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.

This paper investigates the prevalence and interaction of overweight/obesity-related lifestyles (specifically, examining whether subjects meet the recommended criteria), in a representative sample of university students. This study is part of the project EHU12/24, an observational cross-sectional study, designed to assess the prevalence of excess body fat (BF) and major risk of developing overweight/obesity, according to a standardised protocol. In a cohort of 603 students, aged between 18 and 28 years, of the University of the Basque Country, information about meal patterns, diet quality, physical activity, sitting time, sleeping time, toxic habits and anthropometric measurements were collected. Sampling took place from February 2014 to May 2017. Binary logistic regression models adjusted for the covariates were utilised to test the association between lifestyles and risk of excess adiposity. The prevalence of overweight/obesity, according to BF percentage, was 14·4 %. The variables analysed related to meal pattern were associated with diet quality, and less healthy food habits were associated with other less health-related behaviours. Among men, moderate/low physical activity, breakfast skipping, non-adequate breakfast duration, number of eating occasions and eating breakfast alone/depending on the occasion were associated with excess BF, while among women, low MedDietScore, moderate/high alcohol consumption, non-adequate sleep duration, eating breakfast and lunch alone/depending on the occasion. Results suggest that certain unhealthy lifestyle behaviours coexist, interact with one another and increase the risk of overweight/obesity in this population. Sex-specific differences in risk factors of obesity have implications for interventions for primary prevention of obesity within this environment.

Irregular breakfast consumption and food timing patterns in relation to weight status and inflammation were investigated in a cross-sectional manner among 644 participants in the Cancer Prevention Study-3 Diet Assessment Sub-study. Breakfast consumption, and the individual means and the intra-individual standard deviation (isd) of time at first intake of the day, duration of daily intake window and midpoint of daily intake window were collected via six 24-h recalls and examined in relation to BMI, waist circumference (WC) and inflammation (glycoprotein acetyl (GlycA)). Compared with consuming breakfast on all six recalls, linear regression models showed those who consumed breakfast on 4 or 5 of the days had a 1·29 (95 % CI 0·19, 2·38) and 1·64 (95 % CI 0·12, 3·16) kg/m2 higher BMI; no association was found for consuming breakfast ≤3 d. At 1 h later, the average time of first intake was associated with a 0·44 (95 % CI 0·04, 0·84) kg/m2 higher BMI. A 1-h increase in the isd of first intake was associated with a 1·12 (95 % CI 0·49, 1·75) kg/m2 higher BMI; isd in duration and midpoint of intake window were significant prior to additional adjustment for isd in the first intake. One-hour increases in isd for the first intake time (β: 0·15; 95 % CI 0·04, 0·26) and the midpoint of intake window (β: 0·16; 95 % CI 0·02, 0·31) were associated with higher GlycA. No associations were observed for WC independent of BMI. The results provide evidence that irregularity in breakfast consumption and daily intake timing patterns, particularly early in the day, may be related to weight status and inflammation.

Data on the combination of foods consumed simultaneously at specific eating occasions are scarce, primarily due to a lack of assessment tools. We applied a recently developed meal coding system to multiple-day dietary intake data for assessing its ability to estimate food and nutrient intakes and characterise meal-based dietary patterns in the Japanese context. A total of 242 Japanese adults completed sixteen non-consecutive-day weighed dietary records, including 14 734 eating occasions (3788 breakfasts, 3823 lunches, 3856 dinners and 3267 snacks). Common food group combinations were identified by meal type to identify a range of generic meals. Dietary intake was calculated on the basis of not only the standard food composition database but also the substituted generic meal database. In total, eighty generic meals (twenty-three breakfasts, twenty-one lunches, twenty-four dinners and twelve snacks) were identified. The Spearman correlation coefficients between food group intakes calculated based on the standard food composition database and the substituted generic meal database ranged from 0·26 to 0·85 (median 0·69). The corresponding correlations for nutrient intakes ranged from 0·17 to 0·82 (median 0·61). A total of eleven meal patterns were established using principal components analysis, and these accounted for 39·1 % of total meal variance. Considerable variation in patterns was seen in meal type inclusion and choice of staple foods (bread, rice and noodles) and drinks, and also in meal constituents. In conclusion, this study demonstrated the usefulness of a meal coding system for assessing habitual diet, providing a scientific basis towards the development of simple meal-based dietary assessment tools.

There are suggestions that large evening meals are associated with greater BMI. This study reviewed systematically the association between evening energy intake and weight in adults and aimed to determine whether reducing evening intake achieves weight loss. Databases searched were MEDLINE, PubMed, Cinahl, Web of Science, Cochrane Library of Clinical Trials, EMBASE and SCOPUS. Eligible observational studies investigated the relationship between BMI and evening energy intake. Eligible intervention trials compared weight change between groups where the proportion of evening intake was manipulated. Evening intake was defined as energy consumed during a certain time – for example 18.00–21.00 hours – or self-defined meal slots – that is ‘dinner’. The search yielded 121 full texts that were reviewed for eligibility by two independent reviewers. In all, ten observational studies and eight clinical trials were included in the systematic review with four and five included in the meta-analyses, respectively. Four observational studies showed a positive association between large evening intake and BMI, five showed no association and one showed an inverse relationship. The meta-analysis of observational studies showed a non-significant trend between BMI and evening intake (P=0·06). The meta-analysis of intervention trials showed no difference in weight change between small and large dinner groups (−0·89 kg; 95 % CI −2·52, 0·75, P=0·29). This analysis was limited by significant heterogeneity, and many trials had an unknown or high risk of bias. Recommendations to reduce evening intake for weight loss cannot be substantiated by clinical evidence, and more well-controlled intervention trials are needed.

Studying irregular meal patterns fits in with the latest research focusing not only on what people eat but also when they eat, also called chrono-nutrition. Chrono-nutrition involves studying the impact of nutrition on metabolism via circadian patterns, including three aspects of time: (ir)regularity, frequency and clock time. The present paper aimed to narratively review research on irregular meal patterns and cardiometabolic consequences. Only few cross-sectional studies and prospective cohort studies were identified, and most of these suggested that eating meals irregularly is associated with a higher risk of the metabolic syndrome and cardiometabolic risk factors, including BMI and blood pressure. This was supported by two randomised controlled intervention studies showing that consuming meals regularly for 2 weeks v. an irregular meal pattern, led to beneficial impact on cardiometabolic risk factors as lower peak insulin, lower fasting total and LDL-cholesterol, both in lean and obese women. In conclusion, the limited evidence on meal regularity and cardiometabolic consequences supports the hypothesis that consuming meals irregularly is adversely associated with cardiometabolic risk. However, it also highlights the need for more large-scale studies, including detailed dietary assessment to further advance the understanding of the impact of chrono-nutrition on public health.

Daily breakfast consumption is a common eating behaviour among people who have maintained their weight loss after weight-loss management. However, there is not a precise definition for breakfast in the literature. The purpose of this study was to investigate potential associations between breakfast consumption (based on several definitions) and weight-loss maintenance, as well as to explore differences in breakfast quality between individuals who managed to maintain part of the weight loss and in those who regained weight loss. The study sample consisted of 354 participants of the MedWeight study (age: 32 (sd 10) years, 61 % women) who had lost ≥10 % of their initial body weight and either maintained the loss for ≥1 year (maintainers, n 257) or regained weight loss (regainers, n 97). Participants completed online questionnaires and reported their dietary intake through two telephone 24-h recalls. Breakfast consumption was evaluated using twelve different definitions. The analysis indicated that breakfast consumption was associated with weight-loss maintenance only in men, when using self-reported breakfast consumption or the following breakfast definitions: (1) the first eating episode consumed at home and (2) the first eating episode consumed at home excluding caffeinated drinks. This association remained statistically significant even after adjustment for potential confounding factors. Thus, breakfast, the first eating episode of the day, when consumed at home, may be protective against weight regaining.

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.

With the aim of testing the effects of food quality on meal patterns 127 213 visits by 22 lactating cows to 12 computerized feeders supplying two foods, high forage (HF) and high concentrate (HC) consisting of grass silage and concentrate were analysed. The foods were composed of the same ingredients but the proportion of concentrate dry matter (DM) in the food DM differed between HC (0·59) and HF (0·27). Each of the foods was offered ad libitum to 11 cows from the start of lactation until 156 (s.e. 9) days after calving. Mean daily fresh food intake (49·2 kg) was not affected by treatment. Mean daily intake of DM differed between HC (23·6 kg) and HF (17·8 kg). After estimating individual meal criteria, visits were grouped into meals. The mean daily number of meals was 6·6, the mean fresh food intake per meal was 7·6 kg and neither was affected by treatment. Cows consuming HF had longer meals (41·4 v. 31·3 min) but a lower feeding rate than cows consuming HC (233 v. 337 g of fresh food per min and 78 v. 156 g DM per min). Pre- and post-prandial correlation coefficients were sometimes statistically significant but always low (R2 from 0 to 0·05) and not affected by treatment. Food intake per hour of the feeding cycle (defined as the intake during a meal divided by length of the meal plus the duration of the preceding between-meal interval) showed a diurnal pattern in the shape of a sine-wave with low values of about 1·5 kg/h for cycles starting just after midnight and high values of more than 3·0 kg/h for cycles starting just after noon. Neither the mean, nor the amplitude, nor the shift of the sine-wave were affected by treatment. The data suggest that similar mechanisms are responsible for the short-term intake regulation of HC and HF. No evidence was found to suggest that the diurnal meal pattern of cows consuming HF deviated from that of cows consuming HC as a result of differences between foods in constraints related to their physical properties.

A 2 × 2 × 2 factorial experiment was conducted with 128 growing-finishing steer calves to examine the effects of feeding whole v. rolled barley in diets containing either a constant proportion of concentrate (0·67) or proportionately 0·33 concentrate for 56 days followed by 0·90 concentrate for 83 days, with the concentrate being given at either 08.00 or 15.30 h. Steers given hay at 08.00 h and concentrate at 15.50 h grew proportionately 0·05 faster (P < 0-05) and had better dry matter (DM): gain ratios (P < 0·05) during the first 56 days than those given concentrate at 08.00 h and hay at 09.00 h. By the end of the trial steers fed at 15.50 h had similar daily gains to steers fed at 08.00 h but required proportionately 0·02 less DM: gain (P <0·05). No significant difference in gain was detected between steers given whole (1·30 kg/day) or rolled (1·38 kg/day) barley, but those given whole barley ate proportionately 0-08 more DM daily and had a proportionately 0-15 poorer DM: gain ratio (P < 0-05). The digestibility of diets containing whole grain was reduced (P < 0-05). Thirty-six steers given whole barley bloated compared with nine given rolled barley (P < 0·05). No significant differences were found either in DM intake or in final proportion of concentrate in the diet between steers given the diet containing proportionately 0·67 concentrate throughout the feeding period and those given the variable concentrate diets. There was a trend for DM: gain ratios to be poorer for steers given the constant proportion of concentrate (6·89 v. 6·65).