Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Meal pattern, food choice, nutrient intake and lifestyle factors in The Göteborg 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, Göteborg, 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.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout


  • Bajekal M, Sundquist J & Jarman B (1996): The Swedish UPA score: An administrative tool for identification of underpriviliged areas. Scand. J. Soc. Med. 3, 177–185.

    Article  Google Scholar 

  • Berg-Kelly K (1995): Normative developmental behaviour with implications for health and health promotion among adolescents: a Swedish cross-sectional survey. Acta Paediatr. 84, 278–288.

    Article  CAS  Google Scholar 

  • Bergström E, Hernell O & Persson Lå (1993): Dietary changes in Swedish adolescents. Acta Paediatr. 82, 472–480.

    Article  Google Scholar 

  • Biro M, McMahon R, Striegel-Moore R, Crawford P, Obarzanek E, Morrison J, Barton B & Falkner F (2001): Impact of timing of pubertal maturation on growth in black and white female adolescents: The National Heart, Lung, and Blood Institute Growth and Health Study. J.Pediatr. 138, 636–643.

    Article  CAS  Google Scholar 

  • Cavadini C, Decarli B, Grin J, Narring F & Michaud P-A (2000): Food habits and sport activity during adolescence: differences between athletic and non-athletic teenagers in Switzerland. Eur. J. Clin. Nutr. 54(Suppl 1), S16–S20.

    Article  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM & Dietz WH (2000): Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 1–6.

    Article  Google Scholar 

  • Crawley HF & While D (1995): The diet and body weight of British teenage smokers at 16–17 y. Eur. J. Clin. Nutr. 49, 904–914.

    CAS  PubMed  Google Scholar 

  • Crawley H (1997): Dietary and lifestyle differences between Scottish teenagers and those living in England and Wales. Eur. J. Clin. Nutr. 51, 87–91.

    Article  CAS  Google Scholar 

  • Elmén H, Höglund D, Niklasson A & Nilsson W (1995): Birth weight for gestational age and sex as a health indicator at local area level. Int. J. Health. Sci. 6, 117–126.

    Google Scholar 

  • FAO/WHO/UNU (1985): Energy and protein requirements. Report of a Joint FAO/WHO/UNU consultation. Technical Report Series 724. World Health Organization: Geneva.

  • Frost Andersen L, Nes M, Sandstad B, Bjorneboe G-EA & Drevon CA (1995): Dietary intake among Norwegian adolescents. Eur. J. Clin. Nutr. 49, 555–564.

    Google Scholar 

  • Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA & Prentice AM (1991): Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur. J. Clin. Nutr. 45, 569–581.

    CAS  Google Scholar 

  • Hallberg L & Hulthén L (2000): Prediction of dietary iron absorption: an algorithm for calculating absorption and bioavailability of dietary iron. Am. J. Clin. Nutr. 71, 1147–1160.

    Article  CAS  Google Scholar 

  • Höglund D, Samuelson G & Mark A (1998): Food habits in Swedish adolescents in relation to socioeconomic conditions. Eur. J. Clin. Nutr. 52, 784–789.

    Article  Google Scholar 

  • Hulshof KFAM, Löwik MRH, Kok FJ, Wedel M, Brants HAM, Hermus RJJ & ten Hoor F (1991): Diet and other lifestyle factors in high and low socio-economic groups (Dutch Nutrition Surveillance System). Eur. J. Clin. Nutr. 45, 441–450.

    CAS  Google Scholar 

  • Jarman B (1983): Identification of underprivileged areas. BMJ 286, 1705–1709.

    Article  CAS  Google Scholar 

  • Juul A, Bang P, Hertel NT, Main K, Dalgaard P, Jorgensen K, Muller J, Hall K & Skakkebaeck NE (1994): Serum insulin-like growth factor-I in 1030 healthy children, adolescents, and adults: relation to age, sex, stage of puberty, testicular size, and body mass index. J. Clin. Endocrinol. Metab. 78, 744–752.

    CAS  PubMed  Google Scholar 

  • Livingstone MBE, Prentice AM, Coward WA, Strain JJ, Black AE, Davies PS, Stewart CM, Mc Kenna PG & Whitehead RG (1992): Validation of estimates of energy intake by weighed dietary record and diet history in children and adolescents. Am. J. Clin. Nutr. 56, 29–35.

    Article  CAS  Google Scholar 

  • Maclure M, Travis LB, Willett W & MacMohan B (1991): A prospective cohort study of nutrient intake and age at menarche. Am. J. Clin. Nutr. 54(4), 649–656.

    Article  CAS  Google Scholar 

  • Pollitt E & Mathews R (1998): Breakfast nad cognition: an integrative summary. Am. J. Clin. Nutr. 67(Suppl), 804S–813S.

    Article  CAS  Google Scholar 

  • Post GB & Kemper HCG (1993): Nutrient intake and biological maturation during adolescence. The Amsterdam Growth and Health Longitudinal Study. Eur. J. Clin. Nutr. 47, 400–408.

    CAS  PubMed  Google Scholar 

  • Post GB, de Venthe W, Kemper HCG & Twisk JWR (2001): Longitudinal trends in and tracking of energy and nutrient intake over 20 years in a Dutch cohort of men and women between 13 and 33 years of age: The Amsterdam growth and health longitudinal study. Br.J. Nutr. 85, 375–385.

    Article  CAS  Google Scholar 

  • Ruxton CHS & Kirk TR (1997): Breakfast: a review of associations with measures of dietary intake, physiology and biochemistry. Br. J. Nutr. 78, 199–213.

    Article  CAS  Google Scholar 

  • Samuelson G, Bratteby L-E, Enghardt H & Hedgren M (1996): Food habits and energy and nutrient intake in Swedish adolescents approaching the year 2000. Acta Paediatr. 415(Supp l), 1–20.

    Article  CAS  Google Scholar 

  • Schofield WN (1985): Predicting basal metabolic rate, new standards and review of previous work. Hum. Nutr. Clin. Nutr. 39C(Suppl. 1), 5–41.

    Google Scholar 

  • Sjöberg A & Hulthén L (2003): Under and overreporting of energy intake in an adolescent population — relation to BMI and maturation (manuscript).

  • Sjöberg A, Hulthén L & Hallberg L (2003): Assessment of habitual meal pattern and intake of foods, energy and nutrients in adolescents; comparison of a diet history with a seven day record (manuscript).

  • Statistics Sweden (1982): Swedish Socioeconomic classification (SEI). Stockholm: Reports in Statistical Coordination.

  • Swedish National Food Administration (1989): Swedish Nutrition Recommendations (Svenska näringsrekommendationer). Vår Föda 41, 271–280 (in Swedish).

  • Swedish National Food Administration Energy and Nutrients (1994). Uppsala, Sweden: Swedish National Food Administration.

  • van Lenthe FJ, Kemper HCG & van Mechelen W (1996): Rapid maturation in adolescence results in greater obesity in adulthood: The Amsterdam Growth and Health Study. Am. J. Clin. Nutr. 64, 18–24.

    Article  CAS  Google Scholar 

  • Von Post-Skagegård M, Samuelson G, Karlström B, Mohsen R, Berglund L & Bratteby L-E (2002): Changes in food habits in healthy Swedish adolescents during the transition from adolescence to adulthood. Eur. J. Clin. Nutr. 56, 532–538.

    Article  Google Scholar 

  • Watt RG & Sheiham A (1996): Dietary patterns and changes in inner city adolescents. J. Hum. Nutr. Diet. 9, 451–461.

    Article  Google Scholar 

  • Wyon DP, Abrahamsson L, Järtelius M & Fletcher RJ (1997): An experimental study of the effects of energy intake at breakfast on the test performance of 10-year-old children in school. Int. J. Food. Sci. Nutr. 48, 5–12.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to A Sjöberg.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Sjöberg, A., Hallberg, L., Höglund, D. et al. Meal pattern, food choice, nutrient intake and lifestyle factors in The Göteborg Adolescence Study. Eur J Clin Nutr 57, 1569–1578 (2003).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • adolescent nutrition
  • diet surveys
  • interviews
  • food habits
  • energy intake
  • breakfast

This article is cited by


Quick links