Association of Meal and Snack Patterns With Mortality of All‐Cause, Cardiovascular Disease, and Cancer: The US National Health and Nutrition Examination Survey, 2003 to 2014

Jun 23, 2021Journal of the American Heart Association

Meal and Snack Habits Linked to Risk of Death from All Causes, Heart Disease, and Cancer in US Adults

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Abstract

During 149,875 person-years of follow-up, 2,192 deaths, including 676 from cardiovascular disease and 476 from cancer, were documented.

Consuming fruit-lunch is associated with lower mortality risks for all causes (hazard ratio 0.82) and cardiovascular disease (HR 0.66).
Participants who had a Western-lunch had a higher likelihood of dying from cardiovascular disease (HR 1.44).
Vegetable-dinner consumption is linked to lower mortality risks for all causes (HR 0.69), cardiovascular disease (HR 0.77), and cancer (HR 0.63).
Eating a fruit-snack after breakfast may reduce the risk of all-cause (HR 0.78) and cancer mortality (HR 0.55).
Dairy-snack consumption after dinner is associated with lower risks of all-cause (HR 0.82) and cardiovascular disease mortality (HR 0.67).
Starchy-snack consumption after main meals is associated with higher mortality risks for all causes (HR 1.50) and cardiovascular disease (HR 1.55).

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Background Although accumulating evidence has demonstrated that consumption time of energy and macronutrients plays an important role in maintaining health, the association between consumption time of different foods and cardiovascular disease, cancer, and all-cause mortalities is still largely unknown. Methods and Results A noninstitutionalized household population of the US 21 503 participants from National Health and Nutrition Examination Survey was included. Meal patterns and snack patterns throughout a whole day were measured using 24-hour dietary recall. Principal component analysis was performed to establish dietary patterns. Cox proportional hazards models were used to evaluate the association between dietary patterns across meals and cardiovascular disease (CVD), cancer, and all-cause mortalities. During the 149 875 person-years of follow-up, 2192 deaths including 676 deaths because of CVD and 476 because of cancer were documented. After adjusting for potential confounders, participants consuming fruit-lunch had lower mortality risks of all-cause (hazard ratio [HR], 0.82; 95% CI, 0.72-0.92) and CVD (HR, 0.66; 95% CI, 0.49-0.87); whereas participants who consumed Western-lunch were more likely to die because of CVD (HR, 1.44; 95% CI, 1.10-1.89). Participants who consumed vegetable-dinner had lower mortality risks of all-cause, CVD, and cancer (HR, 0.69; 95% CI, 0.60-0.78; HR, 0.77; 95% CI, 0.61-0.95; HR, 0.63; 95% CI, 0.48-0.83). For the snack patterns, participants who consumed fruit-snack after breakfast had lower mortality risks of all-cause and cancer (HR, 0.78; 95% CI, 0.66-0.93; HR, 0.55; 95% CI, 0.39-0.78), and participants who consumed dairy-snack after dinner had lower risks of all-cause and CVD mortalities (HR, 0.82; 95% CI, 0.72-0.94; HR, 0.67; 95% CI, 0.52-0.87). Participants who consumed a starchy-snack after main meals had greater mortality risks of all-cause (HR, 1.50; 95% CI, 1.24-1.82; HR, 1.52; 95% CI, 1.27-1.81; HR, 1.50; 95% CI, 1.25-1.80) and CVD (HR, 1.55; 95% CI, 1.08-2.24; HR, 1.44; 95% CI, 1.03-2.02; HR, 1.57; 95% CI, 1.10-2.23). Conclusions Fruit-snack after breakfast, fruit-lunch, vegetable-dinner, and dairy-snack after dinner was associated with lower mortality risks of CVD, cancer, and all-cause; whereas Western-lunch and starchy-snack after main meals had greater CVD and all-cause mortalities. all-cause CVD cancer all-cause cancer all-cause CVD after-breakfast after-lunch after-dinner after-breakfast after-lunch after-dinner

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Association of Meal and Snack Patterns With Mortality of All‐Cause, Cardiovascular Disease, and Cancer: The US National Health and Nutrition Examination Survey, 2003 to 2014

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