Meal occasion, overweight, obesity and central obesity in children and adults: a cross-sectional study based on a nationally representative survey. Colombia, 2015

OBJECTIVE: To establish the association of the number of meals/day with overweight (Ow), obesity (Ob) and central obesity (CO). DESIGN: Cross-sectional, nationally representative surveys. SETTING: Colombia. PARTICIPANTS: A total of 6985 children aged 5–17 years and 7846 adults aged 18–64 years were included. MAIN OUTCOMES AND MEASURES: According to the WHO, Ow was defined in children as a body mass index (BMI)-for-age Z-score between >1 and ≤2 and in adults as a BMI between ≥25 and <30 (kg/m(2)). Ob was defined as a Z-score >2 in children and as a BMI ≥30 in adults. CO in children was established by sex and age using cut-off points equivalent to those of adults established by the International Diabetes Federation: ≥90 and ≥80 cm in males and females, respectively. The number of meals/day was estimated with a Food Frequency Questionnaire. Meals/day were grouped into three categories: (reference ≤3, 4 and 5+ meals/day). Crude and adjusted relative prevalence ratios (PRs) and their 95% CIs were calculated. The adjustments included usual energy intake/day and physical activity. RESULTS: In children, 18.5% had Ow, 6.7% had Ob and 4.0% had CO. The adjusted PRs for five or more meals/day versus three or fewer meals/day were 1.10 (95% CI 0.79 to 1.55) for Ow, 0.95 (95% CI 0.57 to 1.59) for Ob and 1.06 (95% CI 0.72 to 1.55) for CO. In adults, 32.3% had Ow, 13.1% had Ob and 44.8% had CO. The adjusted PRs for five or more meals/day versus three or fewer meals/day were 0.58 (95% CI 0.45 to 0.76) for Ow, 0.51 (95% CI 0.36 to 0.72) for Ob and 0.70 (95% CI 0.54 to 0.92) for CO. CONCLUSIONS: In children, meals/day were not associated with Ow, Ob or CO. In adults, this inverse relationship exists regardless of energy intake/day, whether physical activity goals are met, sex, age and other potentially confounding sociodemographic and environmental variables.