Self-Reported Weekend Temporal Eating Patterns of American Adults Differ From Weekday: National Health and Nutrition Examination Surveys: 2015-2020 Prepandemic.

BACKGROUND: Weekend-weekday differences in time of ingestive events may be implicated in adverse metabolic and health outcomes. However, little is known about the nature of weekend-weekday differences in temporal eating behaviors of the US adult population. OBJECTIVE: The study aimed to examine weekend-weekday differences in temporal and energy characteristics of ingestive events self-reported by American adults. DESIGN: Observational; within-person comparative. PARTICIPANTS/SETTING: The data were from the National Health and Nutrition Examination Surveys (NHANES) 2015-March 2020 (pre-pandemic) for ≥20-year-old adults who provided 1 weekday (M-Th) and 1 weekend (F, S, Su) 24-h dietary recall (n = 3564 men and 3823 women). MAIN OUTCOME MEASURES: Prespecified primary temporal outcomes were recalled: time of ingestive events, and the duration of ingestive and fasting windows. Secondary outcomes included frequency and energy characteristics of ingestive events. STATISTICAL ANALYSIS PERFORMED: Gender-specific, survey-weighted, multiple linear regression models that accounted for complex survey design with dummy covariates for weekend/weekday, mode of recall administration (in-person on day 1 and telephone on day 2), and a respondent-specific fixed intercept. RESULTS: In both men and women, the weekend recalled time of first ingestive event, breakfast, and lunch were later than weekday (P ≤ .0008); however, no statistically significant differences were observed in time of dinner and the last eating episode. The mean weekend ingestive window (interval between the time of first and last eating events of the day) was shorter by 24 minutes (95% confidence interval [CI], -32, -11) in men and 18 minutes (95% CI, -20, -15) in women, and the mean overnight fasting window was correspondingly longer (P ≤ .0001). No statistically significant differences were observed between weekend and weekday frequency of ingestive events. Energy density of weekend food selections reported by women, and of beverages by men, was found to be higher than weekday (P ≤ .002). CONCLUSIONS: Weekend ingestive patterns were characterized by later time of first ingestive event, breakfast, and lunch, and selection of higher-energy-density foods and beverages.

Circadian timing of eating and BMI among adults in the American Time Use Survey.

BACKGROUND/OBJECTIVES: Experimental studies of time-restricted eating suggest that limiting the daily eating window, shifting intake to the biological morning, and avoiding eating close to the biological night may promote metabolic health and prevent weight gain. SUBJECTS/METHODS: We used the Eating & Health Module of the 2006-2008 and 2014-2016 American Time Use Survey to examine cross-sectional associations of timing of eating in relation to sleep/wake times as a proxy for circadian timing with body mass index (BMI). The analytical sample included 38 302 respondents (18-64 years; BMI 18.5-50.0 kg/m2). A single 24-hour time use diary was used to calculate circadian timing of eating variables: eating window (time between first and last eating activity); morning fast (time between end of sleep and start of eating window); and evening fast (time between end of eating window and start of sleep). Multinomial logistic regression and predictive margins were used to estimate adjusted population prevalences (AP) by BMI categories and changes in prevalences associated with a one-hour change in circadian timing of eating, controlling for sociodemographic and temporal characteristics. RESULTS: A one-hour increase in eating window was associated with lower adjusted prevalence of obesity (AP = 27.1%, SE = 0.1%). Conversely, a one-hour increase in morning fast (AP = 28.7%, SE = 0.1%) and evening fast (AP = 28.5%, SE = 0.1%) were each associated with higher prevalence of obesity; interactions revealed differing patterns of association by combination of eating window with morning/evening fast (p < 0.0001). CONCLUSIONS: Contrary to hypotheses, longer eating windows were associated with a lower adjusted prevalence of obesity and longer evening fasts were associated with a higher prevalence of obesity. However, as expected, longer morning fast was associated with a higher adjusted prevalence of obesity. Studies are needed to disentangle the contributions of diet quality/quantity and social desirability bias in the relationship between circadian timing of eating and BMI.

Clock Time of First Eating Episode and Prospective Risk of All-Cause Mortality in US Adults.

BACKGROUND: There is increasing recognition that a morning or evening preference is associated with time of eating, metabolic health, and morbidity. However, few studies have examined the association of time of eating with mortality. OBJECTIVES: To examine the association of time of first recalled ingestive episode with the prospective risk of all-cause mortality. METHODS: We used mortality-linked data from the NHANES conducted in 1988-1994 and 1999-2014 (n = 34,609; age ≥ 40 years). The exposure was quartiles (Q1-Q4) of clock time of first eating episode self-reported in the baseline 24-hour dietary recall. The outcome was follow-up time from the date of NHANES examination to the date of death or end of the follow-up period (31 December 2015). We used proportional hazards regression methods to determine the independent association of time of first eating episode with relative hazard of all-cause mortality, with adjustments for multiple covariates and the complex survey design. Multiple linear regression methods were used to examine the associations of time of first eating episode with baseline cardiometabolic biomarkers and dietary attributes. RESULTS: In this national cohort, with a median age of ∼55 years (95% CI: 54.6-55.4 years) at baseline and a median follow-up of 8.3 years (IQR, 8.75 years), there were 10,303 deaths. The median times of first eating episodes in Q1-Q4 were 05:45, 07:00, 08:00, and 10:00, respectively. Covariate-adjusted relative hazards of mortality in Q1 to Q3 of the time of the first eating episode were 0.88 (95% CI: 0.81-0.96), 0.88 (95% CI: 0.81-0.95), 0.94 (95% CI: 0.87-1.02), with Q4 as the referent (P = 0.0008). Qualitative dietary attributes were inversely related with the time of the first eating episode; however, BMI and serum concentrations of glycemic biomarkers increased with later times of first eating episode (P ≤ 0.0001). CONCLUSIONS: Recall of an earlier time of the first eating episode by ≥40-year-old US participants was suggestive of a small relative survival advantage in this observational study.

Self-Reported Olfactory Dysfunction and Diet Quality: Findings from the 2011-2014 National Health and Nutrition Examination Survey (NHANES).

We identified associations between self-reported olfactory dysfunction (OD) and dietary attributes in participants aged ≥40 years (n = 6,356) from the nationally representative 2011-2014 National Health and Nutrition Examination Survey (NHANES). The chemosensory questionnaire and 24-h dietary recalls were administered by trained interviewers. OD was defined as self-report of either smell problems in the last year, worse smell relative to age 25, or perceiving phantom odors. Dietary outcomes included Healthy Eating Index 2015 score (HEI) with adequacy and moderation components (higher scores indicated higher diet quality), dietary diversity, energy density, and intake of major food groups. Survey-weighted linear regression models estimated OD-diet associations, adjusting for socio-demographic, lifestyle, and clinical factors. Adjusted mean difference (95% CI) between those with versus without OD, showed that adults with OD had significantly lower HEI moderation score (-0.67 (-1.22, -0.11)) and diets higher in energy density (0.06 (0.00, 0.11)), and percent energy from saturated fat (0.47 (0.12, 0.81)), total fat (0.96 (0.22, 1.70)), and added sugar (1.00 (0.33, 1.66)). Age and sex-stratified analyses showed that younger females (40-64 years) primarily accounted for the associations with diet quality and total/saturated fat intake. These findings inform dietary screening and recommendations for adults who report OD, including those experiencing transient or persistent smell loss with COVID-19.

Within-person compensation for snack energy by US adults, NHANES 2007-2014.

BACKGROUND: Most Americans snack and some snack several times a day; however, compensatory dietary and eating behaviors associated with snacking in free-living individuals are poorly understood. OBJECTIVE: The aim of the study was to examine within-person differences in reported energy intake and eating patterns on a snack day relative to a no-snack day. METHODS: We used 2 d of dietary recall data from the NHANES 2007-2014 to replicate the crossover nutrition study paradigm in a natural setting. Respondents reporting a snack episode in only one of two available dietary recalls were eligible for inclusion in the study (n = 1,917 men and 1,860 women). We used multivariable regression methods to compare within-person differences in quantitative, qualitative, and eating pattern outcomes between the snack and no-snack recall days. RESULTS: On the snack day, snack episodes provided (mean difference and 95% CI) 493 (454, 532) kcal of energy in men and 360 (328, 392) kcal in women. The 24-h energy intake on snack day was higher by 239 (140, 337) kcal in men and 219 (164, 273) kcal in women (P < 0.0001). On the snack day, both men and women were more likely to skip main meals and reported lower energy intake from main meals (P < 0.0001); however, the energy density of foods or beverages reported on the snack compared with no-snack days were not different. Fruit servings were higher on the snack day (P ≤ 0.0004), but intakes of vegetables and key micronutrients did not differ. The 24-h ingestive period was longer on the snack day (P < 0.0001). CONCLUSIONS: Free-living men and women partially compensated for snack energy by decreasing energy intake from main meals without adverse associations with qualitative dietary characteristics or time of meal consumption. Women compensated to a smaller extent than men. Thus, over the long term, snack episodes may contribute to positive energy balance, and the risk may be higher in women.

Complementary and compensatory dietary changes associated with consumption or omission of plain water by US adults.

We examined within-person and between-person differences in self-selected diets of free-living individuals when they choose to consume or not to consume plain water. We used 2-days of dietary data from the NHANES 2005-2012 for this study. For within-person analyses, we compared recalls of respondents who reported water in one of the two available recalls (n = 1875 men and 1479 women). For between-person analysis, we compared dietary recalls of respondents who reported water in two, one of two, or zero of two recalls (n = 8632 men and 8907 women). The outcomes examined included reported intakes of 24-h energy from foods, beverages, and dietary and eating pattern attributes. We used covariate-adjusted regression methods for both types of analyses. For within-person analyses, the regression models included separate person-level fixed effects. Relative to the water day, on the no-water day, amount of beverages and energy contribution of beverages were significantly higher in both men (106 kcal) and women (43 kcal) (P ≤ 0.002). However, the water and the no-water days did not differ in 24-h energy intake, or the amount and energy from reported foods (P > 0.05). Energy density of foods, servings of fruits or vegetables and eating patterns did not differ between the water and the no-water day in both men and women (P > 0.05). For between-person analysis, however, intakes of energy and energy density of foods were higher, but density of sodium, potassium, and magnesium were lower among those who reported no water in both recalls. Overall, beverages partially substituted for plain water on the no-water day but qualitative dietary characteristics and eating patterns, which may relate to habitual food intake and personal preferences, were not appreciably different within individuals.

Eating patterns of US adults: Meals, snacks, and time of eating.

The objective of this paper is to update knowledge of eating patterns of US adults with sex and ethnicity specific estimates and discuss the implications of reported patterns with respect to current resurgence of interest in the topic. The eating patterns data were from the NHANES 2009-2014 (n = 15,341 adults). Overall, American adults reported 4.96 ±â€¯0.03 eating episodes in the recall. Women were more likely to report each of the three main meals and all three meals plus one or more snacks relative to men (P < 0.0001). Relative to other ethnic groups, non-Hispanic blacks were less likely to report each meal or a snack or all three meals, and the foods reported for meals and snacks were higher in energy density (P = 0.0001). Of the three meals, the dinner meal, and among snacks, the after-dinner snack, were reported by the highest percentage of Americans; these two eating episodes provided nearly 45% of the 24-h energy intake. The average dinnertime was 6:24 pm, and the average time of the last eating episode of the 24-h ingestive period was 8:18 pm. Given these findings, adoption of eating patterns that advocate less frequent eating and shift in the time of eating are likely to present a challenge. We know little about the validity of eating patterns determined from 24-h recalls or questionnaire instruments. The extent of within person variability and reporting errors in different eating pattern components also need further research.

Secular trends in regional differences in nutritional biomarkers and self-reported dietary intakes among American adults: National Health and Nutrition Examination Survey (NHANES) 1988-1994 to 2009-2010.

OBJECTIVE: To understand the contribution of regional differentials in dietary exposures to regional gradients in health, we examined 20-year trends in the association of US census region of residence with nutritional biomarkers and dietary intakes of American adults. DESIGN: Observational. SETTING: The biomarker and 24 h dietary recall data were from the National Health and Nutrition Examination Surveys (NHANES) conducted during 1988-1994 and 1999-2010. The US census region was operationalized as Northeast, Midwest, South and West. Nutritional biomarker outcomes were serum folate, vitamins B6, B12, C, D and E, and carotenoids; dietary outcomes were intakes of nutrients, food groups and eating patterns. SUBJECTS: US adults, n>8000-40 000 for biomarkers and >43 000 for dietary outcomes. RESULTS: The interactions of survey time period and region were not significant for the examined biomarker and dietary outcomes, indicating similar secular trends among regions. The main effect of region was significant for all nutritional biomarkers except serum vitamin B6, most dietary micronutrients, food groups and eating patterns (P<0·001). The mean serum folate, vitamins B12, C and E, and all carotenoid (except lycopene) biomarker levels, and intakes of dietary fibre, vitamins A, E, C and B6, folate, K, Ca, Mg and Fe, fruits, vegetables and whole grains, were higher in the West and Northeast regions, relative to the South and Midwest regions. CONCLUSIONS: Overall, the regional gradients in dietary exposure, expressed objectively as biomarkers or as self-reported nutrient and food group intakes, paralleled trajectories reported for health outcomes and were remarkably persistent over time.

A prospective study of frequency of eating restaurant prepared meals and subsequent 9-year risk of all-cause and cardiometabolic mortality in US adults.

Restaurant prepared foods are known to be energy-dense and high in fat and sodium, but lower in protective nutrients. There is evidence of higher risk of adiposity, type II diabetes, and heart disease in frequent consumers of restaurant meals. However, the risk of mortality as a long-term health consequence of frequent consumption of restaurant meals has not been examined. We examined the prospective risk of all-cause and coronary heart disease, cerebrovascular disease and diabetes (cardiometabolic) mortality in relation to frequency of eating restaurant prepared meals in a national cohort. We used frequency of eating restaurant prepared meals information collected in the National Health and Nutrition Examination Surveys, conducted from 1999-2004, with mortality follow-up completed through Dec. 31, 2011 (baseline age ≥ 40y; n = 9107). We estimated the relative hazard of all-cause and cardiometabolic mortality associated with weekly frequency of eating restaurant meals using Cox-proportional hazards regression methods to adjust for multiple covariates. All analyses accounted for complex survey design and included sample weights. Over 33% of all respondents reported eating ≥3 restaurant prepared meals/week. In this cohort, 2200 deaths due to all causes and 665 cardiometabolic deaths occurred over a median follow-up of 9 years. The covariate-adjusted hazard ratio of all cause or cardiometabolic mortality in men and women reporters of <1 or 1-2 restaurant prepared meals did not differ from those reporting ≥3 meals/week (P>0.05). The results were robust to effect modification by baseline BMI, years of education, and baseline morbidity. Expectedly, the 24-h dietary intakes of whole grains, fruits, dietary fiber, folate, vitamin C, potassium and magnesium at baseline were lower, but energy, energy density, and energy from fat were higher in more frequent restaurant meal reporters (P<0.05). Baseline serum HDL cholesterol, folate, and some carotenoids were inversely associated with the frequency of eating restaurant prepared meals (P<0.05); however, serum concentrations of total cholesterol, triglycerides, fasting glucose, insulin, glycated hemoglobin, and c-reactive protein were unrelated (P<0.05). The weekly frequency of eating restaurant prepared meals and prospective risk of mortality after 9 years were not related in this cohort.

A prospective study of water intake and subsequent risk of all-cause mortality in a national cohort.

BACKGROUND: Water, an essential nutrient, is believed to be related to a variety of health outcomes. Published studies have examined the association of fluid or beverage intake with risk of mortality from coronary diseases, diabetes, or cancer, but few studies have examined the association of total water intake with all-cause mortality. OBJECTIVE: We examined prospective risk of mortality from all causes in relation to intakes of total water and each of the 3 water sources. DESIGN: We used public-domain, mortality-linked water intake data from the NHANES conducted in 1988-1994 and 1999-2004 for this prospective cohort study (n = 12,660 women and 12,050 men; aged ≥25 y). Mortality follow-up was completed through 31 December 2011. We used sex-specific Cox proportional hazards regression methods that were appropriate for complex surveys to examine the independent associations of plain water, beverage water, water in foods, and total water with multiple covariate-adjusted risk of mortality from all causes. RESULTS: Over a median of 11.4 y of follow-up, 3504 men and 3032 women died of any cause in this cohort. In men, neither total water intake nor each of the individual water source variables (plain water, water in beverages, and water in foods) was independently related with risk of all-cause mortality. In women, risk of mortality increased slightly in the highest quartile of total or plain water intake but did not approach the Bonferroni-corrected level of significance of P < 0.002. CONCLUSIONS: There was no survival advantage in association with higher total or plain water intake in men or women in this national cohort. The slight increase in risk of mortality noted in women with higher total and plain water intakes may be spurious and requires further investigation.

Within-person comparison of eating behaviors, time of eating, and dietary intake on days with and without breakfast: NHANES 2005-2010.

BACKGROUND: Breakfast omission is known to be associated with lower 24-h energy intake. However, little is known about downstream eating behaviors subsequent to skipping breakfast in free-living individuals. OBJECTIVE: We replicated the traditional crossover design of nutrition studies in a naturalistic setting to compare within-person differences in self-reported eating behaviors, energy intake, and other dietary characteristics of individuals on a day that included breakfast with a day that omitted breakfast. DESIGN: We used cross-sectional dietary data for 2132 adult respondents who reported breakfast in only one of 2 dietary recalls in the NHANES 2005-2010. Dietary outcomes examined included meal- and snack-eating behaviors, clock time of eating episodes, and intakes of energy, macronutrients, and food groups. Regression methods accounted for replicate diet measurements, covariates, and survey-design characteristics. RESULTS: The breakfast meal provided a mean of 508 kcal in men and 374 kcal in women, but differences in 24-h energy intakes between the breakfast and no-breakfast day were 247 and 187 kcal, respectively. Energy intakes at the lunch meal were higher on the no-breakfast day (202 kcal in men and 121 kcal in women), and the reported time of lunch was ∼35 min earlier. The energy contribution of dinner or its reported time did not differ. A higher number of energy-adjusted servings of fruit and whole grains were reported on the breakfast day, but the energy and macronutrient density of reported foods were not different. CONCLUSIONS: In free-living American adults, the eating time for lunch was earlier, and the lunch meal provided more energy on the no-breakfast day than on the breakfast day. Although the quality of dietary selections reflected in the energy and macronutrient density of a day's intake did not differ between the breakfast and the no-breakfast day, breakfast skippers may need encouragement to consume fruit and whole grains at other eating episodes.

40-year trends in meal and snack eating behaviors of American adults.

BACKGROUND: Understanding changes in profiles of eating behaviors over time may provide insights into contributors to upward trajectories of obesity in the US population. Yet little is known about whether or not characteristics of meal and snack eating behaviors reported by adult Americans have changed over time. OBJECTIVE: To examine time trends in the distribution of day's intake into individual meal and snack behaviors and related attributes in the US adult population. DESIGN: The study was observational with cross-sectional data from national surveys fielded over 40 years. PARTICIPANTS/SETTING: Nationally representative dietary data from nine National Health and Nutrition Examination Surveys conducted from 1971-1974 to 2009-2010 (N=62,298 participants aged 20-74 years) were used to describe eating behaviors. OUTCOMES EXAMINED: The respondent-labeled eating behaviors examined included main meals (breakfast, lunch, and dinner), and snacks (before breakfast, between breakfast and lunch, between lunch and dinner, after dinner, or other). For each eating behavior, percent of reporters, relative contribution to 24-hour energy intake, the clock time of report, and intermeal/snack intervals were examined. STATISTICAL ANALYSIS: Multivariable logistic and linear regression methods for analysis of complex survey data adjusted for characteristics of respondents in each survey. RESULTS: Over the 40-year span examined reports of each individual named main meal (or all three main meals) declined, but reports of only two out of three meals or the same meal more than once increased; the percentage of 24-hour energy from snacks reported between lunch and dinner or snacks that displaced meals increased; clock times of breakfast and lunch were later, and intervals between dinner and after-dinner snack were shorter. Changes in several snack reporting behaviors (eg, report of any snack or ≥2 snacks), were significant in women only. CONCLUSIONS: Several meal and snack eating behaviors of American adults changed over time, with a greater change in snack behaviors of women relative to men.

Evidence for efficacy and effectiveness of changes in eating frequency for body weight management.

In self-reported diets of free living individuals, frequent eating is associated with higher energy intake, yet beliefs about the possible beneficial effect of higher eating frequency for managing body weight persist. Prospective cohort studies and controlled trials of manipulation of eating frequency published by 31 December 2012 were reviewed to assess whether variation in eating frequency may be an adjunct to weight management. Four prospective cohort studies were identified; 2 of these included adults followed for 10 y and 2 followed pre-adolescent/adolescent girls for 6 or 10 y. Within each age category, the findings of the 2 studies were contradictory. Six controlled trials with adult subjects serving as their own controls found no significant changes in body weight due to manipulation of eating frequency interventions lasting 6-8 wk. In 6 additional intervention trials of 8-52 wk duration, free-living adults were counseled to change the eating frequency of self-selected food intake with no significant differences in weight loss attributable to eating frequency. Overall, the consistency of the null findings from controlled trials of manipulation of eating frequency for promoting weight loss suggests that beliefs about the role of higher eating frequency in adult weight management are not supported by evidence. Interpretation of the evidence from published observational studies is complicated by differences in definition of eating frequency and limited knowledge of systematic and random errors in measurement of eating frequency.

Association of self-reported sleep duration with eating behaviors of American adults: NHANES 2005-2010.

BACKGROUND: Published evidence suggests an inverse association between sleep duration and body weight status. OBJECTIVE: We examined the association of sleep duration with eating behaviors reported by adult Americans to understand the relation between sleep duration and body weight status. DESIGN: This cross-sectional study used sleep duration and dietary data from the continuous NHANES conducted from 2005 to 2010 (n = 15,199, age ≥20 y). Eating behaviors examined included the following: reporting of and energy from main meals (breakfast, lunch, and dinner) and snacks (before breakfast, after dinner, and after 2000 h), intermeal intervals, time of day of main meal reporting, and intakes of macronutrients and beverages. Multiple regression methods were used to examine the independent association of hours of sleep duration grouped as short (≤6 h), average (7-8 h), and long (≥9 h) with eating behavior outcomes. RESULTS: Relative to average-duration sleepers, a smaller percentage of short-duration sleepers mentioned breakfast, lunch (women only), and dinner in the recall (P ≤ 0.04). They also reported a lower mean percentage of energy from main meals but higher energy from all snacks (P ≤ 0.0004) and after 2000 h (P = 0.03). Short-duration sleepers reported the earliest eating time of the first episode and the latest time of the last eating episode. Absolute amounts of sugar and caffeine and percentage of energy from beverages (women only) were higher in short-duration sleepers. However, the total number of eating episodes and energy intake were not related with sleep duration. CONCLUSIONS: Short-duration sleepers began eating earlier and ended their eating later in the day, but despite the longer eating period, they did not report more eating events. Profiles of the relative contribution of main meals and snacks, at or after 2000 h eating, and beverages in short-duration sleepers were suggestive of eating behaviors that may increase energy intake, but 24-h energy intake did not differ among categories of sleep duration.

Diets of drinkers on drinking and nondrinking days: NHANES 2003-2008.

BACKGROUND: Alcohol may affect dietary intake. However, little is known about diets on drinking days in the US population. OBJECTIVE: We determined whether the diets of drinkers differ on drinking compared with nondrinking days. DESIGN: Data were from the 2003-2008 NHANES Mobile Examination Center interview. We identified 1864 current drinkers (1126 men and 738 women) who completed two 24-h dietary recalls, one of which was on a drinking day and the other of which was on a nondrinking day. Sex-specific repeated-measures analyses that were adjusted for dietary recall order and recall day of the week were used to compare within-individual differences in energy, nutrient, and food-group intakes. Analyses were weighted to produce representative estimates. RESULTS: On their drinking (compared with nondrinking) days, men consumed an excess 168 nonalcohol kcal (P < 0.01), which was reflected in higher intakes of nutrients including total protein (P < 0.001), total fat (P < 0.01), saturated fat (P < 0.01), monounsaturated fat (P < 0.01), potassium (P < 0.001), and sodium (P < 0.05). Men also had higher intakes of food groups including meat (P < 0.001), white potatoes (P < 0.05), and discretionary oil and solid fat (P < 0.05) and lower intakes of total fruit (P < 0.05) and milk (P < 0.05). Women did not consume excess nonalcohol kilocalories but had higher intakes of total fat (P < 0.05), monounsaturated fat (P < 0.05), polyunsaturated fat (P < 0.05), potassium (P < 0.01), and discretionary oil and solid fat (P < 0.05) and lower intakes of milk (P < 0.01) and milk products (P < 0.01). CONCLUSIONS: These mostly moderate drinkers had poorer diets on drinking days. Same-day associations between alcohol and diet could be useful targets for public health efforts to improve dietary intake.

Family income and education were related with 30-year time trends in dietary and meal behaviors of American children and adolescents.

Recent survey data reveal the persistence of long-acknowledged socioeconomic status (SES) differentials in the prevalence of obesity in U.S. children and adolescents. We examined 30-y changes in the association of dietary and meal behaviors with family income and education to understand the possible contribution of these trends to SES trends in obesity rates in 2- to 19-y-old Americans. We used dietary and SES data for 2- to 19-y olds from the NHANES 1971-1974 to 2003-2008 (n = 39,822). The secular changes in the independent association of family income and education with 24-h dietary behaviors [energy intake (kcal), amount of foods and beverages (g), percent energy from all beverages and from nutritive beverages, and energy density of foods] and 24-h meal behaviors [number of eating occasions, energy from snack episodes (%), and mention of breakfast] were examined using multivariable regression methods. The secular increase in energy intake and food and beverage amount was significant in the lowest family SES categories. The positive association of family income and education with intakes of energy, food amounts, and beverage energy, noted in 1971-1974 or 1976-1980, was not observed in later surveys. There was an age gradient in changes in most diet and SES associations over time, with largest adverse changes in 12- to 19-y olds. Higher education was associated with lower energy from snack episodes, breakfast skipping, and energy density of foods and these associations did not change over time. Overall, these results suggest both income and education differentials in secular increases in food amounts and energy intakes.

Media coverage and awareness of the 2010 Dietary Guidelines for Americans and MyPlate.

PURPOSE: To examine the extent and content of coverage of the 2010 Dietary Guidelines for Americans (DGA) and MyPlate in selected mass media outlets and to determine the prevalence of awareness of this recent guidance among adults. DESIGN: Qualitative content analysis of media coverage, from January 2011 to October 2011, and a cross-sectional survey of the 2010 DGA and MyPlate. SETTING: Large metropolitan area. PARTICIPANTS: Four major newspapers (New York Times, Wall Street Journal, New York Daily News, and New York Post), three network television channels (ABC, CBS, and NBC), and six print magazines (Cooking Light, Ebony, Essence, Jet, O! The Oprah Magazine, and Shape). Adults aged ≥50 years (n = 200), college students (n = 219), and African-American women (n = 167); response rates >70%. METHODS: Number and content of news stories and self-administered survey of prevalence of awareness of DGA and MyPlate. RESULTS: Twelve newspaper, 14 television, and two magazine stories covered the 2010 DGA and MyPlate. The DGA coverage emphasized population-group-specific sodium recommendations, and MyPlate coverage emphasized the plate icon. Awareness of the DGA and MyPlate varied from approximately 6% in college students to 22% among ≥50-year-olds. CONCLUSION: The newspapers and television (but not magazines) covered both the 2010 DGA and MyPlate; the content was accurate but brief. However, the awareness of this guidance in study samples was low.

Association of food form with self-reported 24-h energy intake and meal patterns in US adults: NHANES 2003-2008.

BACKGROUND: Laboratory studies suggest that food form (beverages compared with solid foods) evokes behavioral and physiologic responses that modify short-term appetite and food intake. Beverage energy may be less satiating and poorly compensated, which leads to higher energy intake. OBJECTIVE: We examined associations between 24-h energy consumed in beverages and a variety of meal and dietary attributes to quantify the contribution of beverage consumption to the energy content of diets in free-living individuals consuming their self-selected diets. DESIGN: We used dietary recall data for adults (n = 13,704) in NHANES 2003-2008 to examine the multiple covariate-adjusted associations between 24-h energy from beverages and nonbeverages and associations between beverage intake, eating behaviors, and the energy density of beverage and nonbeverage foods. RESULTS: In the highest tertile of 24-h beverage energy intake, beverages provided >30% of energy. Total 24-h energy and nonbeverage energy consumption and energy density (kcal/g) of both beverage and nonbeverage foods increased with increasing energy from beverages (P < 0.0001). With increasing 24-h beverage energy consumption, the reported frequency of all, snack, and beverage-only ingestive episodes and length of the ingestive period increased, whereas the percentage of energy from main meals decreased (P < 0.0001). CONCLUSIONS: Higher 24-h beverage energy intake was related to higher energy intake from nonbeverage foods, quality of food selections, and distribution of 24-h energy into main meal and snack episodes. Moderation of beverage-only ingestive episodes and curtailing the length of the ingestion period may hold potential to lower uncompensated beverage energy consumption in the US population.