Glycemic control greatly relies on total dietary and carbohydrate intakes, but more importantly the distribution of these intakes throughout the day. The purpose of this study was to understand meal and snack patterns and their contribution to the day’s intakes in people with and without diabetes. Meal and snack intakes were assessed for adults over 30 years of age (n=23708) using dietary and hemoglobin A1c data from the 2005-2016 National Health and Nutrition Examination Survey (NHANES). Dietary intakes were assessed from a 24-hour dietary recall. Participants self-reported meals and snacks. Intakes were aggregated to obtain nutrients consumed at meals and snacks and were used to compute the percent of the total day’s intakes contributed by each meal or snack. Participants were stratified into diabetes status using A1c values: <5.7% (nondiabetes, n=14841); 5.7-6.4% (prediabetes, n=5923); 6.5-6.9% (controlled diabetes, n=923); and >7% (poorly controlled diabetes, n=2021). Data were weighted to create a nationally representative sample. Significantly less adults with controlled and poorly controlled diabetes consumed all three meals per day (60-62%, P<0.001). Lunch was the most skipped meal (19.8-25.8%) across all groups, with nondiabetes having the highest percent (P<0.001). Snacks contributed more energy, carbohydrates, and added sugars than breakfast in all groups. Dinner contributed nearly 40% of protein, sodium, and saturated fat intakes as well as more than one-third of total energy. Breakfast accounted for nearly half the day’s whole grain intake, yet mean daily intakes were below 0.5 ounces. Distributing food intake, especially carbohydrates, throughout the day is an effective strategy to promote optimal glycemic control. Meal skipping, particularly lunch more than breakfast, was more common in adults with diabetes, with considerable intakes of energy and carbohydrates obtained during dinner and snacks, suggesting uneven meal distribution is prevalent.

Disclosure

O. Kelly: Employee; Self; Abbott. Employee; Spouse/Partner; Abbott. S.M. Fanelli: None. J.L. Krok-Schoen: None. C.A. Taylor: Consultant; Self; Abbott Laboratories. Research Support; Self; Abbott Laboratories. Other Relationship; Self; Elsevier.

Funding

Abbott Nutrition

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