Meal pattern, food choice, nutrient intake and lifestyle factors in The Goteborg Adolescence Study

Objective: To relate meal pattern of Swedish adolescents to food choice, nutrient intake and other lifestyle factors. Design: Cross-sectional study including diet history and interview about smoking, ethnicity, social factors and retrospectively collected data of menarche and growth. Setting: School setting, Goteborg, Sweden. Subjects: A total of 611 boys and 634 girls in grade 9 (15-16 y). Results: The majority of the students, 65% of the boys and 52% of the girls, consumed three main meals daily. The in-between meals, however, contributed the major part of the energy intake. The energy intake was 12.9+/-3.5 MJ (mean+/-s.d.) for boys and 9.0+/-2.5 MJ for girls. Irregular breakfast eating, 12% of the boys and 24% of the girls, was related to negative lifestyle factors where smoking was the strongest, odds ratio 3.8 (95% CI: 2.6-5.4) and to irregular intake of lunch and dinner. These boys and girls had a food choice including a higher percentage of energy from snack food (26% vs 20% and 19% in boys and girls respectively, all P<0.001), mostly consumed between the main meals. These groups had significantly lower intakes of micronutrients, but higher intakes of sucrose and alcohol compared to the groups with regular breakfast intake. Girls omitting breakfasts and lunches (8%) also had a less healthy food choice and the poorest nutrient intake. These girls had matured earlier, with menarche age of 12.2 +/- 1.1 y vs 12.9 +/- 1.0 y (P<0.001) in girls with regular main meal intake. Conclusions: Meal pattern with omission of breakfast or breakfast and lunch was related to a clustering of less healthy lifestyle factors and food choice leading to a poorer nutrient intake. Sponsorship: The Swedish Medical Research Council (project B94-19X-04721-19A), the Swedish Mill Industry and the Wilhelm and Martina Lundgren Foundation.