The associations between evening eating and quality of energy and macronutrients and obesity: the National Health and Nutrition Examination Survey (NHANES), 2003-2016.

Background: This study aimed to investigate the associations between evening eating and quality of energy and macronutrients and obesity among U.S. adults.

Subjects/methods: This study adopted the data from the National Health and Nutrition Examination Survey (2003-2016), which involved a total of 27,911 participants. The differences in the ratios of energy and macronutrients with it is 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 < 40.0), morbid obesity (BMI ≥ 40.0), and abdominal obesity (WC > 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 the ΔRatio in terms of energy were positively associated with morbid obesity compared with those in the lowest quartile (OR_{ΔRatio of energy} 1.27; 95% CI 1.01;1.61) from fat (OR_{ΔRatio of fat} 1.27, 95% CI 1.01;1.60); saturated fatty acids(OR_{ΔRatio of SFA} 1.27, 95% CI 1.01;1.59) and unsaturated fatty acids (OR_{ΔRatio of USFA} 1.28, 95% CI 1.02;1.5). The highest quartile of the ΔRatio of low-quality carbohydrates was associated with increased odds of abdominal obesity (OR_{ΔRatio of low-quality carbohydrates} 1.16; 95%CI 1.03-1.31). Moreover, the 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: In conclusion, with this nationally representative sample of U.S adults, this study demonstrated that excessive intake of energy at dinner than breakfast during a day was associated with a greater risk of obesity, mainly from low-quality carbohydrates, fat, SFAs, and USFA. This study emphasized the importance of diet quality and evening eating in the prevention of obesity.