We are what we eat. The food that goes into our body determines our well-being, health and fitness. A diet that lacks nutrients is a great disaster on the individual’s body as it paves way for non-communicable diseases which impairs quality of life and causes death. Focus is given to different foods and their nutrition content but in reality, we take these foods together as meals or snacks. So, getting to know more about the nutritional composition of meals, different meal combinations and how their variations affect diet quality brings on a clearer picture on the relationship between diet and diseases. Most of the dietary advises revolve around the type and quantity of food individuals should consume instead of focusing on the eating pattern. Eating pattern indicates how people eat during eating occasion (EO) which includes indicators such as frequency, timing of meals, frequency, timing of snacks and skipped meals.
Every meal is integral for nutrient addition to our body. Skipping breakfast increases the risk of obesity, cardiovascular risk and decreased micronutrients intake. But there are not many studies associating macronutrients and eating patterns such as meals and snacks and their overall diet quality. Diet quality is measured by the quality of foods that individual eats using diet scores that have been established. Most studies that measure diet quality and meal/snack frequencies use questionnaires to assess eating patterns and the studies are even more limited when it comes to examining meal and snack frequencies. When we have a better understanding of the effects of meals and snacks on diet quality it is possible to motivate people to follow dietary guidelines and achieve the recommended levels of nutrients through foods.
Assessing Meal & Snack Impact on Diet Quality
9338 volunteers participated in the study and two dietary recalls were taken on consecutive days. 65% (6053) participants completed both dietary recalls which included questions on the type and time of EO whose response options included choices among breakfast, brunch, lunch, dinner, supper, snack, morning tea, afternoon tea, drink or beverage, extended consumption and others. Generally, there is no hard and fast rule on what defines an EO as participants are mostly required to identify their own EO while some use time of day to identify an EO. In this study, an EO was defined as any occasion during which a food or beverage was consumed that contained a minimum energy content of 50 kcal and there was at least a time gap of 15 minute between two successive EOs. The EOs were split into meals and snacks depending on the volunteers’ reporting of breakfast, lunch, brunch, dinner or supper and snacks, morning tea, afternoon tea and beverages/breaks respectively.
All the nutrients required by the body for well-being and preventing diseases such as cardiovascular disease, iodine deficiency, iron deficiency and hypertension was noted and mean total dietary intake of these nutrients such as carbohydrates, fats, proteins, sugars, dietary fiber, folate, sodium, potassium, calcium, iron, iodine, MUFAs, PUFAs and SFAs was calculated.
Diet quality was assessed using dietary guidelines index (DGI) of 2013. DGI-2013 contains 13 components each of which was scored on a range of 1 to 10 where the highest score indicated that the individual was maximum compliant of the dietary guideline. Of the 13 components 7 (fruits, vegetables, cereals, dairy, food variety, lean meat and fluid intake) of them assess the adequacy of the diet while the other 6 (discretionary foods, saturated foods, salt, added sugar, alcohol and moderate intake of unsaturated fat) assess the moderation of the dietary intake. Each of the participant’s smoking attributes, alcohol consumption status, physical activity levels and sedentary behavior was noted. After excluding participants based on certain criteria there were finally 2053 men and 2270 women available for the study. The results were as follows:
Association between Meal Pattern Nutrient Intake & Overall Diet Quality
Some 10 studies were analyzed for the contribution of meals and snacks to energy and nutrient intakes. It was found that lunch and evening meals contributed to the greatest proportion of total daily energy, protein, fat and carbohydrate intake. We define primary meals as those that provide us with the largest volume of food. An analysis of meals and snacks proved that snacks contributed towards lower total energy from fat and protein in comparison to meals. Two studies showed that consumption of protein was highest in the evening especially among older adults, two studies showed that snacks contributed towards more consumption of total sugars but not total carbohydrates than meals and one study showed that snacks consumed after lunchtime contained less protein and fiber than morning snacks.
One study on Finnish meal patterns found that meals contributed more fiber and carotenoids but less sugar, vitamin C and alcohol than snacks. Another Dutch study found that dinner meals were major contributors to intake of iron, zinc, vitamin B1, B6, B12, C, D and E. But there are also studies that show that snacks too contribute significantly to addition of nutrients such as Ca, Fe, vitamin C, thiamin, riboflavin and niacin.
18 studies focused on eating frequencies and identified that higher the eating frequency greater was the nutrient intake-when individuals ate for six or more times daily their intake of carbohydrates and fiber was increased but they had lower intake of fat and protein in comparison to those who ate less than three times daily. Yet another study found that men with a dominant snacking frequency had lower fiber and micronutrient intake.
It is clearly proven that meals play a prominent role in determining the nutrition intake. This might be because you get to eat a variety of foods, pick from a diverse range of foods that include plenty of fruits and vegetables and eat them at definite timings. Whereas, snacks are taken in between to avoid hunger pangs during meals and to keep you comfortable through the day. Though choosing a snack depends on your choice, we mostly choose from crisps, fried items and junks which decrease total nutrient intake greatly. Hence, the frequency of your meal consumption greatly plays a role in determining overall diet quality.
Meal Frequency and not snack frequency is associated with micronutrients intake and overall diet quality: https://academic.oup.com/jn/article/146/10/2027/4584875?searchresult=1
Understanding meal patterns: Definitions, methodology and impact on nutrient intake and diet quality: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501369/
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