Temporal meal patterns in relation to diet quality and body mass index: findings from a cross-sectional analysis

Although recent studies suggest associations between temporal meal patterns, diet quality, and health outcomes such as obesity and cardiometabolic risk, the evidence remains inconclusive, highlighting the need for further investigation. This study aimed to evaluate meal patterns, including meal frequency, breakfast skipping and timing of energy intake (late or early), and their associations with diet quality and body mass index.

The study was completed as a secondary analysis of two cross-sectional, national dietary surveys, Riksmaten Adults 2010-11 (n = 1796) and Riksmaten Adolescents 2016-17(n = 2967). Meal patterns were reported for 3-4 days using two different web-based methods. Among adolescents, weight was measured using standardised methods, whereas adults provided self-reported weight. Diet quality was evaluated with the Swedish Healthy Eating Index 2025.

Meal patterns differed according to weight status, where adults with obesity or adolescents with overweight or obesity reported a lower meal frequency and more often skipped breakfast. A low eating frequency, breakfast skipping, and a late energy distribution were negatively associated with diet quality. A high meal frequency (OR 0.44 CI 0.28-0.68) and a late energy distribution (OR 0.70 CI 0.57-0.85) were associated with a decreased risk for overweight or obesity in adolescents.

Our study suggests that there may be a benefit in having a higher eating frequency and consuming breakfast, with regard to diet quality and weight.