The association of energy, macronutrients, and food sources consumption at dinner versus breakfast with obesity: The National Health and Nutrition Examination Survey (NHANES), 2003-2016

Abstract Background This study aimed to investigate the association of the difference of dietary consumption (energy, macronutrients, and foods) at dinner versus breakfast with obesity among U.S adults. Subjects/Methods: This study adopted the data from the National Health and Nutrition Examination Survey (2003–2016), involving a total of 27911 participants. The differences in the ratio of total energy and three macronutrients with six subgroups at dinner versus breakfast (ΔRatio) were categorized into quartiles. The differences in the consumption of 17 types of food at dinner versus breakfast (ΔFoods) were considered as continuous variables. Body Mass Index (BMI) and Waist circumference (WC) were used to define general obesity (30.0 ≤ BMI 102 cm for men or WC > 88 cm for women). Multiple logistic and linear regression models were developed. Results: After a variety of covariates were adjusted, participants in the highest quartile (higher energy/macronutrient intake at dinner than breakfast) of ΔRatio in terms of energy, fat, saturated fatty acids (SFA), and unsaturated fatty acids (USFA) was positively associated with morbid obesity compared with those in the lowest quartile (ORΔRatio of energy 1.27, 95%CI 1.01;1.61; ORΔRatio of fat 1.27, 95%CI 1.01;1.60; ORΔRatio of SFA 1.27, 95%CI 1.01;1.59; ORΔRatio of USFA 1.28, 95%CI 1.02;1.59). The highest quartile of ΔRatio of low-quality carbohydrate led to higher odds of abdominal obesity (ORΔRatio of low−quality carbohydrate 1.16; 95%CI 1.03–1.31). Meanwhile, ΔRatio of low-quality carbohydrates was significantly positively associated with BMI (coefficient: 0.562, 95%CI: 0.217–0.907). ΔFoods including whole fruits, other starchy vegetables, added sugars, poultry, dairy, and nuts were positively associated with obesity. Conclusions: This study indicated that among US adults, higher intake of energy, macronutrients (low-quality carbohydrate, fat, SFA, and USFA), and foods (whole fruits, other starchy vegetables, added sugars, poultry, dairy, and nuts) at dinner than breakfast was associated with higher odds of having obesity. In conclusion, this study emphasized the importance of diet quality and meal-timing in the prevention of obesity.