To provide an in-depth analysis of the relationship between obesity and fast-food consumption by comparing urban obese and normal-weight Saudi Arabian children.

A multicentre cross-sectional study was conducted from December 2015 to March 2016. Participants were divided into two groups (normal weight and obese) and further stratified by sex. Groups were randomly selected using a multistage stratified cluster-sampling technique. A self-paced questionnaire was used to collect data relating to food consumption. Weight height and waist circumference were measured and bioelectrical impedance analysis was performed in all children.

Capital of Saudi Arabia, Riyadh.

Children aged 9·00–11·99 years (n 1023).

Compared with normal-weight groups, intake frequency of fast food/week was higher among the obese groups (P<0·001), irrespective of fast-food consumption outside (P<0·001) or inside (P<0·001) the home; and larger portion sizes were preferred in obese groups (P<0·001). Families eating fast-food meals together was a protective factor against obesity (OR; 95 % CI: 2·67; 1·44, 4·96, P<0·001), with similar results for families ordering from a ‘healthy meals menu’ for their children (1·90; 1·24, 2·90, P=0·002). Taste of fast foods (P=0·021), child-friendly menu (P=0·020) and meal cost (P<0·001) were identified as main reasons why parents took their children to fast-food restaurants; these data were replicated for parents with obese boys, but not girls.

Development of effective interventions to reduce fast-food consumption in Saudi Arabian schoolchildren requires greater research-based evidence of fast-food consumption habits and practices associated with increased childhood obesity.

To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.

Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995–2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.

Twenty-seven centres across ten European countries.

Women (64 %) and men (36 %) aged 35–74 years (n 36 020).

Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38–43 % for women and 41–45 % for men within Mediterranean countries compared with 16–27 % for women and 20–26 % for men in central and northern European countries. Likewise, a south–north gradient was found for daily energy intake from snacks, with 13–20 % (women) and 10–17 % (men) in Mediterranean countries compared with 24–34 % (women) and 23–35 % (men) in central/northern Europe.

We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.

To assess whether the amount of fruits and vegetables consumed depends on the serving size or on how often fruits and vegetables are eaten.

Estimation of the weight of serving sizes and the number of fruits and vegetables eaten daily, using a validated food diary method.

Free-living men and women participating in the Norfolk arm of the European Prospective Investigation into Cancer and Nutrition (EPIC).

Two hundred and sixty-nine men and women sampled from EPIC–Norfolk to participate in a study of simple methods of assessing fruit and vegetable intakes.

The average portion of all fruits and vegetables measured was 87 g, close to the standard portion size of 80 g used as the basis of ‘5-a-day’ recommendations. There was a wide variation; the average portion size for baked beans was 147 g while for lettuce it was 26 g. The 20th and 80th percentiles also showed a large range, e.g. 39–72 g for carrots and 60–150 g for strawberries. Women ate more fruit than did men but fewer vegetables, so the total amount of fruit and vegetables eaten by men and women was the same. High consumers of fruits and vegetables (≥400 g day-1) ate them ~5 times a day whilst low consumers (<400 g day-1) ate them less often (~3 servings per day, P<0.01). Portion size differed little between high and low consumers.

Frequency of intake is more important than portion size when distinguishing between high and low consumption of fruits and vegetables. Therefore, to increase intakes, low consumers should eat fruits and vegetables more often. This endorses the ‘5-a-day’ healthy eating message.