Temporal Dietary Patterns Are Associated with Obesity in US Adults

Abstract

Background The integration of time with dietary patterns throughout a day, or temporal dietary patterns (TDPs), have been linked with dietary quality but relations to health are unknown. Objective The association between TDPs and selected health status indicators and obesity, type 2 diabetes (T2D), and metabolic syndrome (MetS) was determined. Methods The first-day 24-h dietary recall from 1627 nonpregnant US adult participants aged 20–65 y from the NHANES 2003–2006 was used to determine timing, amount of energy intake, and sequence of eating occasions (EOs). Modified dynamic time warping (MDTW) and kernel k-means algorithm clustered participants into 4 groups representing distinct TDPs. Multivariate regression models determined associations between TDPs and health status, controlling for potential confounders, and adjusting for the survey design and multiple comparisons (P <0.05/6). Results A cluster representing a TDP with evenly spaced, energy balanced EOs reaching ≤1200 kcal between 06:00 to 10:00, 12:00 to 15:00, and 18:00 to 22:00, had statistically significant and clinically meaningful lower mean BMI (P <0.0001), waist circumference (WC) (P <0.0001), and 75% lower odds of obesity compared with 3 other clusters representing patterns with much higher peaks of energy: 1000–2400 kcal between 15:00 and 18:00 (OR: 5.3; 95% CI: 2.8, 10.1), 800–2400 kcal between 11:00 and 15:00 (OR: 4.4; 95% CI: 2.5, 7.9), and 1000–2600 kcal between 18:00 and 23:00 (OR: 6.7; 95% CI: 3.9, 11.6). Conclusions Individuals with a TDP characterized by evenly spaced, energy balanced EOs had significantly lower mean BMI, WC, and odds of obesity compared with the other patterns with higher energy intake peaks at different times throughout the day, providing evidence that incorporating time with other aspects of a dietary pattern may be important to health status.

Association of Time-of-Day Energy Intake Patterns with Nutrient Intakes, Diet Quality, and Insulin Resistance

“…Epidemiological studies suggest meal timing or time of energy intake has a relationship with obesity [10,14,26,27], blood pressure [12,28,29], and type 2 diabetes [10,30], but study examining time-of-day patterns of energy intake in relation to insulin resistance is lacking. The "Evening dominant pattern" observed in the present study was associated with higher insulin resistance risk, compared with the "Noon dominant pattern", after adjusting for sociodemographic, lifestyle, and other cardiometabolic risk factors.…”

“…Yet, the question of whether there is a specific time-of-day pattern of energy distribution in a day that is more beneficial or detrimental to health remains unclear. Although studies [2,13,14] applying kernel k-Means Clustering with an appropriate distance metric to NHANES data based on energy contribution, time of dietary intake, and a number of intake occasions have identified different temporal dietary patterns in the adult U.S. population 20 years and older, the cluster techniques used in this study allocated subjects to clusters based on pre-determined cluster number and no statistical tests were available in determining the optimal number of clusters. Moreover, evidence regarding time-of-day energy intake patterns and their dietary profiles and health implications is still lacking in the Asian population.…”

Dietary patterns related to total mortality and cancer mortality in the United States

“…Most studies in the United States have focused on investigating associations between specific dietary factors and chronic diseases [12][13][14].The association between the adherence dietary patterns and total mortality and mortality due to cancer in the general population is still limited. Dietary patterns condense information about food consumption, reflect diet composition, and capture the overall effect of dietary exposures on health and disease.…”

“…Several studies evaluated the effect of dietary patterns and mortality in other countries [8][9][10][11]. In the United States, studies have shown the association between adherence to specific dietary patterns and chronic diseases, including obesity [12,13], cardiovascular disease, and diabetes [14]. Moreover, only a few studies have investigated the relationship between specific dietary patterns and total mortality [15][16][17][18][19][20].…”

Trajectories of Energy Intake Distribution and Risk of Dyslipidemia: Findings from the China Health and Nutrition Survey (1991–2018)

“…One study cross-sectionally examined the association between energy intake at different times of the day and blood lipid levels, but a full spectrum of energy distribution pattern across the day was not investigated in this study [10]. In contrast, other cross-sectional studies [13][14][15] have assessed daily energy distribution pattern in other population, however, the effect on dyslipidemia was not examined. Besides, to our knowledge, few studies has examined the secular trend of energy intake distribution, and no study has examined the longitudinal association between long-term energy intake distribution pattern and risk of dyslipidemia.…”