary assessment methods such as 24 h recalls and food records.

    “Much data on meal patterns have been derived from dietary assessment methods such as 24 h recalls and food records.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    Additional criteria have been applied in the literature regarding the time intervals between eating occasions, a minimum-energy criterion to define each individual eating occasion, and whether beverage-only eating occasions are included or excluded.

    “However, despite this neutral definition, additional criteria have been applied in the literature with regards to the time intervals between EO, a minimum-energy criterion to define each individual EO and whether beverage-only EO are included or excluded.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    The main approaches to defining meals are participant-identified, time-of-day, food-based classification, and neutral.

    “The main approaches to defining meals are: participant-identified, time-of-day, food-based classification (FBC) and neutral.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Contextual information is not always collected as part of the recall or food record and thus only examination of meal patterning may be possible.

    “Contextual information is not always collected as part of the recall or food record and thus only examination of meal patterning may be possible.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    The food-based classification of eating occasions has had limited uptake, probably due to the complexity of the FBC criteria.

    “but generally the FBC of EO has had limited uptake, probably due to the complexity of the FBC criteria.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Time-of-day definitions were also common, as well as a combination of two definitions.

    “Time-of-day definitions were also common( 35 , 36 , 64 , 67 , 72 , 76 ) as well as a combination of two definitions (for example, self-identified and time-of-day, or time-of-day and type/combination of foods eaten)( 30 , 65 , 68 , 73 , 81 ).”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [35] Almoosawi S, Winter J, Prynne CJ, et al (2012) Daily profiles of energy and nutrient intakes: are eating profiles changing over time? Eur J Clin Nutr 66, 678– 686. 22190135 PMC3389619 source

      Not checked in the free run.

    • cites [36] Summerbell CD, Moody RC, Shanks J, et al (1995) Sources of energy from meals versus snacks in 220 people in four age groups. Eur J Clin Nutr 49, 33– 41. 7713049

      Not checked in the free run.

    • cites [64] Min C, Noh H, Kang YS, et al (2011) Skipping breakfast is associated with diet quality and metabolic syndrome risk factors of adults. Nutr Res Pract 5, 455– 463. 22125684 PMC3221832 source

      Not checked in the free run.

    • cites [67] Basdevant A, Craplet C & Guy-Grand B (1993) Snacking patterns in obese French women. Appetite 21, 17– 23. 8239632 source

      Not checked in the free run.

    • cites [72] Coates AO, Potter JD, Caan BJ, et al (2002) Eating frequency and the risk of colon cancer. Nutr Cancer 43, 121– 126. 12588690 source

      Not checked in the free run.

    • cites [76] Kant AK, Schatzkin A & Ballard-Barbash R (1997) Evening eating and subsequent long-term weight change in a national cohort. Int J Obes Relat Metab Disord 21, 407– 412. 9152744 source

      Not checked in the free run.

    • cites [30] Kearney JM, Hulshof KF & Gibney MJ (2001) Eating patterns – temporal distribution, converging and diverging foods, meals eaten inside and outside of the home – implications for developing FBDG. Public Health Nutr 4, 693– 698. 11683564 source

      Not checked in the free run.

    • cites [65] Roos E & Prättälä R (1997) Meal pattern and nutrient intake among adult Finns. Appetite 29, 11– 24. 9268421 source

      Not checked in the free run.

    • cites [68] Nicklas TA, Myers L, Reger C, et al (1998) Impact of breakfast consumption on nutritional adequacy of the diets of young adults in Bogalusa, Louisiana: ethnic and gender contrasts. J Am Diet Assoc 98, 1432– 1438. 9850113 source

      Not checked in the free run.

    • cites [73] Berner LA, Becker G, Wise M, et al (2013) Characterization of dietary protein among older adults in the United States: amount, animal sources, and meal patterns. J Acad Nutr Diet 113, 809– 815. 23491327 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Eleven studies applied no additional criteria, whereas other studies delineated eating occasions using 15-min, 30-min, 45-min plus 50 kcal, or 59-min intervals.

    “For example, eleven studies( 23 , 45 – 47 , 52 , 66 , 69 , 75 , 78 , 80 , 82 ) applied no additional criteria, whereas in other studies, EO were delineated using 15-min time intervals( 57 , 70 , 77 ), a 30-min interval( 53 ), a 45-min interval plus a 50 kcal (210 kJ) energy criterion( 15 ) and a 59-min interval (applied to meals only)( 48 ).”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [23] Deshmukh-Taskar PR, Radcliffe JD, Liu Y, et al (2010) Do breakfast skipping and breakfast type affect energy intake, nutrient intake, nutrient adequacy, and diet quality in young adults? NHANES 1999-2002. J Am Coll Nutr 29, 407– 418. 21041816 source

      Not checked in the free run.

    • cites [45] Berteus Forslund H, Torgerson JS, Sjostrom L, et al (2005) Snacking frequency in relation to energy intake and food choices in obese men and women compared to a reference population. Int J Obes (Lond) 29, 711– 719. 15809664 source

      Not checked in the free run.

    • cites [46] Hampl JS, Heaton CL & Taylor CA (2003) Snacking patterns influence energy and nutrient intakes but not body mass index. J Hum Nutr Diet 16, 3– 11. 12581404 source

      Not checked in the free run.

    • cites [47] Ovaskainen ML, Reinivuo H, Tapanainen H, et al (2006) Snacks as an element of energy intake and food consumption. Eur J Clin Nutr 60, 494– 501. 16319836 source

      Not checked in the free run.

    • cites [52] Kerver JM, Yang EJ, Obayashi S, et al (2006) Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults. J Am Diet Assoc 106, 46– 53. 16390666 source

      Not checked in the free run.

    • cites [66] Barr SI, DiFrancesco L & Fulgoni VL III (2013) Consumption of breakfast and the type of breakfast consumed are positively associated with nutrient intakes and adequacy of Canadian adults. J Nutr 143, 86– 92. 23173176 source

      Not checked in the free run.

    • cites [69] Williams P (2005) Breakfast and the diets of Australian adults: an analysis of data from the 1995 National Nutrition Survey. Int J Food Sci Nutr 56, 65– 79. 16019316 source

      Not checked in the free run.

    • cites [75] Khan MA & Lipke LK (1982) Snacking and its contribution to food and nutrient intake of college students. J Am Diet Assoc 81, 583– 587. 7130573 source

      Not checked in the free run.

    • cites [78] Edelstein SL, Barrett-Connor EL, Wingard DL, et al (1992) Increased meal frequency associated with decreased cholesterol concentrations; Rancho Bernardo, CA, 1984-1987. Am J Clin Nutr 55, 664– 669. 1550041 source

      Not checked in the free run.

    • cites [80] Holmbäck I, Ericson U, Gullberg B, et al (2010) A high eating frequency is associated with an overall healthy lifestyle in middle-aged men and women and reduced likelihood of general and central obesity in men. Br J Nutr 104, 1065– 1073. 20500929 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Meal patterns were mostly participant-identified, although these studies varied in the additional criteria used to determine an individual eating occasion, meal and/or snack, and their treatment of beverages.

    “Meal patterns were mostly participant-identified( 15 , 23 , 45 – 48 , 52 , 53 , 57 , 66 , 69 , 70 , 75 , 77 , 78 , 82 ), although these studies varied in the additional criteria used to determine an individual EO, meal and/or snack, and their treatment of beverages.”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [15] Bellisle F, Dalix AM, Mennen L, et al (2003) Contribution of snacks and meals in the diet of French adults: a diet-diary study. Physiol Behav 79, 183– 189. 12834789 source

      Not checked in the free run.

    • cites [23] Deshmukh-Taskar PR, Radcliffe JD, Liu Y, et al (2010) Do breakfast skipping and breakfast type affect energy intake, nutrient intake, nutrient adequacy, and diet quality in young adults? NHANES 1999-2002. J Am Coll Nutr 29, 407– 418. 21041816 source

      Not checked in the free run.

    • cites [45] Berteus Forslund H, Torgerson JS, Sjostrom L, et al (2005) Snacking frequency in relation to energy intake and food choices in obese men and women compared to a reference population. Int J Obes (Lond) 29, 711– 719. 15809664 source

      Not checked in the free run.

    • cites [46] Hampl JS, Heaton CL & Taylor CA (2003) Snacking patterns influence energy and nutrient intakes but not body mass index. J Hum Nutr Diet 16, 3– 11. 12581404 source

      Not checked in the free run.

    • cites [47] Ovaskainen ML, Reinivuo H, Tapanainen H, et al (2006) Snacks as an element of energy intake and food consumption. Eur J Clin Nutr 60, 494– 501. 16319836 source

      Not checked in the free run.

    • cites [48] Howarth NC, Huang TT, Roberts SB, et al (2007) Eating patterns and dietary composition in relation to BMI in younger and older adults. Int J Obes (Lond) 31, 675– 684. 16953255 source

      Not checked in the free run.

    • cites [52] Kerver JM, Yang EJ, Obayashi S, et al (2006) Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults. J Am Diet Assoc 106, 46– 53. 16390666 source

      Not checked in the free run.

    • cites [53] Ovaskainen ML, Tapanainen H & Pakkala H (2010) Changes in the contribution of snacks to the daily energy intake of Finnish adults. Appetite 54, 623– 626. 20347899 source

      Not checked in the free run.

    • cites [57] Zizza C, Siega-Riz AM & Popkin BM (2001) Significant increase in young adults' snacking between 1977-1978 and 1994-1996 represents a cause for concern! Prev Med 32, 303– 310. 11304090 source

      Not checked in the free run.

    • cites [66] Barr SI, DiFrancesco L & Fulgoni VL III (2013) Consumption of breakfast and the type of breakfast consumed are positively associated with nutrient intakes and adequacy of Canadian adults. J Nutr 143, 86– 92. 23173176 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In these studies, a higher eating frequency was also associated with higher nutrient densities of folate, vitamin C and Fe, and Ca and K.

    “In these studies, a higher eating frequency was also associated with higher nutrient densities of folate, vitamin C and Fe( 52 , 80 ), and Ca and K( 52 ).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [52] Kerver JM, Yang EJ, Obayashi S, et al (2006) Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults. J Am Diet Assoc 106, 46– 53. 16390666 source

      Not checked in the free run.

    • cites [80] Holmbäck I, Ericson U, Gullberg B, et al (2010) A high eating frequency is associated with an overall healthy lifestyle in middle-aged men and women and reduced likelihood of general and central obesity in men. Br J Nutr 104, 1065– 1073. 20500929 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Two large population-based studies, one in US adults and one in Swedish adults, found that those who ate six or more times per day had higher intakes of carbohydrate and fibre but lower intakes of fat and protein compared with adults who ate once or twice per day or less than three times per day, respectively.

    “Two large population-based studies, one in US adults( 52 ) and the other in Swedish adults( 80 ), found that those who ate six or more times per d had higher intakes of carbohydrate and fibre but lower intakes of fat and protein compared with adults who ate once or twice per d or less than three times per d, respectively.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [52] Kerver JM, Yang EJ, Obayashi S, et al (2006) Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults. J Am Diet Assoc 106, 46– 53. 16390666 source

      Not checked in the free run.

    • cites [80] Holmbäck I, Ericson U, Gullberg B, et al (2010) A high eating frequency is associated with an overall healthy lifestyle in middle-aged men and women and reduced likelihood of general and central obesity in men. Br J Nutr 104, 1065– 1073. 20500929 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Two studies reported that snacks provided a greater percentage of total sugars but not total carbohydrate than meals.

    “Interestingly, two studies( 36 , 81 ) reported that snacks provided a greater percentage of total sugars but not total carbohydrate than meals”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [36] Summerbell CD, Moody RC, Shanks J, et al (1995) Sources of energy from meals versus snacks in 220 people in four age groups. Eur J Clin Nutr 49, 33– 41. 7713049

      Not checked in the free run.

    • cites [81] Winkler G, Döring A & Keil U (1999) Meal patterns in middle-aged men in Southern Germany: results from the MONICA Augsburg dietary survey 1984/85. Appetite 32, 33– 37. 9989911 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Another study reported no association between snacking between meals and diet quality, and Kim & Kim found that a HEI score significantly decreased according to each increased quartile of a snack-dominant eating score.

    “Conversely, another study reported no association between snacking between meals and diet quality( 91 ), and Kim & Kim( 83 ) found that a HEI score significantly decreased according to each increased quartile of a snack-dominant eating score (high snack frequency and low meal frequency) (P< 0·01).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [91] Dewolfe J & Millan K (2003) Dietary intake of older adults in the Kingston area. Can J Diet Pract Res 64, 16– 24. 12631405 source

      Not checked in the free run.

    • cites [83] Kim SY & Kim SM (2010) Energy intake and snack choice by the meal patterns of employed people. Nutr Res Pract 4, 43– 50. 20198208 PMC2830414 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Of the nine studies identified that examined associations between skipping breakfast and diet quality, six found a negative association and three found no association.

    “Of the nine studies identified that examined associations between skipping breakfast and diet quality, six found a negative association( 22 , 23 , 86 , 87 , 90 , 94 ) and three found no association( 28 , 91 , 93 ).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [22] Smith KJ, Gall SL, McNaughton SA, et al (2010) Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study. Am J Clin Nutr 92, 1316– 1325. 20926520 source

      Not checked in the free run.

    • cites [23] Deshmukh-Taskar PR, Radcliffe JD, Liu Y, et al (2010) Do breakfast skipping and breakfast type affect energy intake, nutrient intake, nutrient adequacy, and diet quality in young adults? NHANES 1999-2002. J Am Coll Nutr 29, 407– 418. 21041816 source

      Not checked in the free run.

    • cites [86] Mekary RA, Giovannucci E, Cahill L, et al (2013) Eating patterns and type 2 diabetes risk in older women: breakfast consumption and eating frequency. Am J Clin Nutr 98, 436– 443. 23761483 PMC3712552 source

      Not checked in the free run.

  • May combine two claims.

    Findingreasoning

    Meal patterns were mostly assessed using a participant-identified approach; however, the methods used to measure participants' eating occasions varied across studies.

    “Meal patterns were mostly assessed using a participant-identified approach( 23 , 56 , 85 , 86 , 88 – 91 ); however, the methods used to measure participants' EO also varied across these studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A total of six studies examined the influence of breakfast skipping on nutrient intakes and only one study examined the nutritional impact of omitting the lunch or dinner meal.

    “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.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    Measures of eating frequency may include beverage-only occasions, but these types of eating occasions have not always been considered when examining the relationship between meal patterns and nutritional intake.

    “Measures of eating frequency may include beverage-only occasions, however, these types of EO have not always been considered when examining the relationship between meal patterns and nutritional intake.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    To date, a variety of definitions has been used to examine meal patterns.

    “To date, a variety of definitions has been used to examine meal patterns.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Studies examining eating frequency differ in the methods used to define meals and snacks and in the time-gap used to separate individual eating occasions, which may affect the reported frequency of eating occasions.

    “studies that have examined eating frequency (including meal and/or snack frequency) differ in both the methods used to define meals and snacks and the time-gap to separate individual EO, which may make an impact on the frequency of the respective EO reported.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingnone given

    The nutritional impact of snack, meal and overall eating frequency remains unclear, and little research has examined how meal timing influences nutritional intake or overall diet quality.

    “In addition the nutritional impact of snack, meal and overall eating frequency remains unclear and little research has looked at the how meal timing influences nutritional intake/overall diet quality.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Research suggests that different meal and/or snack patterns are related to both nutrient intakes and overall diet quality, with the most consistent finding being an inverse relationship between skipping breakfast and nutrient intakes/diet quality.

    “Research suggests that different meal and/or snack patterns are related to both nutrient intakes and overall diet quality, with the most consistent finding being an inverse relationship between skipping breakfast and nutrient intakes/diet quality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Most meal or snack definitions include beverages alongside food, but not all studies explicitly considered a beverage-only occasion as a separate eating occasion.

    “while most meal or snack definitions include beverages alongside food, not all studies explicitly considered a beverage-only occasion as a separate EO( 40 , 41 , 67 , 72 , 78 , 82 ).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [40] Drummond SE, Crombie NE, Cursiter MC, et al (1998) Evidence that eating frequency is inversely related to body weight status in male, but not female, non-obese adults reporting valid dietary intakes. Int J Obes Relat Metab Disord 22, 105– 112. 9504318 source

      Not checked in the free run.

    • cites [41] Duval K, Strychar I, Cyr MJ, et al (2008) Physical activity is a confounding factor of the relation between eating frequency and body composition. Am J Clin Nutr 88, 1200– 1205. 18996853 source

      Not checked in the free run.

    • cites [67] Basdevant A, Craplet C & Guy-Grand B (1993) Snacking patterns in obese French women. Appetite 21, 17– 23. 8239632 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Breakfast skipping was consistently inversely associated with diet quality in six out of nine studies, despite the different definitions used (time-of-day and participant-identified), and in some cases no clear definition was provided.

    “Breakfast skipping was consistently inversely associated with diet quality in six out of nine studies, despite the different definitions used (time-of-day( 88 , 94 ) and participant identified( 22 , 23 , 28 , 86 , 90 )), and in some cases, no clear definition was provided( 87 , 93 ).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [88] Kim S, DeRoo LA & Sandler DP (2011) Eating patterns and nutritional characteristics associated with sleep duration. Public Health Nutr 14, 889– 895. 21029511 PMC3179429 source

      Not checked in the free run.

    • cites [94] Azadbakht L, Haghighatdoost F, Feizi A, et al (2013) Breakfast eating pattern and its association with dietary quality indices and anthropometric measurements in young women in Isfahan. Nutrition 29, 420– 425. 23312764 source

      Not checked in the free run.

    • cites [22] Smith KJ, Gall SL, McNaughton SA, et al (2010) Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study. Am J Clin Nutr 92, 1316– 1325. 20926520 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Studies examining associations between meal timing and diet quality are rare.

    “Studies examining associations between meal timing and diet quality are rare.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    Because of the limited dietary assessment methods available, most research has focused on meal patterning.

    “However, due to the limited dietary assessment methods available, most research has focused on meal patterning.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    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.

    “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.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Few applications of innovative statistical techniques to examining meal patterns have been tested in the literature.

    “Further work is also required in developing and applying innovative statistical techniques to examining meal patterns, with few applications tested in the literature.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Findingnone given

    A major issue still remains of the different definitions available to researchers when conducting meal patterns research.

    “A major issue still remains of the different definitions available to researchers when conducting meal patterns research.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    FFQ provide estimates of the frequency and types of foods that are usually consumed, but do not provide data that directly allow examination of eating occasions.

    “While FFQ provide estimates of the frequency and types of foods that are usually consumed, they do not provide data that directly allow examination of EO”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Meals have been described according to three constructs: patterning, format, and context.

    “Meals have been described according to three constructs: (1) patterning (for example, frequency, spacing, regularity, skipping, timing); (2) format (for example, types of food combinations, sequencing of foods, nutrient profile/content); and (3) context (for example, eating with others or with the family, eating in front of the television or out of the home) (Table 1)( 10 – 13 ).”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [10] Meiselman HL (2009) Dimensions of the meal: a summary. In Meals in Science and Practice: Interdisciplinary Research and Business Applications, [ Meiselman HL, editor]. Boca Raton, FL: CRC Press, Woodhead Publishing Ltd. source

      Not checked in the free run.

    • cites [11] Mäkelä J, Kjaernes U, Pipping Ekström M, et al (1999) Nordic meals: methodological notes on a comparative survey. Appetite 32, 73– 79. 9989916 source

      Not checked in the free run.

    • cites [12] Bisogni CA, Falk LW, Madore E, et al (2007) Dimensions of everyday eating and drinking episodes. Appetite 48, 218– 231. 17088011 source

      Not checked in the free run.

    • cites [13] Mattes RD (2008) Food palatability, rheology, and meal patterning. JPEN J Parenter Enteral Nutr 32, 572– 574. 18753396 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In a prospective study of 1253 UK adults, lunch and evening meal contributed the greatest proportion of total daily energy, protein, fat and carbohydrate intake, consistent over time.

    “In a prospective study of 1253 adults from the UK, Almoosawi et al. ( 35 ) examined 17-year changes in the contributions of breakfast, lunch and dinner to macronutrient intake. The authors found that the lunch and evening meal contributed the greatest proportion of total daily energy, protein, fat and carbohydrate intake, which was consistent over time.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Almoosawi S, Winter J, Prynne CJ, et al (2012) Daily profiles of energy and nutrient intakes: are eating profiles changing over time? Eur J Clin Nutr 66, 678– 686. 22190135 PMC3389619 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Roos & Prättälä found that, per unit of energy, meals contributed more fibre and carotenoids but less sugar, vitamin C and alcohol than snacks.

    “Roos & Prättälä( 65 ) examined the impact of adherence to a conventional Finnish meal pattern (breakfast, warm lunch and warm dinner plus two snacks) among 1861 adults aged 25–64 years and found, per unit of energy, that meals contributed more fibre and carotenoids but less sugar, vitamin C and alcohol than snacks.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [65] Roos E & Prättälä R (1997) Meal pattern and nutrient intake among adult Finns. Appetite 29, 11– 24. 9268421 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Winkler et al. noted that snacks eaten after lunchtime contained less protein and fibre than the morning snack.

    “Winkler et al. ( 81 ) noted that snacks eaten after lunchtime contained less protein and fibre than the morning snack.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [81] Winkler G, Döring A & Keil U (1999) Meal patterns in middle-aged men in Southern Germany: results from the MONICA Augsburg dietary survey 1984/85. Appetite 32, 33– 37. 9989911 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In the same study, snacks were important contributors of Fe and Ca intake among women, whose meal contributions of these micronutrients were only about 65% and about 79% of the RDA, respectively.

    “In the same study, snacks were important contributors of Fe and Ca intake among women, whose meal contributions of these micronutrients were only about 65 % and about 79 % of the RDA, respectively.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [75] Khan MA & Lipke LK (1982) Snacking and its contribution to food and nutrient intake of college students. J Am Diet Assoc 81, 583– 587. 7130573 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    Adjustment for multiple important sociodemographic and lifestyle-related confounders and exclusion of energy misreporters did not attenuate the significance of the results in these two studies.

    “Adjustment for multiple important sociodemographic and lifestyle-related confounders( 52 ) and exclusion of energy misreporters( 80 ) did not attenuate the significance of the results in these two studies.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [52] Kerver JM, Yang EJ, Obayashi S, et al (2006) Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults. J Am Diet Assoc 106, 46– 53. 16390666 source

      Not checked in the free run.

    • cites [80] Holmbäck I, Ericson U, Gullberg B, et al (2010) A high eating frequency is associated with an overall healthy lifestyle in middle-aged men and women and reduced likelihood of general and central obesity in men. Br J Nutr 104, 1065– 1073. 20500929 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The finding that meals contributed more fibre and carotenoids but less sugar, vitamin C and alcohol than snacks remained consistent across sex and after adjustment for age and region.

    “This finding remained consistent across sex and after adjustment for age and region.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [65] Roos E & Prättälä R (1997) Meal pattern and nutrient intake among adult Finns. Appetite 29, 11– 24. 9268421 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Among a large sample of US men and women, an increasing proportion of energy consumed after 17.00 hours was associated with an increase in mean daily alcohol intake but a decrease in mean carbohydrate intake.

    “Among a large sample of US men and women, an increasing proportion of energy consumed after 17.00 hours was associated with an increase in mean daily alcohol intake but a decrease in mean carbohydrate intake (P< 0·05).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [76] Kant AK, Schatzkin A & Ballard-Barbash R (1997) Evening eating and subsequent long-term weight change in a national cohort. Int J Obes Relat Metab Disord 21, 407– 412. 9152744

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The lack of association in two of the latter studies may be explained by their respective study populations: overall diet quality was high among men in the US Health Professionals Follow-up study, and Dewolfe & Millan used a small convenience sample of older adults from a single region in Canada.

    “However, the lack of association in two of these latter studies may be explained by their respective study populations; overall diet quality was high among men in the US Health Professionals Follow-up study( 28 ) while Dewolfe & Millan( 91 ) used a small convenience sample of eighty-four female and twenty-one male older adults from a single region in Canada.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [28] Cahill LE, Chiuve SE, Mekary RA, et al (2013) Prospective study of breakfast eating and incident coronary heart disease in a cohort of male US health professionals. Circulation 128, 337– 343. 23877060 PMC3797523 source

      Not checked in the free run.

    • cites [91] Dewolfe J & Millan K (2003) Dietary intake of older adults in the Kingston area. Can J Diet Pract Res 64, 16– 24. 12631405 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Although there has been general consensus that a universally accepted definition of a meal is crucial, there have been few attempts to define meals in a consistent and standardised way.

    “Although over the past few decades there has been general consensus that a universally accepted definition of a meal is crucial( 54 , 98 ), there have been few attempts to define meals in a consistent and standardised way.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [54] Gibney MJ & Wolever TM (1997) Periodicity of eating and human health: present perspective and future directions. Br J Nutr 77, Suppl. 1, S3– S5. 9155489 source

      Not checked in the free run.

    • cites [98] Oltersdorf U, Schlettwein-Gsell D & Winkler G (1999) Assessing eating patterns – an emerging research topic in nutritional sciences: introduction to the symposium. Appetite 32, 1– 7. 9989907 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    In allowing participants to identify meals and snacks, subjective decision-making is inherently present.

    “In allowing participants to identify meals and snacks, subjective decision-making is inherently present.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Larger time intervals used to separate eating occasions may cause eating occasions, including beverage-only occasions, to be overlooked, which may affect associations between eating frequency and energy and nutrient intakes.

    “In addition, larger time intervals used to separate EO may result in EO, including beverage-only occasions, being overlooked and this may affect associations between eating frequency and energy and nutrient intakes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The lexical and semantic features of questionnaire items can differ between studies and may influence participant responses.

    “The lexical and semantic features of questionnaire items can differ between studies and may influence participant responses( 97 ).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [97] Schwarz N (1999) Self-reports: how the questions shape the answers. Am Psychol 54, 93– 105. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Potential overlap in the meal patterns being examined further complicates comparisons between studies.

    “Another important consideration for future research examining eating frequency is potential overlap in the meal patterns that are being examined, which further complicates comparisons between studies.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Although it is widely acknowledged that different definitions used to define meals and snacks are likely to hamper interpretation of findings across studies, research explicitly examining the impact of these different definitions is rare.

    “Although it is widely acknowledged that different definitions used to define meals/snacks are likely to hamper interpretation of findings across studies( 8 , 44 ), research explicitly examining the impact of these different definitions is rare( 55 ).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [8] Johnson GH & Anderson GH (2010) Snacking definitions: impact on interpretation of the literature and dietary recommendations. Crit Rev Food Sci Nutr 50, 848– 871. 20924867 source

      Not checked in the free run.

    • cites [44] Gatenby SJ (1997) Eating frequency: methodological and dietary aspects. Br J Nutr 77, Suppl. 1, S7– S20. 9155490 source

      Not checked in the free run.

    • cites [55] Murakami K & Livingstone MB (2014) Eating frequency in relation to body mass index and waist circumference in British adults. Int J Obes (Lond) 38, 1200– 1206. 24406480 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Without a clear definition, misclassification bias is likely, thus affecting the interpretation of associations with nutrients both within and across studies.

    “Without a clear definition misclassification bias is likely, thus affecting the interpretation of associations with nutrients both within and across studies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Emerging evidence supports a role of sugar-sweetened beverages in the aetiology of obesity and cardiometabolic risk.

    “This may be an important consideration given the emerging evidence of sugar-sweetened beverages (SSB) in the aetiology of obesity( 102 , 103 ) and cardiometabolic risk( 104 , 105 ).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [102] Malik VS, Schulze MB & Hu FB (2006) Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 84, 274– 288. 16895873 PMC3210834 source

      Not checked in the free run.

    • cites [103] Malik VS, Pan A, Willett WC, et al (2013) Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr 98, 1084– 1102. 23966427 PMC3778861 source

      Not checked in the free run.

    • cites [104] Bhupathiraju SN, Pan A, Malik VS, et al (2013) Caffeinated and caffeine-free beverages and risk of type 2 diabetes. Am J Clin Nutr 97, 155– 166. 23151535 PMC3522135 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    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. snacks, meal skipping or meal timing.

    “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. snacks, meal skipping or meal timing.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In a recent study, compared with a definition including all energy-containing eating occasions, a definition using a minimum energy criterion of ≥210 kJ produced a stronger correlation between eating frequency and energy intake (men: r=0.45 vs 0.53; women: r=0.39 vs 0.57), and this remained after excluding energy misreporters.

    “A recent study( 55 ) showed that, compared with a definition that included all energy-containing EO, there was a stronger correlation between eating frequency and EI after applying a definition that used a minimum energy criterion of ≥ 210 kJ (men: r 0·45 v. 0·53; women r 0·39 v. 0·57, respectively), which remained after excluding energy misreporters.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [55] Murakami K & Livingstone MB (2014) Eating frequency in relation to body mass index and waist circumference in British adults. Int J Obes (Lond) 38, 1200– 1206. 24406480 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    A number of additional criteria have been adopted in meal pattern research, which may affect the types of meal patterns reported and described in the literature.

    “In addition, a number of additional criteria have been adopted in meal pattern research, which may have an impact on the types of meal patterns reported and described in the literature.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    Because few studies have examined associations between meal patterns and diet quality, the impact of different meal definitions is difficult to assess.

    “As few studies have examined associations between meal patterns and diet quality, the impact of different meal definitions is difficult to assess.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationnone given

    While a time-of-day approach can be applied consistently for all participants, it may not capture meals and snacks eaten at varied times.

    “While a time-of-day approach can be applied consistently for all participants, it may not capture meals and snacks eaten at varied times.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    Skipping meals other than breakfast has rarely been examined but may be important, particularly for vulnerable groups such as the elderly.

    “Skipping meals other than breakfast has rarely been examined but may be important, particularly for vulnerable groups such as the elderly( 69 , 91 ).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [69] Williams P (2005) Breakfast and the diets of Australian adults: an analysis of data from the 1995 National Nutrition Survey. Int J Food Sci Nutr 56, 65– 79. 16019316 source

      Not checked in the free run.

    • cites [91] Dewolfe J & Millan K (2003) Dietary intake of older adults in the Kingston area. Can J Diet Pract Res 64, 16– 24. 12631405 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    Questions regarding meals in questionnaires may not be well defined, and this may extend to how respondents should consider beverages.

    “Importantly, questions regarding meals in questionnaires may not be well defined and this may extend to how respondents should consider beverages.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    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.

    “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.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Specific food records have been adapted to collect contextual information (for example, the Weekly Food Diary method), but this method also involves a high participant burden.

    “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.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] de Castro JM (1987) Macronutrient relationships with meal patterns and mood in the spontaneous feeding behavior of humans. Physiol Behav 39, 561– 569. 3588700 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The heterogeneity of meal definitions is a major impediment to the interpretation of findings across studies in this field of research.

    “The heterogeneity of meal definitions is a major impediment to the interpretation of findings across studies in this field of research.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Beverage-only occasions may be especially relevant among certain subgroups of the population; for example, adolescent and young adult males have been shown to be high consumers of sugar-sweetened beverages.

    “Moreover, beverage-only occasions may be especially relevant among certain subgroups of the population; for example, adolescent and young adult males have been shown to be high consumers of SSB( 106 ).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [106] Australian Bureau of Statistics (2014) Soft Drink, Burgers and Chips – The Diet of Our Youth. Australian Health Survey: Nutrition First Results – Foods and Nutrients, 2011–12. Canberra: ABS, Cat. no. 4364·0·55·007.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Because eating frequency is positively related to energy intake, it may be that those who under-report energy intake also under-report their eating frequency.

    “As eating frequency is positively related to EI, it may be that those who under-report EI also under-report their eating frequency( 45 , 108 ).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [45] Berteus Forslund H, Torgerson JS, Sjostrom L, et al (2005) Snacking frequency in relation to energy intake and food choices in obese men and women compared to a reference population. Int J Obes (Lond) 29, 711– 719. 15809664 source

      Not checked in the free run.

    • cites [108] Bellisle F, McDevitt R & Prentice AM (1997) Meal frequency and energy balance. Br J Nutr 77, Suppl. 1, S57– S70. 9155494 source

      Not checked in the free run.

65 of 65

  • The paper relies on this without support.

    People consume combinations of foods as meals and snacks rather than as individual foods and nutrients.

    “However, people consume combinations of foods as meals and snacks rather than as individual foods and nutrients.”

  • The paper relies on this without support.

    Understanding the nutritional composition of meals and the ways in which different meal patterns make an impact on diet quality might help to elucidate important diet–disease relationships.

    “Understanding the nutritional composition of meals and the ways in which different meal patterns make an impact on diet quality might help to elucidate important diet–disease relationships.”

  • The paper relies on this without support.

    Meal patterns are multidimensional and can be described according to their patterning, format and context.

    “Meal patterns are multidimensional and can be described according to their patterning, format and context.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A recent prospective cohort study from Norway by Wennberg et al. found that irregular eating of meals at age 16 years was associated with a higher prevalence of the metabolic syndrome 27 years later at age 43 years in 889 participants.

    “These findings were confirmed by a recent prospective cohort study from Norway by Wennberg et al. (39) who found that irregular eating of meals at age 16 years was associated with a higher prevalence of the metabolic syndrome 27 years later at age 43 years in 889 participants.”

    From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [39]

  • In the Wennberg et al. study, the association was largely explained by an unhealthy lifestyle at age 16 years and when correcting for lifestyle factors, the only statistically significant association was observed for poor breakfast consumption.

    “However, they found that this was largely explained by an unhealthy lifestyle at age 16 years and when correcting for lifestyle factors (such as BMI at age 16 years, smoking, alcohol consumption, physical activity and consumption of sweets and pastries at age 16 years), the only statistically significant association was observed for poor breakfast consumption.”

    From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [39]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Breakfast consumers and skippers are assigned opposite nutrient-inadequacy results

    Major

    Table 3 says a higher percentage of breakfast consumers failed to meet the RDA thresholds in the Nicklas study. The narrative cites that same study (68) as evidence that breakfast skippers had a higher prevalence of inadequate intakes, reversing the comparison.

  • Dewolfe study's participant sexes are reversed

    Minor

    Table 4 reports eighty-four men and twenty-one women, whereas the narrative describes eighty-four women and twenty-one men.

  • Two different meal contributions to women's iron RDA are given

    Minor

    Table 3 says meals provided about 57·5 % of women's iron RDA in the Khan study; the narrative gives about 65 % for the same contribution.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. 2014, Soft Drink, Burgers and Chips – The Diet of Our Youth. Australian Health Survey: Nutrition First Results – Foods and Nutrients, 2011–12

Cited by

Sorted by citations

Related

Authors
Leech, R. M., Worsley, A., Timperio, A., & McNaughton, S. A.
Affiliations
Deakin University (AU)
Corresponding author
Leech, Rebecca M.
ORCID
Venue
Nutrition Research Reviews
Publisher
Cambridge University Press (CUP)
Published
2015-03-19
Volume
28
Issue
1
Pages
1-21
ISSN
  • 0954-4224 (ISSN-L)
  • 1475-2700
DOI
10.1017/s0954422414000262
PMC
PMC4501369
OpenAlex
W1993708032
Cited by
379
References
114
Citations by year
2026: 15 · 2025: 31 · 2024: 40 · 2023: 32 · 2022: 40 · 2021: 57 · 2020: 40 · 2019: 39 · 2018: 36 · 2017: 23 · 2016: 17 · 2015: 7 · 2014: 1
FWCI
4.01
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrition Research Reviews (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Medicine › Physiology › Dietary Effects on Health
Keywords
meal patterns, meal timing, breakfast skipping, nutrient intake, diet quality, eating occasions, snacks, adults
MeSH terms
Adult, Energy Intake, Diet, Feeding Behavior, Food, Humans, Nutritive Value, Time Factors, Diet Records, Meals, Breakfast, Snacks, Food Quality

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

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