Distribution of energy and macronutrient intakes across eating occasions in European children from 3 to 8 years of age: The EU Childhood Obesity Project Study

Purpose We aimed to characterize the distribution of energy and macronutrient intakes across eating occasions (EO) in European children from preschool to school age. Methods Data from 3-day weighed food records were collected from children at ages 3, 4, 5, 6 and 8 years from Belgium, Germany, Italy, Poland and Spain. Food intakes were assigned to EO based on country-specific daytimes for breakfast, lunch, supper and snacks (morning, afternoon). The average energy and nutrient intakes were expressed as percentage of total energy intake (%E). Nutrients were additionally expressed as percentage per EO (%E-EO). Foods were assigned to food groups;variation in intake was calculated via coefficient of variation (CV). We analyzed age trends in diurnal intake using mixed-effects beta regression. Results The 740 healthy children included in the analysis consumed the largest proportion of daily energy at lunch (31%E +/- 8, M +/- SD) and supper (26%E +/- 8), followed by breakfast (19%E +/- 7) and snacks [afternoon (16%E +/- 8);morning (8%E +/- 7)], with the most variable intake at morning snack (CV = 0.9). The nutrient composition at lunch and supper was highest for fat (36 +/- 9%E-Lunch;39 +/- 11%E-Supper) and protein (18 +/- 5%E-Lunch;18 +/- 6%E-Supper) and at breakfast and snacks for carbohydrates (54 +/- 12%E-Breakfast;62 +/- 12%E-Snacks). High-sugar content foods were consumed in relatively large proportions at breakfast and snacks. Food intakes varied significantly with age, with lower snack intakes at later ages (p < 0.001). Conclusion Possibly unhealthy EOs with high-fat intakes and high-sugar-content foods were observed. Changes in nutrient composition of EOs may be beneficial for health. Trial registry: ClinicalTrials.gov: NCT00338689;19/June/2006