Higher intake energy, protein, and polyunsaturated fatty acids at dinner versus breakfast increase the risk of hyperhomocysteinemia among adults in the USA.

PURPOSE

This study analyzed the relation of energy and macronutrient intake at dinner versus breakfast with the risk of hyperhomocysteinemia (Hhcy).

METHODS

Up to 12,474 adults, in which 1,387 with Hhcy, completed a questionnaire about energy and macronutrient intake in the National Health and Nutrition Examination. The differences (Δ) in that between dinner and breakfast (Δ = dinner - breakfast) were categorized into quartiles. Logistic regression analyses or restrictive cubic spline regressions were conducted to determine the relation in Δ and the risk of Hhcy, as well as the change in risk when 5% energy at dinner was substituted with those at breakfast through isocaloric substitution models.

RESULTS

After adjusted the confounders, results showed that compared to the research objects in the lowest quartile, those in the highest quartile were more prone to get Hhcy (odds ratio (OR) = 1.26, 95% CI = 1.03-1.56; OR = 1.25, 95% CI = 1.01-1.55; OR = 1.22, 95% CI = 1.01-1.49, respectively). Isocalorically replacing 5% energy at dinner with energy at breakfast was related to 5% lower Hhcy risk. Replacing 5% of energy provided by protein at dinner with that by protein or PUFA at breakfast was related to 10% and 11% lower Hhcy risk, respectively. Replacing 5% energy provided by PUFA at dinner with that by protein or PUFA at breakfast were associated with 8% and 6% lower Hhcy risk, respectively.

CONCLUSION

The optimal intake period for energy, protein, and polyunsaturated fatty acid intake for reducing Hhcy risk in adults was the morning.