Meal and snack frequency in relation to diet quality in US children and adolescents: the National Health and Nutrition Examination Survey 2003–2012

ObjectiveTo examine the associations of meal frequency (MF) and snack frequency (SF) with diet quality.DesignDietary intake was assessed using two 24 h dietary recalls. All eating occasions providing ≥210 kJ of energy were divided into meals or snacks on the basis of contribution to energy intake (≥15 % or SettingNationally representative sample of the US population.SubjectsChildren aged 6–11 years (n 4269) and adolescents aged 12–19 years (n 6193) in the National Health and Nutrition Examination Survey 2003–2012.ResultsIrrespective of the definition of meals, higher MF was associated with higher HEI-2010 in both children and adolescents. One additional meal per day increased HEI-2010 by 1·45–3·59 points (all PP=0·001) and 1·00 (PConclusionsIn a representative sample of US children and adolescents, MF was associated with better diet quality, while the associations for SF varied depending on the definition of snacks. The findings highlight the importance of applying different definitions of meals and snacks when assessing the impact of dietary patterns on health.