Meal patterns associated with energy intake in people with obesity

It is widely assumed that people with obesity have several common eating patterns, including breakfast skipping, eating during the night and high fast-food consumption. However, differences in individual meal and dietary patterns may be crucial to optimising obesity treatment. Therefore, we investigated the inter-individual variation in eating patterns, hypothesising that individuals with obesity show different dietary and meal patterns, and that these associate with self-reported energy intake (rEI) and/or anthropometric measures. Cross-sectional data from 192 participants (aged 20-55 years) with obesity, including 6 d of weighed food records, were analysed. Meal patterns and dietary patterns were derived using exploratory hierarchical cluster analysis and k-means cluster analysis, respectively. Five clear meal patterns were found based on the time-of-day with the highest mean rEI. The daily rEI was highest among 'midnight-eaters' (10 669 (sd 2301) kJ), and significantly (P < 0·05) higher than 'dinner-eaters' (8619 (sd 2301) kJ), 'lunch-eaters' (8703 (sd 2176) kJ) and 'supper-eaters' (8786 (sd 1925) kJ), but not 'regular-eaters' (9749 (sd 2720) kJ). Despite differences of up to 2050 kJ between meal patterns, there were no significant differences in anthropometric measures or physical activity level (PAL). Four dietary patterns were also found with significant differences in intake of specific food groups, but without significant differences in anthropometry, PAL or rEI. Our data highlight meal timing as a determinant of individual energy intake in people with obesity. The study supports the importance of considering a person's specific meal pattern, with possible implications for more person-focused guidelines and targeted advice.