Eating is often discussed as if it were mainly a matter of individual choice: what people prefer, how much self-control they exercise, or whether they know enough about nutrition. New research from Pakistan suggests that the timing and regularity of meals may be shaped just as strongly by the social world around the person.
A peer-reviewed study published in Humanities and Social Sciences Communications on 28 September 2026 found that 46.1% of 412 Pakistani adults met the researchers’ criteria for unhealthy meal frequency. The pattern was not evenly distributed. It was reported by 52.2% of women compared with 31.1% of men.
Rather than treating irregular eating as an isolated personal habit, researchers Ruby Khan, Sumbal Khan and Bakht Pari examined demographic, psychological and sociocultural influences together. Their results point particularly toward cultural pressures, family food rules and gender-role expectations as important correlates of disrupted meal patterns.
What counts as an unhealthy meal pattern?
The study focused on what the authors call unhealthy meal frequency, or UMF. This is broader than simply eating too much or too little. It captures the behavioural organisation of eating, including skipping meals, eating at irregular times and other maladaptive patterns that disturb normal meal frequency.
That distinction matters. Nutrition research frequently concentrates on calories, nutrients or dietary quality. Two people could consume broadly similar foods over time while organising those foods very differently across the day. Regularity can also intersect with work, household responsibilities, family expectations, emotional responses and access to food.
Pakistan offers a particularly useful setting for examining these relationships because rapid urbanisation and changing social roles coexist with strong family and cultural structures. The researchers therefore set out to study meal behaviour in context rather than separating it from the social environment in which eating takes place.
The researchers studied 412 adults
The analysis used a cross-sectional sample of 412 Pakistani adults and a culturally adapted assessment of eating behaviours. The researchers examined the prevalence and forms of unhealthy meal frequency and then tested demographic, psychological and sociocultural factors as potential predictors.
The study also paid particular attention to gender and regional differences. Psychological variables included emotional eating, while the sociocultural analysis incorporated factors such as cultural pressure, family food rules and gender-role expectations.
This design allowed the researchers to ask more than whether stress or emotional eating accompanied irregular meals. They could assess whether those individual-level factors remained the strongest signals after the wider social context was considered.
The study received ethical approval from the Family Care Center Hayatabad Ethical Committee, and participants provided electronic informed consent before taking part.
Unhealthy meal frequency was common, especially among women
Across the full sample, 46.1% of participants met the study’s criteria for unhealthy meal frequency. In practical terms, that means the behaviour was not confined to a small high-risk subgroup. Nearly one in every two adults in this particular sample fell into the study’s unhealthy-frequency category.
The gender difference was substantial. Among women, prevalence reached 52.2%, compared with 31.1% among men. The absolute gap was therefore 21.1 percentage points.
The most common manifestations were irregular meal timing and meal skipping. These findings are important because they shift attention from the contents of a plate to the structure surrounding meals. A nutrition intervention focused only on which foods to choose could miss why a person is skipping or delaying meals in the first place.
Regional differences also emerged. Punjab recorded the highest prevalence of unhealthy meal frequency in the study. That does not establish that living in Punjab itself causes irregular eating. Regional comparisons can reflect differences in the sampled participants, urbanisation, household structures, economic circumstances and other measured or unmeasured influences.
Social pressures were more prominent than psychology alone
One of the study’s most consequential findings came from the multivariate analysis. Sociocultural factors, particularly cultural pressures, family food rules and gender-role expectations, emerged as the strongest independent predictors of unhealthy meal frequency. Their influence exceeded that of psychological factors such as emotional eating in the researchers’ model.
This does not mean psychology is irrelevant. Emotional eating was still part of the picture. Instead, the results suggest that individual emotional responses may operate within a larger social system that shapes when, how and under what expectations people eat.
The researchers found that emotional eating partially mediated the relationship between cultural pressures and unhealthy meal frequency. Mediation is an attempt to describe a statistical pathway. In this case, some of the association between cultural pressure and meal patterns was accounted for by emotional eating, while some remained outside that pathway.
Gender also moderated the association, with substantially stronger effects among women. A moderator changes the strength or pattern of a relationship. The result therefore suggests that the connection between sociocultural pressure and irregular eating was not equivalent for men and women in this sample.
Why the gender gap deserves attention
The 52.2% versus 31.1% prevalence difference should not be reduced to an assumption that women simply make different dietary choices. The study’s broader analysis points toward the possibility that expectations around gender, household food practices and cultural norms help organise those choices.
This is an important distinction for public health. If meal disruption is partly embedded in family routines and gendered responsibilities, information campaigns telling individuals to eat regularly may have limited effect unless the circumstances that make regular eating difficult are also addressed.
The findings also provide a useful counterweight to explanations that frame problematic eating exclusively as an expression of personal motivation or emotional regulation. Individual behaviour still matters, but behaviour occurs inside households, workplaces and communities with their own schedules and expectations.
The study identifies associations, not causes
The results need careful interpretation because the study was cross-sectional. Researchers measured participants at one broad point in time rather than following them prospectively to establish which factor changed first.
That means the analysis cannot demonstrate that cultural pressure causes unhealthy meal frequency, that emotional eating is definitively produced by cultural pressure, or that changing a particular family rule would necessarily change meal behaviour. Statistical mediation in cross-sectional data is especially important to interpret as a proposed relationship rather than proof of a chronological causal chain.
Self-reported eating behaviour can also be affected by recall, interpretation and social desirability. A culturally adapted assessment improves contextual relevance, but measurement cannot capture every economic, household or nutritional influence on daily eating.
The sample of 412 adults is informative but does not by itself establish national prevalence for Pakistan. The reported 46.1% figure describes the study sample under the researchers’ definition and should not be presented as though nearly half of all Pakistani adults necessarily have the same pattern.
Nutrition policy may need to look beyond education
The practical implication is not that conventional nutrition education should be abandoned. Rather, the study suggests that knowledge may be only one component of eating behaviour.
Interventions could benefit from asking whether household food rules, care responsibilities, gender expectations and daily schedules create structural barriers to regular meals. Family-level approaches may sometimes be more appropriate than placing the full responsibility on one person.
The gender difference also suggests that interventions should be evaluated for whether they work similarly for women and men. A programme designed around individual decision-making could have weaker effects if the strongest constraints are social or household-based.
For researchers, longitudinal studies would be a valuable next step. Following people over time could help establish whether changes in cultural pressure, emotional eating or family circumstances precede changes in meal frequency. More representative sampling would also help determine how closely the prevalence estimates reflect Pakistan’s wider adult population.
A meal is also a social event
The broader message from the study is straightforward but easy to overlook. Eating behaviour is not produced by appetite alone. Meals are scheduled around work and care, negotiated within families and influenced by ideas about gender, responsibility and acceptable behaviour.
In this sample, nearly half of participants met the researchers’ threshold for unhealthy meal frequency, and women reported the pattern much more often than men. The statistical analysis then pointed beyond emotional eating alone toward a network of sociocultural influences.
That makes irregular eating a potentially useful window into a much wider question: not simply why an individual skips a meal, but what social conditions make that meal easier or harder to have in the first place.
Source Information
Study: “Investigating the complex dynamics of psychological stress and sociocultural influences on unhealthy meal frequency as a subclinical indicator of disordered eating behaviours”
Authors: Ruby Khan, Sumbal Khan and Bakht Pari
Journal: Humanities and Social Sciences Communications
Published: 28 September 2026
DOI: 10.1057/s41599-026-08939-6
