Measures of Diet Quality across Calendar and Winter Holiday Seasons among Midlife Women: A 1-Year Longitudinal Study Using the Automated Self-Administered 24-Hour Recall

Systematic seasonal bias may confound efforts to estimate usual dietary intake and diet quality. Little is known about dietary quality over the winter holiday season.The aims of this study were to test for differences in intakes of energy, percentage of energy from macronutrients, fruits and vegetables, and diet quality measured using the Healthy Eating Index 2010 (HEI-2010) by calendar and winter holiday seasons.Longitudinal cohort design.Data were derived from the Life in All Seasons study. Two cohorts of women aged 40 to 60 years (N=52) from the greater Grand Forks, ND, area were followed for 1 year each between July 2012 and July 2014. Each woman completed an online diet recall using the Automated Self-Administered 24-Hour Recall every 10 days during the year, with a 92% response rate.Effects of calendar and winter holiday seasons on intakes of energy, percent energy from macronutrients, HEI-2010 total and component scores, and grams per day of individual fruits and vegetables were tested using mixed linear models.The mean total HEI-2010 score was 60.1±1.4. There were seasonal differences in some HEI-2010 component scores, but not in total scores. More lettuce or mixed lettuce salad was consumed during summer than during winter (P=0.034), and more fresh tomatoes were consumed during summer and fall compared with winter (P=0.001). More corn, berries, peaches and nectarines, and melons (P<0.001) were consumed during summer. There was no seasonal difference in reported intakes of energy (P=0.793). The total HEI-2010 score for dietary intake observed over the winter holiday season was lower than the rest of the year (P<0.001). Reported energy intake was not different (P=0.228).In this population, diet quality is significantly lower during the winter holiday period, but mostly consistent by season. Multiple recalls in any season can give a reasonable representation of usual overall diet quality throughout the year.