Selected eating behaviours and excess body weight: a systematic review

Examining Predictors of Breakfast Skipping and Breakfast Program Use Among Secondary School Students in the COMPASS Study

BACKGROUND

Many Canadian schools offer breakfast programs; however, students' engagement in these programs is low, while breakfast skipping is highly prevalent among youth. This study examined whether the availability of breakfast programs supports adolescents' regular breakfast eating, and identified characteristics of breakfast skippers who are not using these programs.

METHODS

Data from 30,771 secondary school students from Ontario and Alberta, Canada, participating in Year 3 (2014-2015) of the COMPASS study were used for descriptive and logistic regression analyses. Participants were categorized by self-reported breakfast eating and school breakfast program use.

RESULTS

Sixteen percent of participants reported using school breakfast programs. Breakfast skipping was highly prevalent among participants, regardless of their breakfast program use. Characteristics significantly associated with program use included traveling to school via public transit or a school bus, being a bullying victim, and having a high school connectedness score. A desire to lose weight and non-involvement in school sports were significantly associated with being a "breakfast skipper/nonprogram user."

CONCLUSIONS

School breakfast programs do not consistently support regular breakfast eating, even among adolescents actively engaged in these programs. Future research should identify and evaluate practices to bolster participation in breakfast programs and promote regular breakfast eating among adolescents.

Psychometric Properties of the Malay Version of the Dutch Eating Behaviour Questionnaire (DEBQ) in a Sample of Malaysian Adults Attending a Health Care Facility

OBJECTIVE

This study aims to investigate the psychometric properties of the Malay version of the Dutch Eating Behaviour Questionnaire (DEBQ) among Malaysian adults.

METHOD

The Malay version of the DEBQ instrument was administered to 398 outpatients (269 women and 129 men) at the University of Malaya Medical Centre (UMMC). Confirmatory Factor Analysis (CFA) was conducted to study the construct validity of the instrument. Composite reliability coefficient, Raykov's rho, was used to determine the internal consistency.

RESULTS

The proposed three-factor structure for the DEBQ instrument was appropriate, although three items (Items 21, 14 and 27) showed problematic loadings with inappropriate model fit and were removed. The modified version had an appropriate model fit χ²/df = 2.129, TLI = 0.908, CFI = 0.918, RMSEA = 0.053 (90%CI = 0.048-0.058), close-fit P-value = 0.136 and satisfactory internal consistency of 0.914 for emotional eating scale, 0.819 for external eating scale and 0.856 for restrained eating scale.

DISCUSSION

The Malay version of the DEBQ is a valid instrument to study eating behaviour traits among Malaysian adults. Further research is warranted to determine if Items 14 and 27 are appropriate for the Malaysian population.

A New Approach to Image-Based Estimation of Food Volume

A balanced diet is the key to a healthy lifestyle and is crucial for preventing or dealing with many chronic diseases such as diabetes and obesity. Therefore, monitoring diet can be an effective way of improving people’s health. However, manual reporting of food intake has been shown to be inaccurate and often impractical. This paper presents a new approach to food intake quantity estimation using image-based modeling. The modeling method consists of three steps: firstly, a short video of the food is taken by the user’s smartphone. From such a video, six frames are selected based on the pictures’ viewpoints as determined by the smartphone’s orientation sensors. Secondly, the user marks one of the frames to seed an interactive segmentation algorithm. Segmentation is based on a Gaussian Mixture Model alongside the graph-cut algorithm. Finally, a customized image-based modeling algorithm generates a point-cloud to model the food. At the same time, a stochastic object-detection method locates a checkerboard used as size/ground reference. The modeling algorithm is optimized such that the use of six input images still results in an acceptable computation cost. In our evaluation procedure, we achieved an average accuracy of 92 % on a test set that includes images of different kinds of pasta and bread, with an average processing time of about 23 s.

Clusters of Healthy and Unhealthy Eating Behaviors Are Associated With Body Mass Index Among Adults

OBJECTIVE

To identify eating styles from 6 eating behaviors and test their association with body mass index (BMI) among adults.

DESIGN

Cross-sectional analysis of self-report survey data.

SETTING

Twelve primary care and specialty clinics in 5 states.

PARTICIPANTS

Of 11,776 adult patients who consented to participate, 9,977 completed survey questions.

VARIABLES MEASURED

Frequency of eating healthy food, frequency of eating unhealthy food, breakfast frequency, frequency of snacking, overall diet quality, and problem eating behaviors. The primary dependent variable was BMI, calculated from self-reported height and weight data.

ANALYSIS

k-Means cluster analysis of eating behaviors was used to determine eating styles. A categorical variable representing each eating style cluster was entered in a multivariate linear regression predicting BMI, controlling for covariates.

RESULTS

Four eating styles were identified and defined by healthy vs unhealthy diet patterns and engagement in problem eating behaviors. Each group had significantly higher average BMI than the healthy eating style: healthy with problem eating behaviors (β = 1.9; P < .001), unhealthy (β = 2.5; P < .001), and unhealthy with problem eating behaviors (β = 5.1; P < .001).

CONCLUSIONS AND IMPLICATIONS

Future attempts to improve eating styles should address not only the consumption of healthy foods but also snacking behaviors and the emotional component of eating.

The addition of peanuts to habitual diets is associated with lower consumption of savory non-core snacks by men and sweet non-core snacks by women

Snacking is associated with intakes of non-core foods which may predispose to obesity. Peanuts have potential satiety benefits and may assist with weight management; we hypothesized that peanut consumption would reduce intake of non-core snack foods due to compensation. We investigated the effects of adding peanuts to a habitual diet on snacking habits and energy intake. Sixty-one healthy participants (65±7years, body mass index 31±4kg/m²) consumed their habitual diet with or without peanuts (56g/d for 32 women, 84g/d for 29 men) for 12weeks each in a randomized crossover design. Food diaries were analyzed at baseline and after each 12-week period for meal and snack content and timing. Total energy intake was higher (17% for men [P<.001], 9% for women [P<.001]) during the peanut phase. Body weight was 0.5±0.2kg (P=.010) greater during the peanut phase. Snacking occasions increased during the peanut phase (53% for men [P=.001], 14% for women [P=.01]). Servings of other snack foods did not change during the peanut phase (P=.6) compared with control. However, sex-specific analysis revealed that men and women consumed less savory (P<.001) and sweet (P=.01) non-core snacks, respectively, during the peanut phase. Despite increased energy intake and snacking frequency, peanuts may improve the diet through sex-specific reductions of non-core foods; for optimal energy balance, peanuts should be substituted rather than added to the diet.

Differences in meal patterns and timing with regard to central obesity in the ANIBES ('Anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain') Study

Objective

To study the association of meal patterns and timing with central obesity to identify the best dietary strategies to deal with the increasing obesity prevalence.

Design

A cross-sectional study performed on data from a representative sample of the Spanish population. Height and waist circumference were measured using standardized procedures and waist-to-height ratio (WHtR) was calculated. The sample was divided into those without central obesity (WHtR<0·5) and those with central obesity (WHtR≥0·5).

Setting

ANIBES (‘Anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain’) Study.

Subjects

Adults aged 18–64 years (n 1655; 798 men and 857 women).

Results

A higher percentage of people ate more than four meals daily in the group without central obesity and those with central obesity more frequently skipped the mid-afternoon snack than those without. Breakfasts containing >25 % of total energy intake and lunches containing >35 % of total energy intake were associated with increased likelihood of central obesity (OR=1·874, 95 % CI 1·019, 3·448; P<0·05 and OR=1·693, 95 % CI 1·264, 2·268; P<0·001, respectively). On the contrary, mid-morning snacks and mid-afternoon snacks containing >15 % of total energy were associated with decreased likelihood of central obesity (OR=0·477, 95 % CI 0·313, 0·727; P<0·001 and OR=0·650, 95 % CI 0·453, 0·932; P<0·05, respectively). The variety of cereals, wholegrain cereals and dairy was higher in the population without central obesity.

Conclusions

Our results suggest that ‘what and when we eat’ should be considered dietary strategies to reduce central obesity.

The Association between Breakfast Skipping and Body Weight, Nutrient Intake, and Metabolic Measures among Participants with Metabolic Syndrome

The effect of skipping breakfast on health, especially in adults, remains a controversial topic. A secondary data analysis was conducted to examine associations between breakfast eating patterns and weight loss, nutrient intake, and metabolic parameters among participants with metabolic syndrome (MetS) (n = 240). Three randomly selected 24-h dietary recalls were collected from each participant at baseline and at the one-year visit. Skipped breakfast was seen in 32.9% at baseline and in 17.4% at the one-year visit, respectively. At baseline, after adjustment for demographics and physical activity, participants who ate breakfast had a higher thiamin, niacin, and folate intake than did breakfast skippers (p < 0.05); other selected parameters including body weight, dietary quality scores, nutrient intake, and metabolic parameters showed no significant differences between the two groups (p ≥ 0.05). From baseline to one year, after adjustment for covariates, mean fat intake increased by 2.7% (95% confidence intervals (CI): -1.0, 6.5%) of total energy in breakfast skippers in comparison to the 1.2% decrease observed in breakfast eaters (95% CI: -3.4, 1.1%) (p = 0.02). Mean changes in other selected parameters showed no significant differences between breakfast skippers and eaters (p > 0.05). This study did not support the hypothesis that skipping breakfast has impact on body weight, nutrient intakes, and selected metabolic measures in participants with MetS.

Eating frequency in relation to BMI in very young children: a longitudinal analysis

OBJECTIVE

Eating less frequently is associated with increased obesity risk in older children but data are potentially confounded by reverse causation, where bigger children eat less often in an effort to control their weight. Longitudinal data, particularly in younger children, are scarce. We aimed to determine whether eating frequency (meals and snacks) at 2 years of age is associated with past, current or subsequent BMI.

DESIGN

Cohort analysis of a randomised controlled trial. Eating frequency at 2 years of age was estimated using 48 h diaries that recorded when each child ate meals and snacks (parent-defined) in five-minute blocks. Body length/height and weight were measured at 1, 2 and 3·5 years of age. Linear regression assessed associations between the number of eating occasions and BMI Z-score, before and after adjustment for potential confounding variables.

SETTING

Prevention of Overweight in Infancy (POI) study, Dunedin, New Zealand.

SUBJECTS

Children (n 371) aged 1-3·5 years.

RESULTS

On average, children ate 5·5 (sd 1·2) times/d at 2 years of age, with most children (88-89 %) eating 4-7 times/d. Eating frequency at 2 years was not associated with current (difference in BMI Z-score per additional eating occasion; 95 % CI: -0·02; -0·10, 0·05) or subsequent change (0·02; -0·03, 0·06) in BMI. Similarly, BMI at age 1 year did not predict eating frequency at 2 years of age (difference in eating frequency per additional BMI Z-score unit; 95 % CI: -0·03; -0·19, 0·13).

CONCLUSIONS

Number of eating occasions per day was not associated with BMI in young children in the present study.

Automatic diet monitoring: a review of computer vision and wearable sensor-based methods

Food intake and eating habits have a significant impact on people's health. Widespread diseases, such as diabetes and obesity, are directly related to eating habits. Therefore, monitoring diet can be a substantial base for developing methods and services to promote healthy lifestyle and improve personal and national health economy. Studies have demonstrated that manual reporting of food intake is inaccurate and often impractical. Thus, several methods have been proposed to automate the process. This article reviews the most relevant and recent researches on automatic diet monitoring, discussing their strengths and weaknesses. In particular, the article reviews two approaches to this problem, accounting for most of the work in the area. The first approach is based on image analysis and aims at extracting information about food content automatically from food images. The second one relies on wearable sensors and has the detection of eating behaviours as its main goal.

Lifestyle behaviours associated with 5-year weight gain in a prospective cohort of Australian adults aged 26-36 years at baseline

Background

Whether not meeting common guidelines for lifestyle behaviours is associated with weight gain is uncertain. This study examined whether 5-year weight gain was predicted by not meeting guidelines for: breakfast consumption (eating between 6 and 9 am), takeaway food consumption (<2 times/week), television viewing (<2 h/day) and daily steps (≥10,000 steps/day).

Methods

One thousand one hundred and fifty-five Australian participants (43% men, 26–36 years) completed questionnaires and wore a pedometer at baseline (2004-06) and follow-up (2009-11). Weight was measured or self-reported, with a correction factor applied. For each behaviour, participants were classified according to whether they met the guideline: consistently met at baseline and follow-up (reference group); not met at baseline but met at follow-up; met at baseline but not met at follow-up; consistently not met at baseline and follow-up. For each behaviour, weight gain was calculated using linear regression. Weight gain by number of guidelines met was also examined.

Results

Mean 5-year weight gain was 2.0 kg (SD:6.3). Compared to the reference group, additional weight (mean, 95% CI) was gained among those who did not meet the guideline at follow-up, or consistently did not meet the guideline, for breakfast (1.8 kg, 0.7–2.9; 1.5 kg, 0.1–2.8); takeaway food (2.2 kg, 0.7–3.6; 1.9 kg, 0.7–3.1); watching television (1.9 kg, 0.9–2.9; 1.4 kg, 0.4–2.3); and daily steps (2.6 kg, 1.1–4.04; 1.6 kg, 0.5–2.7). Those who met ≤1 guideline at follow-up gained 3.8 kg (95% CI 2.3–5.3) more than those meeting all guidelines.

Conclusion

Individuals who adopted healthier behaviours between baseline and follow-up had similar weight gain to those who met the guidelines at both time points. Encouraging young adults to meet these simple guidelines may reduce weight gain.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3931-y) contains supplementary material, which is available to authorized users.

Temporal eating patterns: a latent class analysis approach

Background

There is some evidence that large energy intakes towards the end of the day are associated with adverse health outcomes, however, studies of temporal eating patterns across the day are rare. This study examines the temporal eating patterns of Australian adults using latent class analysis (LCA), as a novel approach.

Methods

Dietary data (n = 2402 men and n = 2840 women, ≥19 years) from two 24-h recalls collected during the 2011–12 Australian National Nutrition and Physical Activity Survey were analyzed. LCA was performed to identify distinct temporal eating patterns based on whether or not an eating occasion (EO) occurred within each hour of the day. F and adjusted-chi² tests assessed differences in sociodemographic and eating patterns (e.g., meal, snack and EO frequency) between latent classes.

Results

Three patterns, labelled “Conventional” (men: 43%, women: 41%), “Later lunch” (men: 34%, women: 34%) and “Grazing” (men: 23%, women: 25%) were identified. Men and women with a “Grazing” pattern were significantly younger (P < 0.001) and a higher proportion were from major cities (P < 0.01) and were not married (men only, P = 0.01), compared to the “Conventional” and “Later lunch” patterns. The “Grazing” pattern was also characterized by a higher EO frequency (P < 0.01) and snack frequency (P < 0.001) and consumption of a higher proportion of total energy intake from snacks but a lower proportion of total energy intake from meals (P < 0.001).

Conclusions

This study identified three distinct temporal eating patterns in adults that varied by age, EO frequency, snack frequency and energy intake pattern. LCA is a useful approach to capture differences in EO timing across the day. Future research should examine associations between temporal eating patterns and health.

Methodological Challenges in Studies Examining the Effects of Breakfast on Cognitive Performance and Appetite in Children and Adolescents

Breakfast is purported to confer a number of benefits on diet quality, health, appetite regulation, and cognitive performance. However, new evidence has challenged the long-held belief that breakfast is the most important meal of the day. This review aims to provide a comprehensive discussion of the key methodological challenges and considerations in studies assessing the effect of breakfast on cognitive performance and appetite control, along with recommendations for future research. This review focuses on the myriad challenges involved in studying children and adolescents specifically. Key methodological challenges and considerations include study design and location, sampling and sample section, choice of objective cognitive tests, choice of objective and subjective appetite measures, merits of providing a fixed breakfast compared with ad libitum, assessment and definition of habitual breakfast consumption, transparency of treatment condition, difficulty of isolating the direct effects of breakfast consumption, untangling acute and chronic effects, and influence of confounding variables. These methodological challenges have hampered a clear substantiation of the potential positive effects of breakfast on cognition and appetite control and contributed to the debate questioning the notion that breakfast is the most important meal of the day.

Breakfast consumption and adiposity among children and adolescents: an updated review of the literature

BACKGROUND

Breakfast consumption has been associated with reduced risk of overweight and obesity among children, but previous evidence reviews fail to confirm a causal relationship.

OBJECTIVES

To review recent literature on breakfast consumption and adiposity among children and discuss potential underlying mechanisms.

METHODS

A comprehensive literature search of studies published since the 2010 US National Evidence Library review (January 2010-January 2015) was conducted.

RESULTS

Twelve studies met inclusion criteria. All were conducted in industrialized countries: six in Europe, four in the USA, one in China and one in Australia. Ten of the studies used observational longitudinal designs, with follow-up periods ranging from 1 to 27 years (median: 3, mean: 7.4); of these, eight reported inverse associations between breakfast consumption and excess adiposity, while two found no association. The other studies (1 case-control, 1 experimental) each reported a protective effect of breakfast consumption on overweight and obesity among children.

CONCLUSIONS

Findings corroborate results from previous reviews, adding support for a possible, protective role for breakfast consumption in preventing excess adiposity during childhood and adolescence. However, drawing a causal conclusion from the collective evidence is curtailed by methodological limitations and inconsistencies, including study design, follow-up duration and frequency, exposure and outcome assessment, as well as limited consideration of confounding, mediating and effect-modifying variables. More rigorous study designs employing valid and standardized measurement of relevant variables are needed.

Meal Frequency but Not Snack Frequency Is Associated with Micronutrient Intakes and Overall Diet Quality in Australian Men and Women

BACKGROUND

Skipping breakfast is associated with poorer diet quality among adults, but evidence of associations for other eating patterns [e.g., eating occasion (EO), meal, or snack frequency] is equivocal. An understanding of how eating patterns are associated with diet quality is needed to inform population-level dietary recommendations.

OBJECTIVE

We aimed in this cross-sectional study to determine the relation between frequency of meals, snacks, and all EOs with nutrient intakes and diet quality in a representative sample of Australian adults.

METHODS

Dietary data for 5242 adults aged ≥19 y collected via two 24-h recalls during the 2011-2012 National Nutrition and Physical Activity Survey were analyzed. EO, meal, and snack frequency was calculated. Adherence to recommendations for healthy eating was assessed with the use of the 2013 Dietary Guidelines Index (DGI) and its subcomponents. Linear regression, adjusted for covariates and energy misreporting, was used to examine associations between eating patterns, energy-adjusted nutrient intakes, and the DGI-2013.

RESULTS

The frequency of meals, but not of snacks, was positively associated with micronutrient intakes, overall diet quality [men: β = 5.6 (95% CI: 3.9, 7.3); women: β = 4.1 (95% CI: 2.2, 5.9); P < 0.001], and DGI-2013 component scores for cereals, lean meat and alternatives, and alcohol intake (P < 0.05). A higher frequency of all EOs, meals, and snacks was positively associated with DGI-2013 scores for food variety, fruits, and dairy foods (P < 0.05). Conversely, a higher snack frequency was associated with a lower compliance with guidelines for discretionary foods and added sugars among men (P < 0.05).

CONCLUSIONS

These findings suggest that meal frequency is an important determinant of nutrient intakes and diet quality in Australian adults. Inconsistent associations for snack frequency suggest that the quality of snack choices is variable. More research examining the dietary profiles of eating patterns and their relations with diet quality is needed to inform the development of meal-based guidelines and messages that encourage healthy eating.

Comparison of sodium content of meals served by independent takeaways using standard versus reduced holed salt shakers: cross-sectional study

Background

Takeaway food has a relatively poor nutritional profile. Providing takeaway outlets with reduced-holed salt shakers is one method thought to reduce salt use in takeaways, but effects have not been formally tested. We aimed to determine if there was a difference in sodium content of standard fish and chip meals served by Fish & Chip Shops that use standard (17 holes) versus reduced-holed (5 holes) salt shakers, taking advantage of natural variations in salt shakers used.

Methods

We conducted a cross-sectional study of all Fish & Chip Shops in two local government areas (n = 65), where servers added salt to meals as standard practice, and salt shaker used could be identified (n = 61). Standard fish and chip meals were purchased from each shop by incognito researchers and the purchase price and type of salt shaker used noted. Sodium content of full meals and their component parts (fish, chips, and fish batter) was determined using flame photometry. Differences in absolute and relative sodium content of meals and component parts between shops using reduced-holed versus standard salt-shakers were compared using linear regression before and after adjustment for purchase price and area.

Results

Reduced-holed salt shakers were used in 29 of 61 (47.5 %) included shops. There was no difference in absolute sodium content of meals purchased from shops using standard versus reduced-holed shakers (mean = 1147 mg [equivalent to 2.9 g salt]; SD = 424 mg; p > 0.05). Relative sodium content was significantly lower in meals from shops using reduced-holed (mean = 142.5 mg/100 g [equivalent to 0.4 g salt/100 g]; SD = 39.0 mg/100 g) versus standard shakers (mean = 182.0 mg/100 g; [equivalent to 0.5 g salt/100 g]; SD = 68.3 mg/100 g; p = 0.008). This was driven by differences in the sodium content of chips and was extinguished by adjustment for purchase price and area. Price was inversely associated with relative sodium content (p < 0.05).

Conclusions

Using reduced-holed salt shakers in Fish & Chip Shops is associated with lower relative sodium content of fish and chip meals. This is driven by differences in sodium content of chips, making our results relevant to the wide range of takeaways serving chips. Shops serving higher priced meals, which may reflect a more affluent customer base, may be more likely to use reduced-holed shakers.

Intakes of Energy and Discretionary Food in Mexico Are Associated with the Context of Eating: Mealtime, Activity, and Place

BACKGROUND

The prevalence of obesity and the intake of discretionary foods [high saturated fat and/or added sugar (HSFAS) products and sugar-sweetened beverages (SSBs)] are high in Mexico. It is important to understand whether the intakes of HSFAS products and SSBs are associated with the context in which they are consumed.

OBJECTIVE

Our aim was to estimate the associations between total energy and discretionary food (HSFAS products and SSBs) intakes and the context of eating (mealtime, activity, and place).

METHODS

We used data from 10,087 participants aged ≥1 y from the Mexican National Health and Nutrition Survey 2012. Dietary intake was estimated through a 24-h dietary recall that included questions on mealtime, activity, and place in which each food item was consumed. The associations between energy and discretionary food intakes and the context of eating were estimated by using multiple linear regression stratified by age group and adjusted for sociodemographic variables.

RESULTS

Compared with breakfast, the percentage of energy that HSFAS products contributed was 16-29 (range in all age groups) percentage points higher during midafternoon snacks and 16-23 percentage points lower at lunch and almuerzo (Mexican brunch); the percentage of energy from SSBs was 3.4-7.6 percentage points higher during midmorning snacks (P < 0.05). In many age groups and mealtimes, we found that compared with eating only while seated, the percentage of energy as HSFAS was 5.3-14 percentage points higher when watching television (P < 0.05). Compared with eating at home, the percentage of energy from HSFAS was 12-26 percentage points higher on the street and the percentage of energy from SSBs was 3.4-6.0 percentage points higher at school and 2.9-15 percentage points higher at work (P < 0.05).

CONCLUSIONS

These results highlight the need to promote healthier food selection among the Mexican population when snacking and watching television and healthier food environments at work, school, and on the street.

Vending Machines: A Narrative Review of Factors Influencing Items Purchased

Vending machines are a ubiquitous part of our food environments. Unfortunately, items found in vending machines tend to be processed foods and beverages high in salt, sugar, and/or fat. The purpose of this review is to describe intervention and case studies designed to promote healthier vending purchases by consumers and identify which manipulations are most effective. All studies analyzed were intervention or case studies that manipulated vending machines and analyzed sales or revenue data. This literature review is limited to studies conducted in the United States within the past 2 decades (ie, 1994 to 2015), regardless of study population or setting. Ten articles met these criteria based on a search conducted using PubMed. Study manipulations included price changes, increase in healthier items, changes to the advertisements wrapped around vending machines, and promotional signs such as a stoplight system to indicate healthfulness of items and to remind consumers to make healthy choices. Overall, seven studies had manipulations that resulted in statistically significant positive changes in purchasing behavior. Two studies used manipulations that did not influence consumer behavior, and one study was equivocal. Although there was no intervention pattern that ensured changes in purchasing, price reductions were most effective overall. Revenue from vending sales did not change substantially regardless of intervention, which will be important to foster initiation and sustainability of healthier vending. Future research should identify price changes that would balance healthier choices and revenue as well as better marketing to promote purchase of healthier items.

Nutritional Status Associated to Skipping Breakfast in Brazilian Health Service Patients

Recent studies show that skipping breakfast is associated with an increased risk of obesity, diabetes and cardiovascular diseases. In this context, this study evaluated 400 patients from the Brazilian health service who had their nutritional status defined based on the body mass index and were classified as physically active or insufficient active. The energy intake and macronutrients was also assessed by a 24-hour dietary recall where the association of overweight/obesity with the investigated variables was evaluated using chi-square, Student's t test and multivariate analysis (p < 0.05). The main results showed that more than half of the studied population have the habit of omitting breakfast (55.8%), and among those, 81.2% were overweight/obese (p < 0.0001). Almost three-fourths of these individuals consumed no more than 4 meals a day (73.0%), and regarding this meal frequency/day, 78.8% of the individuals who reported having 4 meals or less a day were overweight/obese compared with 57.8% who reported as having 5-6 meals/day (p < 0.0001). The individuals who reported to omit breakfast had a higher chance of being overweight compared with those who had this habit (OR 2.20; 95% CI 1.40-3.60) and the chance of the physically insufficient active individuals to be overweight/obese was 2.9 times higher when compared to the active individuals (p < 0.0001). Our findings suggest that regular breakfast consumption may decrease overweight and obesity risk.

Meal size is a critical driver of weight gain in early childhood

Larger serving sizes and more frequent eating episodes have been implicated in the rising prevalence of obesity at a population level. This study examines the relative contributions of meal size and frequency to weight gain in a large sample of British children. Using 3-day diet diaries from 1939 children aged 21 months from the Gemini twin cohort, we assessed prospective associations between meal size, meal frequency and weight gain from two to five years. Separate longitudinal analyses demonstrated that every 10 kcal increase in meal size was associated with 1.5 g/wk or 4% (p = 0.005) faster growth rate, while meal frequency was not independently associated with growth (β = 0.3 g/wk p = 0.20). Including both meal parameters in the model strengthened associations (meal size: β = 2.6 g/wk, p < 0.001; meal frequency: β = 1.0 g/wk, p = 0.001). Taken together, the implication is that meal size promotes faster growth regardless of frequency, but meal frequency has a significant effect only if meal size is assumed to be held constant. Clearer advice on meal size and frequency, especially advice on appropriate meal size, may help prevent excess weight gain.

Late-night overeating is associated with smaller breakfast, breakfast skipping, and obesity in children: The Healthy Growth Study

OBJECTIVE

Excessive energy intake during evening hours is associated with several health problems. The aim of this study was to investigate for the first time the possible association of late-night overeating with breakfast habits and obesity in a large sample of Greek children ages 9 to 13 y.

METHODS

In all, 2655 schoolchildren (9-13 y) participated in the Healthy Growth Study, a cross-sectional epidemiologic study conducted in 77 primary schools in four large regions in Greece. The present study presents results on 1912 children having full data regarding anthropometric, dietary, physical activity, and physical examination indices.

RESULTS

High-energy intake at dinner and evening snack was associated with higher likelihood of skipping breakfast (odds ratio, 1.85; 95% confidence interval 1.42-2.39) and with lower caloric intake at breakfast (β = 0.14; P < 0.001). Children at the lowest quartile of physical activity levels were found to have a positive association between the calories consumed at dinner and their body mass index (β = 0.11; P = 0.019). This association was inverse for children at the highest quartile of physical activity levels (β = -0.10; P = 0.033).

CONCLUSIONS

Late-night overeating is associated with skipping and/or consuming a smaller breakfast. In children with low levels of physical activity, it is associated with increased body mass index. Future relevant studies are essential to further explore and confirm the findings of the present study.

Eating quickly is associated with waist-to-height ratio among Japanese adolescents: a cross-sectional survey

Background

Central obesity, based on waist circumference (WC), has more adverse effects on health than general obesity, determined by body mass index. To date, eating quickly has been reported to be risk factors for overweight/obesity among children, adolescents, and adults. In contrast, there are few studies on the relationship between fast eating and central obesity among adolescents, particularly in Japan, where WC is not commonly measured in junior high schools. The aim of the present study was to investigate the relationship between eating quickly and waist-to-height ratio (WHtR), an index of central obesity, among adolescents in Japan.

Methods

Study subjects were 2136 seventh-grade school children (12 or 13 years of age) from Ina town junior high schools in Japan, between 2004 and 2009. Measurements of height, weight, and WC were performed, and information about eating habits was collected using a self-administered questionnaire. A logistic regression model was used to calculate the odds ratio (OR) and 95 % confidence interval (95 % CI) for WHtR ≥ 0.5.

Results

Eating quickly significantly increased the OR for WHtR ≥ 0.5 in boys (OR: 2.05, 95 % CI: 1.31–3.23) and girls (2.09, 1.15–3.81). When compared with the “not eating quickly and not eating until full” group, the OR for WHtR ≥ 0.5 in the “eating quickly and eating until full” group was 2.67 (95 % CI: 1.50–4.73) in boys and 2.59 (1.17–5.73) in girls, whereas that in the “eating quickly and not eating until full” group or the “not eating quickly and eating until full” group was not statistically significant regardless of sex.

Conclusions

The present study showed that eating quickly was associated with WHtR ≥ 0.5, and “eating quickly and eating until full” had a substantial impact on WHtR ≥ 0.5 among adolescents. This study suggests that modifying fast eating to a slower pace may help prevent central obesity among adolescents.

Energy Contribution and Nutrient Composition of Breakfast and Their Relations to Overweight in Free-living Individuals: A Systematic Review

Previous systematic reviews on the relation between overweight or obesity and breakfast focused on the frequency of consumption and only partially accounted for breakfast nutritional profiles. Given the central role of these factors, we conducted a systematic review of the literature on this putative relation, with a specific focus on breakfast energy intake and/or breakfast composition. Among the 814 articles identified from the literature search in PubMed, 19, mostly cross-sectional, studies met the inclusion criteria (i.e., studies providing a quantitative estimate of the relation between any measure of weight, overweight, and obesity and breakfast energy intake or breakfast macronutrient composition). We excluded studies in subjects with acquired metabolic disorders, such as diabetes or impaired glucose tolerance. Of the 16 studies that evaluated the amount of energy intake at breakfast, 4 found that a lower energy intake at breakfast was significantly associated with obesity in children, adolescents, and adults, whereas 2 partially overlapping studies found that a higher energy intake was significantly associated with a higher body mass index in children. Of the 8 studies investigating breakfast composition, 3 suggested that a breakfast characterized by a higher amount of carbohydrates and a lower amount of fat is significantly related to normal weight in adults, whereas the others reported mixed results. In conclusion, there is some evidence that a lower energy intake at breakfast is related to obesity, although the studies are few and heterogeneous. Studies on the nutrient composition of breakfast have shown inconsistent results.

Unhealthy eating behaviors and weight gain: A prospective study in young and middle-age adults

OBJECTIVE

Guidelines for obesity prevention recommend reducing certain unhealthy eating behaviors (UEB). However, the association between UEB and weight gain is uncertain.

METHODS

Prospective cohort with 1,638 individuals aged 18-60 years was recruited in 2008-2010. UEB assessed at baseline were: not planning how much to eat, consuming pre-cooked/canned food, buying snacks, eating in fast-food restaurants, not choosing low-calorie foods, not removing visible fat from meat or skin from chicken, and eating while watching TV or seating on a sofa. Participants were followed up through 2012 to assess weight change.

RESULTS

Compared to reporting 0-2 UEB, the multivariate odds ratios (95% confidence interval) for gaining ≥3 kg were 0.97 (0.74-1.28) for 3-4 UEB and 1.61 (1.09-2.39) for ≥5 UEB, P-trend = 0.07. Results were similar for gaining ≥5 kg. The three UEB with the strongest associations with weight gain were: 1) not planning the amount of food to eat, 2) eating at fast-food restaurants, and 3) eating while watching TV; compared to having none of these three behaviors, the odds ratio (95% confidence interval) for gaining ≥3 kg was 1.54 (0.77-3.08) for 1 UEB, 1.70 (0.85-3.37) for 2 UEB, and 2.75 (1.28-5.90) for 3 UEB, P-trend = 0.007. Similar results were obtained for gaining ≥5 kg.

CONCLUSIONS

Several UEB are associated with weight gain.

Association of breakfast consumption with body mass index and prevalence of overweight/obesity in a nationally-representative survey of Canadian adults

Background

This study examined the association of breakfast consumption, and the type of breakfast consumed, with body mass index (BMI; kg/m²) and prevalence rates and odds ratios (OR) of overweight/obesity among Canadian adults. These associations were examined by age group and sex.

Methods

We used data from non-pregnant, non-lactating participants aged ≥ 18 years (n = 12,377) in the Canadian Community Health Survey Cycle 2.2, a population-based, nationally-representative, cross-sectional study. Height and weight were measured, and BMI was calculated. Breakfast consumption was self-reported during a standardized 24-h recall; individuals were classified as breakfast non-consumers, consumers of breakfasts that included ready-to-eat cereal (RTEC) or as other breakfast consumers. Mean BMI and prevalence and OR of overweight/obesity (BMI ≥ 25) were compared among breakfast groups, with adjustment for sociodemographic variables (including age, sex, race, marital status, food security, language spoken at home, physical activity category, smoking, education level and supplement use).

Results

For the entire sample, mean BMI was significantly lower among RTEC-breakfast consumers than other breakfast consumers (mean ± SE 26.5 ± 0.2 vs. 27.1 ± 0.1 kg/m²), but neither group differed significantly from breakfast non-consumers (27.1 ± 0.3 kg/m²). Similar results were seen in women only, but BMI of men did not differ by breakfast category. Overweight/obesity prevalence and OR did not differ among breakfast groups for the entire sample or for all men and women separately. When examined by sex and age group, differences were inconsistent, but tended to be more apparent in women than men.

Conclusion

Among Canadian adults, breakfast consumption was not consistently associated with differences in BMI or overweight/obesity prevalence.

Weight discrimination and unhealthy eating-related behaviors

Individuals with obesity often experience unfair treatment because of their body weight. Such experiences are associated with binge eating, but less is known about its association with other eating-related behaviors and whether these relations are specific to discrimination based on weight or extend to other attributions for discrimination. The present research uses a large national sample (N = 5129) to examine whether weight discrimination is associated with diet and meal rhythmicity, in addition to overeating, and whether these associations generalize to nine other attributions for discrimination. We found that in addition to overeating, weight discrimination was associated with more frequent consumption of convenience foods and less regular meal timing. These associations were generally similar across sex, age, and race. Discrimination based on ancestry, gender, age, religion, and physical disability were also associated with overeating, which suggests that overeating may be a general coping response to discrimination. Unfair treatment because of body weight is associated with unhealthy eating-related behaviors, which may be one pathway through which weight discrimination increases risk for weight gain and obesity.

Breakfast frequency among adolescents: associations with measures of family functioning

OBJECTIVE

To investigate (i) associations between adolescents' frequency of breakfast and family functioning (close relations to parents, quality of family communication and family support) and (ii) if any observed associations between breakfast frequency and family functioning vary by sociodemographic factors.

DESIGN

School-based cross-sectional study. Students completed a web-based questionnaire. Associations were estimated by multilevel multivariate logistic regression.

SETTING

Danish arm of the Health Behaviour in School-aged Children study, 2014.

SUBJECTS

Adolescents aged 13 and 15 years (n 3054) from a random sample of forty-one schools.

RESULTS

Nearly one-quarter of the adolescents had low breakfast frequency. Low breakfast frequency was associated with low family functioning measured by three dimensions. The OR (95 % CI) of low breakfast frequency was 1·81 (1·40, 2·33) for adolescents who reported no close relations to parents, 2·28 (1·61, 3·22) for adolescents who reported low level of quality of family communication and 2·09 (1·39, 3·15) for adolescents who reported low level of family support. Joint effect analyses suggested that the odds of low breakfast frequency among adolescents with low family functioning compared with high family functioning were highest among adolescents being girls, immigrants and living in other than a traditional family structure.

CONCLUSIONS

Low breakfast frequency was associated with low family functioning measured by close relations to parents, quality of family communication and family support. Further, analyses suggested that the associations were more pronounced among girls, immigrants and adolescents from other family structure than traditional. The study highlights the importance of the family setting in promoting regular breakfast frequency among adolescents.

Adiposity, hypertension and weight management behaviours in Ghanaian type 2 diabetes mellitus patients aged 20-70 years

OBJECTIVE

This study assessed the prevalence of general and abdominal obesity and hypertension as well the weight management behaviours of type 2 diabetes mellitus patients.

METHODS

It included 378 diabetes patients seeking care from two hospitals in Ghana. Standard methods and tools were used to assess participants' weight, height, waist circumference (WC), blood pressure (BP) and fasting plasma glucose (FPG). Weight management behaviours were measured using a questionnaire.

RESULTS

The prevalence of general obesity, abdominal obesity and hypertension was 20.1%, 46.6% and 67.7% respectively. Abdominal obesity was more likely in participants who: skipped breakfast, engaged in exercise to lose weight and were generally overweight/obese. General overweight and obesity was more likely in participants who: reported receipt of weight management counselling, engaged in exercise to lose weight, had a weight management plan/goal, and were abdominally obese. Hypertension was less likely in participants who had: no formal education, diabetes for ≥5 years and modified their dietary habits to lose weight but more likely in those who skipped breakfast.

CONCLUSION

Abdominal obesity, general overweight/obesity, and hypertension were frequent in this sample and were influenced by weight management behaviours.

Neighbourhood social capital: measurement issues and associations with health outcomes

We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes.

Characterizing eating patterns: a comparison of eating occasion definitions

BACKGROUND

To date, many approaches have been used to define eating occasions (EOs). A standard definition for EOs is required to facilitate further research.

OBJECTIVE

In this study, we examined the influence of differing definitions of EOs on the characterization of eating patterns.

DESIGN

Cross-sectional dietary data from two 24-h recalls collected during the 2011-12 Australian National Nutrition and Physical Activity Survey (n = 5242 adults, aged ≥19 y) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (individual EOs separated by different time intervals and/or an additional energy criterion of 210 kJ). Frequency of and total energy intake from meals, snacks, and all EOs were estimated, as appropriate. Differences were tested by using F tests, stratified by sex and age group. Agreement between different definitions of meal and snack frequencies was assessed by using intraclass correlation coefficients (ICCs). For each definition, linear regression was used to estimate the proportion of variance in total energy intake (kJ) and amount of food intake (g) predicted by frequency of EOs and meals and snacks.

RESULTS

Among both sexes and across all age groups, mean frequencies of meals differed between the participant-identified and time-of-day definitions (mean difference range = 0.1-0.3; P < 0.001). There were statistically significant differences between mean frequencies of EOs across the 6 neutral definitions (P < 0.001). There was good agreement for snacks (men: ICC = 0.89; women: ICC = 0.87) but not meal frequencies (men: ICC = 0.38; women: ICC = 0.36) between the participant-identified and time-of-day definitions. The neutral definition (15-min time interval plus energy criterion) best predicted variance in total energy intake (R(2) range = 19.3-27.8).

CONCLUSIONS

Different approaches to the definition of EOs affect how eating patterns are characterized, with the neutral definition best predicting variance in total energy intake. Further research that examines how different EO definitions affect associations with health outcomes is needed to develop consensus on a standard EO definition.

Association between meal intake behaviour and abdominal obesity in Spanish adults

The study aims to evaluate the association between abdominal obesity with meal intake behaviour such as having a forenoon meal, having an afternoon meal and snacking. This cross-sectional study includes n = 1314 participants aged 20-79 who were interviewed during the Cardiac health "Semanas del Corazon" events in four Spanish cities (Madrid, Las Palmas, Seville and Valencia) in 2008. Waist circumference, weight and height were assessed to determine abdominal obesity (waist circumference: ≥88 cm in women and ≥102 cm in men) and BMI, respectively. The intake of forenoon and afternoon meal and snacking between the participants' regular meals were assessed with a questionnaire that also included individual risk factors. The information obtained about diet was required to calculate an Unhealthy Habit Score and a score reflecting the Achievement of Dietary Guidelines. Adjusted logistic regressions were used to examine the association between abdominal obesity and the mentioned meal intake behaviour controlling for sex, age, individual risk factors, BMI and diet. Having an afternoon meal (OR 0.60; 95% CI (0.41-0.88)) was negatively associated with abdominal obesity after adjusting for all confounders, whereas the positive association of snacking (OR 1.39; 95% CI (1.05-1.85)) was not independent of BMI (OR 1.25; 95% CI (0.84-1.87)). Taking a forenoon meal did not show any associations (OR 0.92; 95% CI (0.63-1.34)) with abdominal obesity. The results obtained could be helpful in the promotion of healthy habits in nutritional education programmes and also in health programmes preventing abdominal obesity.

Systematic review and meta-analysis of the impact of restaurant menu calorie labeling

We conducted a systematic review and meta-analysis evaluating the relationship between menu calorie labeling and calories ordered or purchased in the PubMed, Web of Science, PolicyFile, and PAIS International databases through October 2013. Among 19 studies, menu calorie labeling was associated with a -18.13 kilocalorie reduction ordered per meal with significant heterogeneity across studies (95% confidence interval = -33.56, -2.70; P = .021; I(2) = 61.0%). However, among 6 controlled studies in restaurant settings, labeling was associated with a nonsignificant -7.63 kilocalorie reduction (95% confidence interval = -21.02, 5.76; P = .264; I(2) = 9.8%). Although current evidence does not support a significant impact on calories ordered, menu calorie labeling is a relatively low-cost education strategy that may lead consumers to purchase slightly fewer calories. These findings are limited by significant heterogeneity among nonrestaurant studies and few studies conducted in restaurant settings.

Consumption of thylakoid-rich spinach extract reduces hunger, increases satiety and reduces cravings for palatable food in overweight women

Green-plant membranes, thylakoids, have previously been found to increase postprandial release of the satiety hormone GLP-1, implicated in reward signaling. The purpose of this study was to investigate how treatment with a single dose of thylakoids before breakfast affects homeostatic as well as hedonic hunger, measured as wanting and liking for palatable food (VAS). We also examined whether treatment effects were correlated to scores for eating behavior. Compared to placebo, intake of thylakoids significantly reduced hunger (21% reduction, p < 0.05), increased satiety (14% increase, p < 0.01), reduced cravings for all snacks and sweets during the day (36% reduction, p < 0.05), as well as cravings for salty (30%, p < 0.01); sweet (38%, p < 0.001); and sweet-and-fat (36%, p < 0.05) snacks, respectively, and decreased subjective liking for sweet (28% reduction, p < 0.01). The treatment effects on wanting all snacks, sweet-and-fat snacks in particular, were positively correlated to higher emotional eating scores (p < 0.01). The treatment effect of thylakoids on scores for wanting and liking were correlated to a reduced intake by treatment (p < 0.01 respectively), even though food intake was not affected significantly. In conclusion, thylakoids may be used as a food supplement to reduce homeostatic and hedonic hunger, associated with overeating and obesity. Individuals scoring higher for emotional eating behavior may have enhanced treatment effect on cravings for palatable food.

Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality

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.

The Influence of Portion Size and Timing of Meals on Weight Balance and Obesity

This review focuses on the influence of portion size and temporal distribution of food intake on weight balance and obesity in adults. The inconsistency of definitions in the area of meal patterns is also discussed. The conclusion is that regular eating habits might facilitate weight balance, while unplanned snacking as well as consuming the major part of the energy intake at the end of the day seem to be unfavourable. Altogether, the research suggests that large portions promote over-consumption and, therefore, limiting portion size of energy dense foods and drinks with added sugar could be recommended. Even if more research is needed, these factors should be taken into consideration in recommendations for obesity prevention.

Meals described as healthy or unhealthy match public health education in England

Dietary guidelines for the general public aim to lower the incidence of nutrition-related diseases by influencing habitual food choices. Yet little is known about how well the guidelines are matched by the actual practices that people regard as healthy or unhealthy. In the present study, British residents were asked in a cognitive interview to write a description of an occasion when either they ate in an unhealthy way or the eating was healthy. The reported foods and drinks, as well as sort of occasion, location, people present and time of day, were categorised by verbal and semantic similarities. The number of mentions of terms in each category was then contrasted between groups in exact probability tests. Perceived unhealthy and healthy eating occasions differed reliably in the sorts of foods and the contexts reported. There was also full agreement with the national guidelines on eating plenty of fruit and vegetables, eating small amounts of foods and drinks high in fat and/or sugar, drinking plenty of water, and cutting down on alcohol. There was a tendency to regard choices of bread, rice, potatoes, pasta and other starchy foods as healthy. Reported healthy and unhealthy eating did not differ in incidences of meat, fish, eggs, beans and other non-dairy sources of protein or of dairy foods and milk. These results indicate that operationally clear recommendations by health professionals are well understood in this culture but members of the public do not make clear distinctions in the case of foods that can be included in moderate amounts in a healthy diet.

Weighing the Evidence of Common Beliefs in Obesity Research

Obesity is a topic on which many views are strongly held in the absence of scientific evidence to support those views, and some views are strongly held despite evidence to contradict those views. We refer to the former as "presumptions" and the latter as "myths." Here, we present nine myths and 10 presumptions surrounding the effects of rapid weight loss; setting realistic goals in weight loss therapy; stage of change or readiness to lose weight; physical education classes; breastfeeding; daily self-weighing; genetic contribution to obesity; the "Freshman 15"; food deserts; regularly eating (versus skipping) breakfast; eating close to bedtime; eating more fruits and vegetables; weight cycling (i.e., yo-yo dieting); snacking; built environment; reducing screen time in childhood obesity; portion size; participation in family mealtime; and drinking water as a means of weight loss. For each of these, we describe the belief and present evidence that the belief is widely held or stated, reasons to support the conjecture that the belief might be true, evidence to directly support or refute the belief, and findings from randomized controlled trials, if available. We conclude with a discussion of the implications of these determinations, conjecture on why so many myths and presumptions exist, and suggestions for limiting the spread of these and other unsubstantiated beliefs about the obesity domain.

Association of the duration of residence with obesity-related eating habits and dietary patterns among Latin-American immigrants in Spain

The dietary patterns of immigrants usually change with the duration of residence and progressively resemble those of the host country. However, very few studies have investigated individuals migrating to countries with a high-quality diet, such as the Mediterranean diet (MD), and none has yet focused on Latin-American immigrants. The present study examined the association of the duration of residence with obesity-related eating habits and dietary patterns among Latin-American immigrants residing in Spain. A cross-sectional study was conducted in 2008–10 in a representative sample of the adult population residing in Spain. Adherence to the MD was defined as a MD Adherence Screener score ≥ 9. Analyses were conducted by including 419 individuals aged 18–64 years born in Latin-American countries. Compared with immigrants residing in Spain for < 5 years, those residing for ≥ 10 years accounted for a lower percentage of individuals who habitually ate at fast-food restaurants and never trimmed visible fat from meat. Moreover, these immigrants were found to have a lower intake of sugary beverages and a higher intake of Na, saturated fat, fibre, olive oil, vegetables and fish and to more frequently strictly adhere to the MD. A longer duration of residence in Spain was found to be associated with both healthy and unhealthy changes in some eating habits and dietary patterns among Latin-American immigrants. Some of the healthy changes observed contrasted the ‘Westernisation’ of the diet reported in studies conducted in other Western countries. The results of the present study support the role of the food environment of the host country in the modification of the dietary patterns of immigrants.