Nutritional quality of meals and snacks assessed by the Food Standards Agency nutrient profiling system in relation to overall diet quality, body mass index, and waist circumference in British adults

Sep 15, 2017Nutrition journal

Meal and snack nutrition quality linked to overall diet, body weight, and waist size in British adults

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Abstract

Higher FSA scores, indicating lower nutritional quality, were associated with poorer overall diet quality in 1451 British adults aged 19-64.

Higher FSA scores for meals and snacks were linked to lower intakes of fruits, vegetables, and nuts.
Increased consumption of biscuits, cakes, pastries, total fat, and saturated fatty acids was associated with higher FSA scores.
Overall diet quality, measured by healthy diet and Mediterranean diet scores, was inversely related to FSA scores for both meals and snacks.
Stronger associations between nutritional quality and diet quality were observed for meals, which contributed significantly to total energy intake.
In women, the nutritional quality of snacks based on energy contribution was positively associated with body mass index and waist circumference.

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BACKGROUND: Studies examining meal and snack eating behaviors in relation to overall diet and health markers are limited, at least partly because there is no definitive consensus about what constitutes a snack, a meal, or an eating occasion. This cross-sectional study examined how nutritional quality of meals and snacks is associated with overall diet quality, body mass index (BMI), and waist circumference.

METHODS: Based on 7-d weighed dietary record data, all eating occasions were divided into meals or snacks based on time (meals: 0600-1000, 1200-1500, and 1800-2100 h; snacks: others) or contribution to energy intake (EI) (meals: ≥15%; snacks: <15%) in 1451 British adults aged 19-64 years participating in the National Diet and Nutrition Survey. Nutritional quality of meals and snacks was assessed as the arithmetic EI-weighted means of the British Food Standards Agency (FSA) nutrient profiling system score of each food and beverage consumed, based on the contents of energy, saturated fatty acid, total sugar, sodium, fruits/vegetables/nuts, dietary fiber, and protein per 100 g.

RESULTS: Irrespective of the definition of meals and snacks, higher FSA scores (lower nutritional quality) of both meals and snacks were associated with unfavorable profiles of individual components of overall diet, including lower intakes of fruits/vegetables/nuts and higher intakes of biscuits/cakes/pastries, total fat, and saturated fatty acid. The FSA scores of meals and snacks were also inversely associated with overall diet quality assessed by the healthy diet indicator (regression coefficient (β) = -0.22 to -0.17 and -0.06 to -0.03, respectively) and Mediterranean diet score (β = -0.25 to -0.19 and -0.08 to -0.05, respectively) in both sexes (P ≤ 0.005). However, the associations were stronger for meals, mainly due to their larger contribution to total EI (64% to 84%). After adjustment for potential confounders, only the FSA score of snacks based on EI contribution was positively associated with BMI and waist circumference in women (P ≤ 0.005).

CONCLUSIONS: Although lower nutritional quality of both meals and snacks assessed by the FSA score was associated with adverse profiles of overall diet quality (but not necessarily adiposity measures), stronger associations were observed for nutritional quality of meals.

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Nutritional quality of meals and snacks assessed by the Food Standards Agency nutrient profiling system in relation to overall diet quality, body mass index, and waist circumference in British adults

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