Cited by 102Nutritional Studies and DietDietary Effects on HealthNutrition, Health and Food Behavior

The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index; none of the 13 sources its claims cite is checked for support yet.

Irregular consumption of energy intake in meals is associated with a higher cardiometabolic risk in adults of a British birth cohort

Open access
Pot, G K, Hardy, R, Stephen, A M·2014·International Journal of Obesity

Abstract

Background/Objectives:A potential risk factor for cardiometabolic diseases is irregular or inconsistent eating, however, research on this topic is scarce. We aimed to study associations between irregular consumption of energy intake in meals and cardiometabolic risk factors.Subject and Methods:Dietary intake data were derived from 5-day estimated diet diaries of 1768 participants of the National Survey of Health and Development. Energy intakes during predefined meals (breakfast, lunch, dinner, between meals) and daily totals were analyzed using a score for irregularity based on the deviation from the 5-day mean energy intake. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for having the metabolic syndrome or one of its components. Models were adjusted for sex, physical activity, socioeconomic status, marital status and smoking.Results:Irregularity scores of energy intake ranged from 0–160 and were highest for between meals. An increased risk of the metabolic syndrome was associated with more irregular energy intake during breakfast (OR=1.34 (0.99, 1.81); P trend=0.04) and between meals (OR=1.36 (1.01, 1.85); P trend=0.04). Moreover, increased waist circumference was associated with irregular energy intake during breakfast (OR=1.90 (1.47, 2.45); P trend <0.01), evening meal (OR=1.36 (1.06, 1.75); P trend=0.02) and daily total (OR=1.34 (1.04, 1.72); P trend=0.01). No significant associations were found for the other components of the metabolic syndrome.Conclusions:Individuals with a more irregular intake of energy, especially during breakfast and between meals, appeared to have an increased cardiometabolic risk.

Overview

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TL;DR

In 1768 British birth cohort participants aged 53, irregular energy intake at breakfast and between meals was associated with higher odds of metabolic syndrome, and irregular intake at several meals was associated with higher waist circumference and BMI. No significant associations were found for the other ATP-III metabolic syndrome components in the main analyses.

Key findings

  • Irregularity scores ranged from 0–160 for breakfast, lunch, evening meal, and between meals, and 0–79 for daily total; scores were highest for between meals.
  • Metabolic syndrome was associated with more irregular energy intake at breakfast (OR 1.34, 95% CI 0.99–1.81; p trend 0.04) and between meals (OR 1.36, 95% CI 1.01–1.85; p trend 0.04); after further adjustment for energy intake at other meals, breakfast OR was 1.38 (1.01–1.87; p trend 0.03) and between meals OR was 1.38 (1.01–1.86; p trend 0.04).
  • Increased waist circumference was associated with irregular energy intake at breakfast (OR 1.90, 1.47–2.45), evening meal (OR 1.36, 1.06–1.75), and daily total (OR 1.34, 1.04–1.72). Increased BMI was associated with irregular intake at breakfast (OR 1.46, 1.14–1.87), evening meal (OR 1.62, 1.27–2.06), between meals (OR 1.35, 1.06–1.72), and daily total (OR 1.45, 1.14–1.85).
  • No significant associations were found for the other ATP-III metabolic syndrome components in the main analyses; secondary linear models reported higher plasma triglycerides with irregular breakfast intake.

Methods

  • Longitudinal birth cohort study using the MRC National Survey of Health and Development (NSHD); 1768 participants at age 53 had dietary and metabolic syndrome data. Dietary intake came from 5-day estimated diet diaries, with predefined meal slots collapsed into breakfast, lunch, evening meal, and between meals.
  • Irregularity score per meal was the absolute difference of individual energy intake from the 5-day mean for that meal, divided by the 5-day mean, multiplied by 100, and averaged over 5 days; daily total was calculated similarly. Logistic regression estimated odds ratios for metabolic syndrome, its components, and BMI, adjusted for sex, socio-economic status, marital status, physical activity, and smoking; a second model further adjusted for energy intake at other meals or estimated energy requirements. Linear regression explored continuous components. Sensitivity analyses included only plausible reporters (n=1441, 83%).

Limitations

  • Stated: metabolic syndrome data were missing for 366 individuals, mainly due to missing HDL cholesterol (n=361), and non-fasting blood samples were used for triglycerides; those with missing data had higher BMI and waist circumference, smoked more, and were less physically active, possibly leading to regression dilution bias.
  • Stated: predefined meal slots are subjective and may not suit subgroups such as shift workers, for whom data were unavailable; the single-age cohort limits generalizability to other ages and populations.
  • Stated and evident: multiple testing could produce false positives, though the authors argue the meal irregularity tests are correlated; the observational design cannot establish causality, and self-reported 5-day diet diaries may not capture long-term eating patterns, with under-reporting possibly attenuating results.

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Integrity signals

Registry

Crossref · 10.1038/ijo.2014.51

Cites

39 of 39 references verified0 citation errors · 0 not checkable

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Claims the paper makes

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Show all 16 claims

  • It may state two separate claims as one. 16
  • Probably not a substantial claim. 15
  • The quote only partly states this claim. 1
26 of 26
  • The paper relies on this without support.

    Regular over-consumption of energy could be a potential risk factor for overweight, obesity and other cardio-metabolic risk factors.

    “Despite the possible beneficial effects of regular meal consumption, regular over-consumption of energy could be a potential risk factor for overweight, obesity and other cardio-metabolic risk factors.”
1 of 1

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  • Conflicting trend p-values for evening-meal irregularity and waist circumference

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    The abstract and Results give the same odds ratio and confidence interval for this association but report different trend p-values: 0.02 versus <0.01.

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Research works printed but not linked: 1

  1. Bates B, Lennox AM, Prentice A, Bates C, Swan G . Headline Results from Years 1, 2 and 3 (combined) of the Rolling Programme (2008/2009- 2010/11). National Diet and Nutrition Survey: London, UK, 2012.

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Metadata

Authors
Pot, G. K., Hardy, R., & Stephen, A. M.
Affiliations
  • MRC Elsie Widdowson Laboratory (GB)
  • MRC Unit for Lifelong Health and Ageing (GB)
Corresponding author
Pot, G K
Venue
International Journal of Obesity
Published
2014-03-28
Volume
38
Issue
12
Pages
1518-1524
ISSN
  • 0307-0565 (ISSN-L)
  • 1476-5497
OpenAlex
W2061589065
Cited by
102
References
39
Citations by year
2026: 6 · 2025: 12 · 2024: 13 · 2023: 12 · 2022: 11 · 2021: 10 · 2020: 13 · 2019: 6 · 2018: 4 · 2017: 5 · 2016: 7 · 2015: 3
FWCI
4.95
Type
journal article
Language
en
Open access
Locations
  • International Journal of Obesity (publishedVersion)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Open Research (University of Surrey) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Medical Research Council (U1200632239)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Keywords
meal timing, cardiometabolic risk, metabolic syndrome, breakfast, waist circumference, dietary habits, National Survey of Health and Development
MeSH terms
Energy Intake, Cardiovascular Diseases, Diet Surveys, Feeding Behavior, Female, United Kingdom, Humans, Longitudinal Studies, Male, Middle Aged, Obesity, Predictive Value of Tests, Surveys and Questionnaires, Risk Factors, Time Factors, Health Behavior, Diet Records, Odds Ratio, Metabolic Syndrome, Waist Circumference, Meals

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