Associations between eating frequency, adiposity, diet, and activity in 9-10-year-old healthy-weight and centrally obese children

Worldwide childhood obesity rates are reaching epidemic proportions with established health consequences that include both the presence of cardiovascular risk factors and strong links to adult morbidity and mortality (1). The distribution of body fat is also thought to predict cardiovascular disease risk with central (abdominal) obesity being more strongly related than total adiposity (2). Evidence also suggests that measures of central obesity, in particular waist-to-height ratio, predict adverse health outcomes including cardiovascular disease independently of BMI. Waistto-height ratio is also associated with percentage body fat in children (3).

Poor diet, next to lack of physical activity, has been implicated as a key determinant of obesity (1); however, it is not clear which specific aspects of dietary behavior, such as eating frequency (EF), should be targeted to reduce obesity (4,5). In order to develop effective strategies for obesity prevention, it is critical to determine how different aspects of children's diet relate to body composition and body fat distribution to enable more specific guidance and intervention strategies in the future.