FREQUENCY OF MEALS CONSUMED BY BRAZILIAN ADOLESCENTS AND ASSOCIATED HABITS: SYSTEMATIC REVIEW

Sousa, Suzy Ferreira de; Wolf, Vaneza Lira Waldow; Martini, Mariana Conteiro San; Assumpção, Daniela de; Barros Filho, Antônio Azevedo de

doi:10.1590/1984-0462/2020/38/2018363

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Brasil

Revista Paulista de Pediatria

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REVIEW ARTICLE • Rev. paul. pediatr. 38 • 2020 • https://doi.org/10.1590/1984-0462/2020/38/2018363 copy

FREQUENCY OF MEALS CONSUMED BY BRAZILIAN ADOLESCENTS AND ASSOCIATED HABITS: SYSTEMATIC REVIEW

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the studies that identified the frequency of meals ingested by Brazilian adolescents and associated habits.

Data sources:

A systematic search was made in the databases and electronic databases: MEDLINE/PubMed, The Latin American and Caribbean Center of Information in Health Sciences (BIREME), Scopus, Web of Science and Embase, with articles published between January/2007 until December/2017, which addressed the evaluation of the frequency of meals performed by adolescents, considering or not associations with eating patterns and meal replacement.

Data synthesis:

6,608 studies were obtained through the search and nine were included in this review, all of them with a cross-sectional design. Eight studies used school surveys and only one was a population survey. Seven studies evaluated the frequency of the main daily meals that ranged from 47.0 to 79.0% at breakfast, from 65.0 to 98.4% at lunch, and from 51.0 to 94.0% at dinner. Five studies identified the frequencies of consumption of snacks between meals, finding higher values for afternoon snack (variation from 42.0 to 78.0%). Regarding the substitution of meals for snacks, in three of the four selected studies; it was observed that this practice occurred mainly in substitution of dinner (24.6 to 42.0%).

Conclusions:

Breakfast was the most omitted meal for adolescents, and dinner was replaced with snacks. Among the between meal snacks, the afternoon snack was the most consumed.

Keywords:
Adolescent; Meals; Feeding behavior

Authors	Year	no	Survey Type	City - State	Age range (years)	Food intake assessment method
Dalla Costa et al. ¹⁴14. Dalla Costa MC, Cordoni Junior L, Matsuo T. Food habits of adolescent students from a municipality in western Paraná, Brazil. Rev Nutr. 2007;20:461-71. http://dx.doi.org/10.1590/S1415-52732007000500002 https://doi.org/http://dx.doi.org/10.159...	2007	2,717	School	Toledo - PR	14 to 19	QFA Semiquantitative ^b
Prochnik Estima et al. ¹⁵15. Prochnik Estima CC, da Costa RS, Sichieri R, Pereira RA, da Veiga GV. Meal consumption patterns and anthropometric measurements in adolescents from a low socioeconomic neighborhood in the metropolitan area of Rio de Janeiro, Brazil. Appetite. 2009;52:735-9. https://doi.org/10.1016/j.appet.2009.03.017 https://doi.org/https://doi.org/10.1016/...	2009	528	Populational	Elíseos Field - RJ	12 to 18	QFA ^a
Leal et al. ¹⁶16. Leal GV, Philippi ST, Matsudo SM, Toassa EC. Food intake and meal patterns of adolescents, São Paulo, Brazil. Rev Bras Epidemiol. 2010;13:1-10. http://dx.doi.org/10.1590/S1415-790X2010000300009 https://doi.org/http://dx.doi.org/10.159...	2010	228	School	Ilhabela - SP	10 to 19	R24 hours ^c
Araki et al. ¹⁷17. Araki EL, Philippi ST, Martinez MF, Estima CC, Leal GV, Alvarenga MS. Pattern of meals eaten by adolescents from technical schools of São Paulo, SP, Brazil. Rev Paul Pediatr. 2011;29:164-70. http://dx.doi.org/10.1590/S0103-05822011000200006 https://doi.org/http://dx.doi.org/10.159...	2011	71	School	Sao Paulo-SP	14 to 17	QAAA ^d
Moraes et al. ¹⁸18. de Moraes AC, Adami F, Falcão MC. Understanding the correlates of adolescents’ dietary intake patterns. A multivariate analysis. Appetite. 2012;58:1057-62. https://doi.org/10.1016/j.appet.2012.01.024 https://doi.org/https://doi.org/10.1016/...	2012	991	School	Maringa - PR	14 to 18	QFA ^a
Caram et al. ¹⁹19. Caram AL, Lamazi EA. Eating habits, nutritional status and body image perceptions of adolescents. Adolesc Saude. 2012;9:21-9.	2012	126	School	Campinas, sp	12 to 18	QFA ^a
Chaves et al. ²⁰20. Chaves OC, Castro C, Machado S, Ribeiro R, Faria G, Priore SE. Anthropometric and biochemical parameters in adolescents and their relationship with eating habits and household food availability. Nutr Hosp. 2013;28:1352-6. https://doi.org/10.3305/nh.2013.28.4.6467 https://doi.org/https://doi.org/10.3305/...	2013	120	School	Viçosa - MG	10 to 13	QFA ^a
Silva et al. ²¹21. Silva FA, Candiá SM, Pequeno MS, Sartorelli DS, Mendes LL, Oliveira RM, et al. Daily meal frequency and associated variables in children and adolescents. J Pediatr (Rio J.). 2017;93:79-86. http://dx.doi.org/10.1016/j.jped.2016.04.008 https://doi.org/http://dx.doi.org/10.101...	2017	708	School	Juiz de Fora - MG	7 to 14	R24 hours ^c
Rodrigues et al. ⁹9. Rodrigues PRM, Luiz RR, Monteiro LS, Ferreira MG, Gonçalves-Silva RM, Pereira RA. Adolescents’ unhealthy eating habits are associated with meal skipping. Nutrition. 2017;42:114-20.e1. https://doi.org/10.1016/j.nut.2017.03.011 https://doi.org/https://doi.org/10.1016/...	2017	1,139	School	Cuiaba - MT	14 to 19	QFA Semiquantitative ^b

Authors	no	Breakfast (%)				Lunch (%)				Dinner (%)				Meal frequency/day (%)
Authors	no	Total	M	F	p-value	Total	M	F	p-value	Total	M	F	p-value	Meal frequency/day (%)
Dalla Costa et al. ¹⁴14. Dalla Costa MC, Cordoni Junior L, Matsuo T. Food habits of adolescent students from a municipality in western Paraná, Brazil. Rev Nutr. 2007;20:461-71. http://dx.doi.org/10.1590/S1415-52732007000500002 https://doi.org/http://dx.doi.org/10.159...	2,717	66.5	-	-	<0.01^a	98.4	-	-	<0.01^a	83.6	-	-	<0.01^a	4 times or more = 55.6
Prochnik Estima et al. ¹⁵15. Prochnik Estima CC, da Costa RS, Sichieri R, Pereira RA, da Veiga GV. Meal consumption patterns and anthropometric measurements in adolescents from a low socioeconomic neighborhood in the metropolitan area of Rio de Janeiro, Brazil. Appetite. 2009;52:735-9. https://doi.org/10.1016/j.appet.2009.03.017 https://doi.org/https://doi.org/10.1016/...	528	77.1	81.1	72.5	0.03rd	86.6	88.2	84.1	0.70	62.5	66.3	58.2	0.25	-
Leal et al. ¹⁶16. Leal GV, Philippi ST, Matsudo SM, Toassa EC. Food intake and meal patterns of adolescents, São Paulo, Brazil. Rev Bras Epidemiol. 2010;13:1-10. http://dx.doi.org/10.1590/S1415-790X2010000300009 https://doi.org/http://dx.doi.org/10.159...	228	79.0	87.0	71.0	<0.01^a	93.0	96	90.0	0.11	94.0	96.0	92.0	0.25	-
Araki et al. ¹⁷17. Araki EL, Philippi ST, Martinez MF, Estima CC, Leal GV, Alvarenga MS. Pattern of meals eaten by adolescents from technical schools of São Paulo, SP, Brazil. Rev Paul Pediatr. 2011;29:164-70. http://dx.doi.org/10.1590/S0103-05822011000200006 https://doi.org/http://dx.doi.org/10.159...	71	49.0	63.0	39.0	0.12	65.0	70	61.0	0.26	51.0	50.0	51.0	0.56	-
Moraes et al. ¹⁸18. de Moraes AC, Adami F, Falcão MC. Understanding the correlates of adolescents’ dietary intake patterns. A multivariate analysis. Appetite. 2012;58:1057-62. https://doi.org/10.1016/j.appet.2012.01.024 https://doi.org/https://doi.org/10.1016/...	991	63.6	62.2	65.4	0.30	93.2	92.4	94.2	0.25	82.7	78.2	88.5	<0.01^a	-
Caram et al. ¹⁹19. Caram AL, Lamazi EA. Eating habits, nutritional status and body image perceptions of adolescents. Adolesc Saude. 2012;9:21-9.	126	56.3	-	-	-	81.7	-	-	-	85.7	-	-	-	3 times = 57.9; 5 to 6 times = 18.3
Chaves et al. ²⁰20. Chaves OC, Castro C, Machado S, Ribeiro R, Faria G, Priore SE. Anthropometric and biochemical parameters in adolescents and their relationship with eating habits and household food availability. Nutr Hosp. 2013;28:1352-6. https://doi.org/10.3305/nh.2013.28.4.6467 https://doi.org/https://doi.org/10.3305/...	120	-	-	-	-	-	-	-	-	-	-	-	-	4 times or more = 83.3
Silva et al. ²¹21. Silva FA, Candiá SM, Pequeno MS, Sartorelli DS, Mendes LL, Oliveira RM, et al. Daily meal frequency and associated variables in children and adolescents. J Pediatr (Rio J.). 2017;93:79-86. http://dx.doi.org/10.1016/j.jped.2016.04.008 https://doi.org/http://dx.doi.org/10.101...	708	-	-	-	-	-	-	-	-	-	-	-	-	4 times or more = 68.8
Rodrigues et al. ⁹9. Rodrigues PRM, Luiz RR, Monteiro LS, Ferreira MG, Gonçalves-Silva RM, Pereira RA. Adolescents’ unhealthy eating habits are associated with meal skipping. Nutrition. 2017;42:114-20.e1. https://doi.org/10.1016/j.nut.2017.03.011 https://doi.org/https://doi.org/10.1016/...	1,139	47.0	55.0	41.0	<0.01^a	78.0	84.0	74.0	<0.01^a	52.0	61.0	44.0	<0.01^a	≥3 times = 28.3

Authors	no	Between-meal Snacks (%)							Replacement of meals for snacks (%)
Authors	no	Total	Morning	p-value	Afternoon	p-value	Night	p-value	Total	Lunch	Dinner	Snack foods which replace meals
Dalla Costa et al. ¹⁴14. Dalla Costa MC, Cordoni Junior L, Matsuo T. Food habits of adolescent students from a municipality in western Paraná, Brazil. Rev Nutr. 2007;20:461-71. http://dx.doi.org/10.1590/S1415-52732007000500002 https://doi.org/http://dx.doi.org/10.159...	2,717	-	-	-	73.0	<0.01 ^a	-	-	-	-	-	-
Prochnik Estima et al. ¹⁵15. Prochnik Estima CC, da Costa RS, Sichieri R, Pereira RA, da Veiga GV. Meal consumption patterns and anthropometric measurements in adolescents from a low socioeconomic neighborhood in the metropolitan area of Rio de Janeiro, Brazil. Appetite. 2009;52:735-9. https://doi.org/10.1016/j.appet.2009.03.017 https://doi.org/https://doi.org/10.1016/...	528	-	3.4	0.90	-	-	9.3	0.72	-	-	40.0	40% replaced at least once a week with snacks and snacks
Leal et al. ¹⁶16. Leal GV, Philippi ST, Matsudo SM, Toassa EC. Food intake and meal patterns of adolescents, São Paulo, Brazil. Rev Bras Epidemiol. 2010;13:1-10. http://dx.doi.org/10.1590/S1415-790X2010000300009 https://doi.org/http://dx.doi.org/10.159...	228	-	42.0	0.77	78.0	0.03 ^a	16.0	0.33	-	6.2	24.6	Snacks: milk, chocolate, bread baguette, margarine and soda
Araki et al. ¹⁷17. Araki EL, Philippi ST, Martinez MF, Estima CC, Leal GV, Alvarenga MS. Pattern of meals eaten by adolescents from technical schools of São Paulo, SP, Brazil. Rev Paul Pediatr. 2011;29:164-70. http://dx.doi.org/10.1590/S0103-05822011000200006 https://doi.org/http://dx.doi.org/10.159...	71	38.0	-	0.13	-	-	-	-	-	17	42.0	Frequency 1-2 times / week Lunch: bread with cold cuts, cheese bread, hamburger, pastries, pizza, chocolate, peanuts, chips, fruits, vitamins, sodas, juices and yogurts Dinner: the most cited were coffee, tea, chocolate milk, soft drinks, cookies, cakes, sweets, breakfast cereals, bread with butter, bread with cold cuts, bread with chicken and tomato, hamburger, hot dogs, pizza, bread with egg and salad
Moraes et al. ¹⁸18. de Moraes AC, Adami F, Falcão MC. Understanding the correlates of adolescents’ dietary intake patterns. A multivariate analysis. Appetite. 2012;58:1057-62. https://doi.org/10.1016/j.appet.2012.01.024 https://doi.org/https://doi.org/10.1016/...	991	-	35.5	0.03 ^b	64.3	0.86	23.6	0.12	-	-	-	-
Caram et al. ¹⁹19. Caram AL, Lamazi EA. Eating habits, nutritional status and body image perceptions of adolescents. Adolesc Saude. 2012;9:21-9.	126	-	13.5	-	42.1	-	10.3	-	-	-	-	-
Chaves et al. ²⁰20. Chaves OC, Castro C, Machado S, Ribeiro R, Faria G, Priore SE. Anthropometric and biochemical parameters in adolescents and their relationship with eating habits and household food availability. Nutr Hosp. 2013;28:1352-6. https://doi.org/10.3305/nh.2013.28.4.6467 https://doi.org/https://doi.org/10.3305/...	120	-	-	-	-	-	-	-	34.2	-	-	Bread, cookie, coffee and chocolate

Authors	Assessment method of food intake pattern	Main results
Dalla Costa et al. ¹⁴14. Dalla Costa MC, Cordoni Junior L, Matsuo T. Food habits of adolescent students from a municipality in western Paraná, Brazil. Rev Nutr. 2007;20:461-71. http://dx.doi.org/10.1590/S1415-52732007000500002 https://doi.org/http://dx.doi.org/10.159...	Five most consumed foods classified according to the eight groups of the food pyramid to	Foods + consumed: bread and rice, lettuce and tomato, banana and orange, whole and skimmed milk, beef and chicken, beans, margarine and mayonnaise, sugar and candy Statistically significant for: Income: + poor in groups 6 and 7; among the + rich in groups 2, 3 and 4; gender: girls + consumption in groups 2 and 8; boys in groups 4, 6 and 7
Prochnik Estima et al. ¹⁵15. Prochnik Estima CC, da Costa RS, Sichieri R, Pereira RA, da Veiga GV. Meal consumption patterns and anthropometric measurements in adolescents from a low socioeconomic neighborhood in the metropolitan area of Rio de Janeiro, Brazil. Appetite. 2009;52:735-9. https://doi.org/10.1016/j.appet.2009.03.017 https://doi.org/https://doi.org/10.1016/...	Assignment of points from 0 to 3 for classification of patterns: Satisfactory: 0-1 Unsatisfactory:> 1	^b PS : prevalence in 66.3% of the sample; ^c PI : among adolescents +15 years old: higher prevalence for girls (38.7%), boys (29.2%); among the younger, girls (40.0%), boys (25.4%) + anthropometric measurements in boys / overweight (1.32)
Leal et al. ¹⁶16. Leal GV, Philippi ST, Matsudo SM, Toassa EC. Food intake and meal patterns of adolescents, São Paulo, Brazil. Rev Bras Epidemiol. 2010;13:1-10. http://dx.doi.org/10.1590/S1415-790X2010000300009 https://doi.org/http://dx.doi.org/10.159...	Foods referred to in R24h classified according to the eight groups of food pyramid ^a and evaluated by the adequacy of the FE x FO ^d	FE x FO ^d: Low consumption: G1 = 0.39; G2 = 0.17; G3 = 0.08; G4 = 0.32 Near adequate: G5 = 0.85; G6 = 1.20; G7 = 1.19 (oils and fats) High consumption: G8 = 3.11
Moraes et al. ¹⁸18. de Moraes AC, Adami F, Falcão MC. Understanding the correlates of adolescents’ dietary intake patterns. A multivariate analysis. Appetite. 2012;58:1057-62. https://doi.org/10.1016/j.appet.2012.01.024 https://doi.org/https://doi.org/10.1016/...	Evaluation of the significant contribution of the consumption of 10 foods and according to Kaiser Criterion> 1 for the standards: 1 - junk food ; 2 - healthy; and 3 - protein	Standard junk food : fried foods, sweets, sodas; positively associated with girls and dinner for boys Healthy Standard: Fruits and Vegetables; positively associated with girls and boys Standard protein: beans, egg and meat; positively associated with lunch and sedentary behavior for girls and negatively associated with lunch and dinner for boys
Caram et al. ¹⁹19. Caram AL, Lamazi EA. Eating habits, nutritional status and body image perceptions of adolescents. Adolesc Saude. 2012;9:21-9.	Food classification in 11 groups and considered as eating habits the consumption ≥4 times / week	Commonly consumed foods: rice (95.2%), french bread (60.3%), beans (82.5%), fruits (60.3%), sweets and candies (57.9%), chocolate ( 53.2%), whole milk (57.9%), juice (61.1%) and soft drinks (50.8%)
Rodrigues et al. ⁹9. Rodrigues PRM, Luiz RR, Monteiro LS, Ferreira MG, Gonçalves-Silva RM, Pereira RA. Adolescents’ unhealthy eating habits are associated with meal skipping. Nutrition. 2017;42:114-20.e1. https://doi.org/10.1016/j.nut.2017.03.011 https://doi.org/https://doi.org/10.1016/...	IQD-R	IQD-R ^f global score = 73.6

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[1] *Corresponding author. E-mail: suzysousa.nutri@gmail.com (S.F. Sousa).