Contribution of meals to energy and nutrient intakes and implication of skipping meals on nutritional status among primary schoolchildren in Malaysia.

Understanding children's diet quality is crucial for developing effective interventions to address dietary-related issues. Thus, this study examines the distribution of energy and nutrient intakes across meals and snacks among primary schoolchildren aged 6.0-12.9 years in Peninsular Malaysia and the implications of meal skipping on their nutritional status. Data from 1,102 children in Peninsular Malaysia from the South East Asian Nutrition Surveys (SEANUTS II), were analysed. Children's height, weight, and waist circumference were measured. Questionnaires captured sociodemographic information and meal consumption patterns. Nutrient distribution across meals and snacks was assessed through a one-day 24-hour dietary recall approach. Logistic regression analysed the association between meal skipping and nutritional status. Breakfast contributed significantly to essential micronutrients, but provided the least energy and macronutrients compared to lunch and dinner. Approximately one-third of daily nutrient intake came from snacking, with contributions ranging from 25% for cobalamin to 36% for both calcium and thiamine. Children who skipped main meals had higher odds of being overweight/obese {skipped one type of meal at least once weekly [(1.59; 95%CI (1.08, 2.33)]; skipped >1 type of meal [1.77; 95%CI (1.12, 2.79]}, and abdominal obese {skipped > 1 type of meal [(1.91; 95%CI (1.17, 3.12)]}. In conclusion, primary schoolchildren in Peninsular Malaysia tended to have higher micronutrient intakes at breakfast and higher energy and macronutrients in subsequent main meals. Meal skipping was linked to elevated body fat. This study underscores the need to prioritise continued education on the importance of healthy dietary habits among children.