Skipping meals increased obesity, cardiometabolic risks among children

Children who do not consume the recommended amounts of important nutrients, mostly due to missing main meals, are more likely to have excess body fat and elevated cardiometabolic risk, according to a trio of studies by researchers in Finland, published between 2011 and 2014.

Aino-Maija Eloranta, a PhD student at the University of Eastern Finland, Kuopio, and colleagues looked at metabolic risk, adiposity and socioeconomic status relative to diet in children aged 6 to 8 years from the Physical Activity and Nutrition in Children (PANIC) Study.

Food consumption and metabolic risk

Eating main meals regularly, decreasing sugar-sweetened beverages and low-fat margarine intake, and increasing vegetable oil consumption should be emphasized early to reduce health risks over a lifetime, according to recent findings in the European Journal of Nutrition.

“A higher cardiometabolic risk in childhood is known to be related to a higher risk of metabolic syndrome and type 2 diabetes in adulthood,” Eloranta told Endocrine Today. “Improving body composition and cardiometabolic health in children through a healthier and more regular diet could prevent major cardiovascular diseases later in life.”

The researchers investigated the associations between daily number of main meals, snacks and food consumption, and metabolic risk score and individual metabolic risk factors in a population sample of 199 girls and 209 boys.

Dietary factors were measured through 4-day food records. Metabolic risk score was calculated based on waist circumference (WC) and systolic and diastolic blood pressure, along with fasting serum insulin and fasting plasma glucose concentrations, triglycerides and HDL cholesterol.

Adjustments were made for age, sex, total physical activity, electronic media time, energy intake and other dietary factors.

Increased metabolic risk score was linked with skipping main meals (standardized regression coefficient beta = –0.18; P<.001); higher intake of non-root vegetables (beta = 0.18; P<.01), low-fat vegetable-oil-based margarine (beta = 0.13; P<.01) and sugar-sweetened beverages (beta = 0.11; P<.05); and lower intake of vegetable oils (beta = –0.1; P<.05).

Red meat consumption was directly associated with metabolic risk score, but statistical significance did not remain after adjusting for energy intake.

“More longitudinal as well as intervention studies are needed in order to understand better the causality and mechanisms behind these findings,” Eloranta said. “Moreover, more research is needed to provide information on most effective ways to change eating frequency to the healthier directions in children.”

Dietary factors and body adiposity

Findings from an earlier cross-sectional analysis published in the International Journal of Obesity suggest more research is needed on the association between protein-rich foods and adiposity in children, according to Eloranta and colleagues

The researchers investigated dietary factors with overweight, body fat percentage (BF%), WC and hip circumference (HC) in 247 girls and 263 boys involved in PANIC.

Weight, height, WC and HC were measured, and BF% was calculated through dual-energy X-ray absorptiometry. Nutrient intakes and meal frequency were assessed through 4-day food records and eating behavior through Children’s Eating Behavior Questionnaire. Overweight was defined by International Obesity Task Force BMI cutoffs.

Eating all three main meals daily was inversely associated with overweight (OR=0.37; 95% CI, 0.18–0.75), BF% (beta = –0.12; P=.012), WC (beta = –0.16; P=.002) and HC (beta = –0.15; P=.002). Enjoyment of food, food responsiveness and emotional overeating were directly linked with overweight, BF%, WC and HC.

Satiety responsiveness was inversely associated with overweight (OR=0.42; 95% CI, 0.26–0.67), BF% (beta = –0.2; P<.001), WC (beta = –0.26; P<.001) and HC (beta = –0.26; P<.001). Slowness in eating was inversely associated with overweight, WC and HC.

Protein intake was directly associated with BF% (beta = –0.11; P=.017), WC (beta = 0.11, P=.02) and HC (beta = 0.13; P=.008).

Food selection and socioeconomic link

Children from the lowest socioeconomic positions were least likely to consume fish, skim milk and fiber-rich bread or to eat main meals, but most likely to use soft margarine, according to findings published in the European Journal of Clinical Nutrition,

In a population sample of 211 girls and 213 boys from PANIC, Eloranta and colleagues investigated the impact of socioeconomic background on nutrient intake, food consumption and meal pattern.

“Half of children do not regularly eat all three main meals,” Eloranta told Endocrine Today. “The nutrient content of their meals is closer to recommendations in that of snacks in children.”

Food records were used to measure nutrient intake and meal pattern, and questionnaires were used to assess food intake and socioeconomic characteristics.

Overall, intake of saturated fat, sucrose and salt was higher than recommended, and intake of vitamin D, iron and fiber lower. Children also had a lower unsaturated-to-saturated fat ratio intake than recommended, with <5% consuming the outlined amounts of vegetables, fruit and berries.

Children with highest parental education were more likely to eat fish (OR=2.2; 95% CI, 1.06–4.54), fiber-rich bread (OR=5.06; 95% CI, 1.8–14.29) and main meals (OR=2.54; 95% CI, 1.34–4.83); however, they were less likely to use soft margarine (OR=0.43; 95% CI, 0.2–0.94) as recommended vs. children with lowest parental education

Children with highest household income were also more likely to consume the recommended skim milk (OR=2.43; 95% CI, 1.21–4.88) and fish (OR=2.21; 95% CI 1.12–4.36) vs. lowest income.

Only 34% of girls and 45% of boys consumed all main meals daily; further, snacks accounted for as much as 42% of total energy intake.
“Skipping meals is more common among children with lower socioeconomic background than other children,” Eloranta said. “Skipping meals is also associated with a higher body adiposity and a higher cardiometabolic risk among children.” — by Allegra Tiver

For more information:

Eloranta AM. Eur J Nutr. 2014;doi:10.1007/s00394-013-0646-z.

Eloranta AM. Int J Obes. 2012;doi:10.1038/ijo.2012.89.

Eloranta AM. Eur J Clin Nutr. 2011;doi:10.1038/ejcn.2011.113.

Aino-Maija Eloranta can be reached at the University of Eastern Finland, Institute of Biomedicine/Physiology, Yliopistonranta 1 A, PO Box 1627, 70211 Kuopio, Finland; email: aino-maija.eloranta@uef.fi.

Disclosure: The researchers report no relevant financial disclosures.