National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
National Health Commission Key Laboratory of Trace Element Nutrition, Beijing 100050, China.
Nutrients. 2022 May 11;14(10):2019. doi: 10.3390/nu14102019.
Few studies have described the status and change of time-of-day of energy intake on a population level. This study aims to investigate the secular trend in time-of-day of energy intake using a Chinese cohort, and to examine demographic disparities in trends. A total of 20,976 adults with at least two waves of dietary data in the China Health and Nutrition Survey (CHNS 1991-2018) were included. A multilevel linear mixed model was applied to the energy proportions of breakfast, lunch and dinner. A multilevel Tobit regression model was applied to the energy proportion of morning snack, afternoon snack and evening snack. Time-demographic interaction terms were tested to examine demographic disparities in the trends. From 1991 to 2018, the marginal mean of the energy proportion of breakfast experienced first a falling and then a rising trend, and the marginal mean of energy proportions of lunch and dinner both presented first a rising and then a falling trend. The marginal means of all snacks took on a rising trend. Significant time-demographic interactions were observed for energy proportion of each eating occasion. On average, female, older and rural people tended to have a higher energy proportion at breakfast and lower energy proportion at lunch and dinner. Female, younger and urban people tended to have higher snack energy proportions. The time-of-day of energy intake has first shifted towards later in the day and then towards a balanced meal pattern in this Chinese cohort. Demographic disparities were observed in both the secular trend and the mean level of energy proportions of eating occasions. The health implications of such meal patterns warrant further investigation.
鲜有研究描述过人群层面上的日均能量摄入时间的变化情况。本研究旨在利用中国队列来调查日均能量摄入时间的变化趋势，并检验不同人群在该趋势中的差异。共纳入了中国健康与营养调查（CHNS，1991-2018 年）中至少有两次饮食数据的 20976 名成年人。采用多水平线性混合模型分析早餐、午餐和晚餐的能量比例。采用多水平 Tobit 回归模型分析早餐饮料、午餐饮料和晚餐饮料的能量比例。检验时间-人口统计学交互项，以检验不同人群在该趋势中的差异。1991 年至 2018 年期间，早餐的边际平均能量比例先呈下降趋势，然后呈上升趋势，午餐和晚餐的边际平均能量比例先呈上升趋势，然后呈下降趋势。所有零食的边际平均值呈上升趋势。每个进食时间点的能量比例都存在显著的时间-人口统计学交互作用。一般来说，女性、年龄较大和农村居民的早餐能量比例较高，午餐和晚餐的能量比例较低。女性、年龄较小和城市居民的零食能量比例较高。在这个中国队列中，日均能量摄入时间先向晚些时候转移，然后又向均衡的膳食模式转移。在该趋势和各进食时间点的平均能量比例方面都存在人口统计学差异。这种膳食模式的健康影响值得进一步研究。
