BACKGROUND: Diet pattern of regular and three meals per day is commonly recommended. Studies investigated the health effect of gorging pattern of diet using meal frequency and meal skipping, but the health effect of meal calorie variation between three regular meals has never been investigated. In this study, maximum meal calorie variation was defined as subtraction calorie for a meal with minimum energy intake from calories for a meal with maximum energy intake between three meals and examined the effect of maximum meal calorie variation between three regular meals a day on cardiovascular risk factors. METHODS: A total of 4,680 healthy subjects aged 20-87 years who underwent medical screening examination, at one tertiary hospital health screening center and completed 24-hour dietary recall was included. Serum cholesterol subfractions, fasting glucose and blood pressure were measured. RESULTS: Maximum meal calorie variation was significantly related to serum concentration of total cholesterol (beta = 1.77; 95% confidence interval [CI], 0.36 to 3.18) and low density lipoprotein-cholesterol (LDL-C) (beta = 1.64; 95% CI, 0.37 to 2.91), body mass index (beta = 0.24; 95% CI, 0.12 to 0.37) and waist circumference (beta = 0.66; 95% CI, 0.34 to 0.98) after adjustment for potential confounders. CONCLUSION: This study suggests the notion that concentration of total cholesterol and LDL-C and obesity indices are related to maximum meal calorie variation between three meals, independently of energy intake and other confounding factors in free-living population.