Childhood obesity, especially when accompanied by metabolic complications like hypertension and insulin resistance, presents a significant public health challenge. At the Nutrition Society Congress 2024 in Belfast, Northern Ireland from July 2-5, 2024, a systematic review presented by BIO-STREAMS partners delved into the associations between meal patterns and the risk of childhood overweight/obesity (Ov/Ob) and metabolically unhealthy obesity (MUO).
Key Insights from the Systematic Review
This extensive review, conducted by researchers from Harokopio University and the University of the Aegean in Greece, scrutinized studies published from January 2013 to June 2023. The goal was to explore how various meal patterns—encompassing meal frequency, timing, context, and whether meals were skipped—impact the risk of childhood Ov/Ob and MUO.
Out of 3,020 initially identified studies, 27 were included in the final review. These studies predominantly had a longitudinal design and examined the relationship between meal patterns and childhood obesity markers. However, none addressed MUO specifically, highlighting a gap in the existing research.
Importance of Breakfast and Family Dinners
One of the standout findings from this review is the consistent association between regular breakfast consumption and lower odds of Ov/Ob, BMI, and body fat percentage. Frequent family dinners, particularly those occurring seven days a week, also correlated with reduced obesity risk. These findings underscore the potential benefits of structured and routine eating habits in managing childhood weight.
“One of the standout findings from this review is the consistent association between regular breakfast consumption and lower odds of Ov/Ob, BMI, and body fat percentage. Frequent family dinners, particularly those occurring seven days a week, also correlated with reduced obesity risk.”
Dr. Meropi Kontogianni, Assoc. Professor of Clinical Nutrition at Harokopio University and one of the lead researchers, emphasized the significance of the findings during her presentation: “Our review highlights the importance of regular meal patterns, particularly breakfast and family dinners, in reducing the risk of childhood obesity. However, the high variability in study designs and definitions calls for more standardized research to draw more definitive conclusions.”
The Impact of Skipping Meals and Eating Context
Skipping breakfast was notably linked to increased obesity markers in four studies, although three studies found no significant associations. This discrepancy points to the complexity of dietary behaviors and their impacts on health.
Additionally, eating while watching TV emerged as a potentially detrimental habit, with limited evidence suggesting a positive association with weight gain. This finding aligns with previous research indicating that distracted eating can lead to overeating and poorer food choices.
Conflicting Evidence on Meal Frequency and Fast Food Consumption
The review found mixed results regarding the frequency of eating occasions (EOs) and their impact on obesity. This inconsistency likely stems from varied definitions of what constitutes an EO across different studies. Surprisingly, no significant associations were reported between the frequency of lunch consumption or fast food intake and obesity risk, suggesting that other factors may play more substantial roles in these contexts.
Methodological Challenges and Research Gaps
A major issue highlighted by this review is the high risk of bias in 81% of the included studies, primarily due to the methods used to assess meal patterns. This methodological concern emphasizes the need for more robust and standardized approaches in future research.
The lack of studies focusing on MUO is a notable gap, underscoring the need for more comprehensive investigations into how meal patterns influence not just weight but also metabolic health in children.
Conclusion and Future Directions
This systematic review illuminates the significant role meal patterns play in childhood obesity. Regular breakfast consumption and family dinners appear to offer protective benefits against obesity, while habits like eating in front of the TV may contribute to weight gain.
Future research should aim to standardize definitions and methodologies related to meal patterns and broaden the focus to include MUO. By addressing these gaps, we can develop more effective dietary interventions and public health strategies to combat childhood obesity and promote healthier lifestyles for children and adolescents.
The findings of this review are part of the Bio-STREAM project, funded by the European Union’s HORIZON 2022 research and innovation program, which continues to explore the intricate relationships between diet and health. As this project progresses, it promises to deliver deeper insights and more precise recommendations for tackling the childhood obesity epidemic.