Infrequent breakfast consumption and lower weekly meal frequency are associated with poor muscle health in Korean older adults.

Maintaining muscle health is a growing concern in aging populations, yet the role of eating frequency remains understudied. This study hypothesized that lower eating frequency, particularly infrequent breakfast consumption, is associated with poorer muscle health in older adults. This study examined the association between eating frequency and muscle outcomes among 3292 adults aged ≥50 years from the 2022-2023 Korea National Health and Nutrition Examination Survey. Meal frequency was categorized by weekly breakfast (0, 1-2, 3-4, 5-7/week), lunch and dinner (≤2, 3-4, 5-7/week), and grouped as ≤12, 13-14, or 15-21 meals/week. Muscle outcomes included the skeletal muscle index (SMI) and handgrip strength (HGS). Sex-stratified multivariable logistic regression models were adjusted for sociodemographic, health behaviors, and clinical and dietary intake. In men, skipping breakfast was associated with higher odds of combined low SMI/HGS (odds ratio [OR]: 2.02; 95% confidence interval [CI], 1.01-4.04). In women, it was associated with low SMI (OR: 1.90; 95% CI, 1.08-3.34). Men consuming 13 to 14 or ≤12 meals/week had higher odds of low SMI (OR: 4.74; 95% CI, 2.39-9.42 and OR: 1.96; 95% CI, 1.22-3.14, respectively) and combined low SMI/HGS (OR: 2.38; 95% CI, 1.11-5.13 and OR: 1.79; 95% CI, 1.07-3.01, respectively). Among women, consuming ≤12 meals/week was associated with low SMI (OR: 1.69; 95% CI, 1.18-2.42). These associations remained consistent in participants aged ≥65 years. No significant associations were found for lunch or dinner frequency. In conclusion, regular meal consumption, especially consistent breakfast intake, may help preserve muscle mass and strength in older adults.