Breakfast skipping may be associated with increased adiposity, particularly among older children and adolescents and for those who are normal weight (as opposed to already overweight).  

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

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• Quality Rating Summary
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• Worksheets
  • Boutelle K, Neumark-Sztainer D, Story M, Resnick M. Weight control behaviors among obese, overweight, and nonoverweight adolescents.  J Pediatr Pscychol 2002;27:531-40.
  • Dwyer JT, Evans M, Stone EJ, Feldman HA, Lytel L, Hoelscher D, Johnson C, Zive M, Yang M. CATCH Cooperative Research Group.  Adolescents’ eating patterns influence their nutrient intakes.  J Am Diet Assoc 2001;101:798-802.
  • Lin BH, Huang CL, French SA. Factors associated with women's and children's body mass indices by income status. Int J Obes Relat Metab Disord. 2004 Apr;28(4):536-42.
  • Nicklas TA, Morales M, Linares A, Yang SJ, Baranowski T, De Moor C, Berenson G. Children's meal patterns have changed over a 21-year period: the Bogalusa Heart Study. J Am Diet Assoc. 2004; 104(5): 753-61
  • Nicklas TA, Yang SJ, Baranowski T, Zakeri I, Berenson G. Eating patterns and obesity in children. The Bogalusa Heart Study. Am J Prev Med. 2003 Jul;25(1):9-16.
  • O'Dea JA, Caputi P. Association between socioeconomic status, weight, age and gender, and the body image and weight control practices of 6- to 19-year-old children and adolescents. Health Educ Res 2001;16:521-32.
  • Ortega RM, Requejo AM, López-Sobaler AM, Quintas ME, Andrés P, Redondo MR, Navia B, López-Bonilla MD, Rivas T. Difference in the breakfast habits of overweight/obese and normal weight schoolchildren.  Int J Vitam Nutr Res 1998; 68:125-32.
  • Pastore DR, Fisher M, Friedman SB. Abnormalities in weight status, eating attitudes, and eating behaviors among urban high school students: correlations with self-esteem and anxiety. J Adolesc Health 1996;18:312-9.
  • Sampson AE, Dixit S, Meyers AF, Houser R Jr. The nutritional impact of breakfast consumption on the diets of inner-city African-American elementary school children.  J Natl Med Assoc 1995;87:195-202.
  • Sekine M, Yamagami T, Hamanishi S, Handa K, Saito T, Nanri S, Kawaminami K, Tokui N, Yoshida K, Kagamimori S. Parental obesity, lifestyle factors and obesity in preschool children: results of the Toyama Birth Cohort study.  J Epidemiol 2002;12:33-9.
  • Siega-Riz AM, Carson T, Popkin B. Three squares or mostly snacks – What do teens really eat? A sociodemographic study of meal patterns. J Adolesc Health 1998;22:29-36.
  • Summerbell CD, Moody RC, Shanks J, Stock MJ, Geissler C. Relationship between feeding pattern and body mass index in 220 free-living people in four age groups. European Journal of Clinical Nutrition 1996;50:513-519.
  • Wolfe WS, Campbell CC, Frongillo EA, Haas JD, Melnik TA. Overweight schoolchildren in New York State: Prevalence and characteristics. Am J Pub Health 1994;84:807-813.

Eating frequency may not be associated with adiposity in children.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Crawley H, Summerbell C. Feeding frequency and BMI among teenagers aged 16-17 years. Int J Obes, 1997;21:159-161.
  • McConahy KL, Smiciklas-Wright H, Birch LL, Mitchell DC, Picciano MF. Food portions are positively related to energy intake and body weight in early childhood. J Pediatr 2002;140:340-347.
  • Nicklas TA, Morales M, Linares A, Yang SJ, Baranowski T, De Moor C, Berenson G. Children's meal patterns have changed over a 21-year period: the Bogalusa Heart Study. J Am Diet Assoc. 2004; 104(5): 753-61
  • Siega-Riz AM, Carson T, Popkin B. Three squares or mostly snacks – What do teens really eat? A sociodemographic study of meal patterns. J Adolesc Health 1998;22:29-36.
  • Summerbell CD, Moody RC, Shanks J, Stock MJ, Geissler C. Relationship between feeding pattern and body mass index in 220 free-living people in four age groups. European Journal of Clinical Nutrition 1996;50:513-519.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Ebbeling CB, Sinclair KB, Pereira MA, Garcia-Lago E, Feldman HA, Ludwig DS. Compensation for energy intake from fast food among overweight and lean adolescents. JAMA. 2004 Jun 16;291(23):2828-33.
  • French SA, Story M, Neumark-Sztainer D, Fulkerson JA, Hannan P. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. International Journal of Obesity. 2001:1823-1833.
  • Gillis LJ, Bar-Or O. Food away from home, sugar-sweetened drink consumption and juvenile obesity. J Am Coll Nutr. 2003 Dec;22(6):539-45.
  • Kelishadi R, Pour MH, Sarraf-Zadegan N, Sadry GH, Ansari R, Alikhassy H, Bashardoust N. Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program - Heart Health Promotion from Childhood. Pediatr Int. 2003 Aug;45(4):435-42.
  • Lin BH, Huang CL, French SA. Factors associated with women's and children's body mass indices by income status. Int J Obes Relat Metab Disord. 2004 Apr;28(4):536-42.
  • Mikkila V, Lahti-Koski M, Pietinen P, Virtanen SM, Rimpela M. Associates of obesity and weight dissatisfaction among Finnish adolescents. Publ Health Nutr 2002;6:49-56.
  • Nicklas TA, Morales M, Linares A, Yang SJ, Baranowski T, De Moor C, Berenson G. Children's meal patterns have changed over a 21-year period: the Bogalusa Heart Study. J Am Diet Assoc. 2004; 104(5): 753-61
  • Pastore DR, Fisher M, Friedman SB. Abnormalities in weight status, eating attitudes, and eating behaviors among urban high school students: correlations with self-esteem and anxiety. J Adolesc Health 1996;18:312-9.
  • Thompson OM, Ballew C, Resnicow K, Must A, Bandini LG, Cyr H, Dietz WH. Food purchased away from home as a predictor of change in BMI z-score among girls. Int J Obes Relat Metab Disord. 2004 Feb;28(2):282-9.

Increased portion sizes may be associated with increased adiposity in children.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

Snacking frequency or snack food intake may not be associated with adiposity in children.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Bandini LG, Vu D, Must A, Cyr H, Goldberg A, Dietz WH.  Comparison of high-calorie, low-nutrient-dense food consumption among obese and non-obese adolescents.  Obes Res 1999;7:438-43.
  • Brewis A. Biocultural aspects of obesity in young Mexican schoolchildren. Am J Hum Biol. 2003 May-Jun;15(3):446-60.
  • Dwyer JT, Evans M, Stone EJ, Feldman HA, Lytel L, Hoelscher D, Johnson C, Zive M, Yang M. CATCH Cooperative Research Group.  Adolescents’ eating patterns influence their nutrient intakes.  J Am Diet Assoc 2001;101:798-802.
  • Kelishadi R, Pour MH, Sarraf-Zadegan N, Sadry GH, Ansari R, Alikhassy H, Bashardoust N. Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program - Heart Health Promotion from Childhood. Pediatr Int. 2003 Aug;45(4):435-42.
  • Locard E, Mamelle N, Billette A, Miginiac M, Munoz F, Rey S. Risk factors of obesity in a fiver year old population.  Parental versus environmental factors.  Int J Obes 1992;16:721-9.
  • Maffeis C, Provera S, Filippi L, Sidoti G, Schena S, Pinelli L, Tatò L. Distribution of food intake as a risk factor for childhood obesity.  Int J Obes 2000;24:75-80.
  • Nicklas TA, Yang SJ, Baranowski T, Zakeri I, Berenson G. Eating patterns and obesity in children. The Bogalusa Heart Study. Am J Prev Med. 2003 Jul;25(1):9-16.
  • O’Dea JA, Abraham S, Heard R. Food habits, body image and weight control practices of young male and female adolescents. Aust J Nutr Diet 1996;53:32-8.
  • Rockett HR, Berkey CS, Field AE, Colditz GA. Cross-sectional measurement of nutrient intake among adolescents in 1996. Prev Med 2001; 33:27-37.
  • Sekine M, Yamagami T, Hamanishi S, Handa K, Saito T, Nanri S, Kawaminami K, Tokui N, Yoshida K, Kagamimori S. Parental obesity, lifestyle factors and obesity in preschool children: results of the Toyama Birth Cohort study.  J Epidemiol 2002;12:33-9.
  • Takahashi E, Yoshida K, Sugimori H, Miyakawa M, Izuno T, Yamagami T, Kagamimori S. Influence factors on the development of obesity in 3-year-old children based on the Toyama Study.  Prev Med 1999;28:203-6.
  • Tanasescu M, Ferris AM, Himmelgreen DA, Rodriguez N, Pérez-Escamilla R. Biobehavioral factors are associated with obesity in Puerto Rican children. J Nutr 2000;130:1734-42.
  • Wolfe WS, Campbell CC, Frongillo EA, Haas JD, Melnik TA. Overweight schoolchildren in New York State: Prevalence and characteristics. Am J Pub Health 1994;84:807-813.

Household food insecurity does not appear to be associated with overweight among children, a finding that may be due, in part, to the fact that a comprehensive measure of child food insecurity was not used in most studies.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Alaimo K, Olson CM, Frongillo EA Jr.  Low family income and food insufficiency in relation to overweight in US children.  Arch Pediatr Adolesc Med 2001; 155:1161-1167.
  • Casey PH, Szeto K, Lensing S, Bogle M, Weber J.  Children in food insufficient, low-income families: Prevalence, health, and nutrition status.  Arch Pediatr Adolesc Med 2001;155:508-14.
  • Cutts DB, Pheley AM, Geppert JS. Hunger in Midwestern inner-city young children.  Arch Pediatr Adolesc Med 1998;152:489-93.
  • Kaiser LL, Melgar-Quiñonez HR, Lamp CL, Johns MC, Sutherlin JM, Harwood JO.  Food security and nutritional outcomes of preschool-age Mexican-American children. J Am Diet Assoc 2002; 102: 924-929.
  • Matheson DM, Varady J, Varady A, Killen JD. Household food security and nutritional status of Hispanic children in the fifth grade.  Am J Clin Nutr 2002;76:210-7.
  • Melgar-Quinonez HR, Kaiser LL. Relationship of child-feeding practices to overweight in low-income Mexican-American preschool-aged children. J Am Diet Assoc. 2004 Jul;104(7):1110-9.
  • Tanasescu M, Ferris AM, Himmelgreen DA, Rodriguez N, Pérez-Escamilla R. Biobehavioral factors are associated with obesity in Puerto Rican children. J Nutr 2000;130:1734-42.