Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults

Objective This study was undertaken to test the hypothesis that specific meal and snack patterns are associated with selected nutrient intakes in US adults. Design Using the 24-hour dietary recall from the Third National Health and Nutrition Examination Survey, meal and snack patterns were described in relation to nutrient intakes. Subjects The study included US adults aged 20 years or older (n=15,978). Statistical analyses performed All statistical analyses accounted for the survey design and sample weights. Linear regression analyses controlled for confounding factors, including energy intakes. Wald F tests were used for determination of significance between means of nutrient intakes by daily eating frequency or meal pattern groups. Results Daily eating frequency was positively related to carbohydrate, folic acid, vitamin C, calcium, magnesium, iron, potassium, and fiber intakes and inversely related to protein, total fat, cholesterol, and sodium intakes. Meal patterns were further categorized into the five most commonly reported meal and snack combinations by population percentages including breakfast (B), lunch (L), dinner (D), and >= 2 snacks (S) (31.6%); B, L, D and 1 S (15.4%); B, D and >= 2 S (13.1%); B, L, D (8.3%); and L, D and >= 2 S (7.6%). Groups reporting B, L, D and 1 S and B, L, D and >= 2 S had the highest intakes of all micronutrients examined except cholesterol, vitamin B-6, and sodium. Breakfast skippers (L, D and >= 2 S) had the lowest intakes of all micronutrients examined except sodium. Conclusions Findings from this cross-sectional survey suggest that meal and snack patterns may be markers for nutrient intakes and therefore diet quality. Complete nutrient intakes should be considered in investigations of meal patterns and health outcomes.