Association between higher eating frequency and lower odds of low muscle mass in Koreans

Background Sarcopenia, an age-related decline in muscle mass and function, is a growing public health concern. While protein intake and exercise are known management strategies, the independent role of meal frequency remains under-explored. This study investigated the association between eating frequency and low muscle mass in middle-aged and older Koreans. Methods Using cross-sectional data from the KoGES cohort ( n = 6,427), we categorized participants into low (1–2 meals/day) and high (3–5 meals/day) eating frequency groups. Low muscle mass was defined as a Muscle Mass Index (MMI, kg/m 2 ) below the sex-specific 20th percentile. We employed binary logistic regression, adjusting for comprehensive confounders including age, sex, BMI, total protein intake, and physical activity. Results Our findings revealed that a higher eating frequency (three or more meals per day) was independently associated with a significantly low odds ratio of low muscle mass (OR = 0.685, 95% CI: 0.566–0.828, p < 0.001), even after adjusting for total protein intake. This suggests that regular meal patterns, beyond total nutrient quantity, may be important for muscle maintenance. Potential mechanisms include optimized insulin secretion and avoidance of chronic energy deficits. Conclusion Despite its cross-sectional design, this study offers novel insights from a large cohort, highlighting meal frequency as a potentially important, yet over-looked, nutritional factor associated with lower odds of low muscle mass. Our results support incorporating regular meal frequency recommendations into strategies for healthy aging.