Temporal Dietary Patterns Derived among the Adult Participants of the National Health and Nutrition Examination Survey 1999-2004 Are Associated with Diet Quality

Temporal dietary patterns, the distribution of energy or nutrient intakes observed over a period of time, is an emerging area of dietary patterns research that incorporates time of dietary intake with frequency and amount of intake to determine population clusters that may have similar characteristics or outcomes related to diet quality.We examined whether differences in diet quality were present between clusters of individuals with similar daily temporal dietary patterns.The first-day 24-hour dietary recall data from the cross-sectional National Health and Nutrition Examination Survey, 1999-2004, were used to determine proportional energy intake, time of intake, frequency of intake occasions, and mean diet quality.Data from 9,326 US adults aged 20 to 65 years were included.The mean diet quality, classified by the Healthy Eating Index-2005, of participant clusters with similar temporal dietary patterns derived on the basis of individual proportional energy intake, time of intake, and frequency of intake, were inferentially compared using multiple linear regression that controlled for potential confounders and other covariates (P<0.05/6).Diet quality differences were present between US population clusters exhibiting similar daily temporal dietary patterns (P<0.001 with one exception, which was P=0.08). Participant characteristics of race/ethnicity, age, household poverty-income ratio, and body mass index were associated with the temporal dietary patterns. The cluster representing the temporal dietary pattern with proportionally equivalent energy consumed during three evenly spaced eating occasions had a significantly greater mean total Healthy Eating Index-2005 score compared with the other temporal dietary pattern clusters.Temporal dietary patterns are associated with differences in US adult daily diet quality, demonstrating that elements beyond food and nutrient intake, such as time, can be incorporated with dietary patterns to determine links to diet quality that enhance knowledge of the complicated interplay of time and dietary patterns.