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Snack quality and snack timing are associated with cardiometabolic blood markers : the ZOE PREDICT study

Bermingham, Kate M. ; May, Anna ; Asnicar, Francesco ; Capdevila, Joan ; Leeming, Emily R. ; Franks, Paul W. LU ; Valdes, Ana M. ; Wolf, Jonathan ; Hadjigeorgiou, George and Delahanty, Linda M. , et al. (2024) In European Journal of Nutrition 63(1). p.121-133
Abstract

Background: Snacking is a common diet behaviour which accounts for a large proportion of daily energy intake, making it a key determinant of diet quality. However, the relationship between snacking frequency, quality and timing with cardiometabolic health remains unclear. Design: Demography, diet, health (fasting and postprandial cardiometabolic blood and anthropometrics markers) and stool metagenomics data were assessed in the UK PREDICT 1 cohort (N = 1002) (NCT03479866). Snacks (foods or drinks consumed between main meals) were self-reported (weighed records) across 2–4 days. Average snacking frequency and quality [snack diet index (SDI)] were determined (N = 854 after exclusions). Associations between snacking frequency, quality and... (More)

Background: Snacking is a common diet behaviour which accounts for a large proportion of daily energy intake, making it a key determinant of diet quality. However, the relationship between snacking frequency, quality and timing with cardiometabolic health remains unclear. Design: Demography, diet, health (fasting and postprandial cardiometabolic blood and anthropometrics markers) and stool metagenomics data were assessed in the UK PREDICT 1 cohort (N = 1002) (NCT03479866). Snacks (foods or drinks consumed between main meals) were self-reported (weighed records) across 2–4 days. Average snacking frequency and quality [snack diet index (SDI)] were determined (N = 854 after exclusions). Associations between snacking frequency, quality and timing with cardiometabolic blood and anthropometric markers were assessed using regression models (adjusted for age, sex, BMI, education, physical activity level and main meal quality). Results: Participants were aged (mean, SD) 46.1 ± 11.9 years, had a mean BMI of 25.6 ± 4.88 kg/m2 and were predominantly female (73%). 95% of participants were snackers (≥ 1 snack/day; n = 813); mean daily snack intake was 2.28 snacks/day (24 ± 16% of daily calories; 203 ± 170 kcal); and 44% of participants were discordant for meal and snack quality. In snackers, overall snacking frequency and quantity of snack energy were not associated with cardiometabolic risk markers. However, lower snack quality (SDI range 1–11) was associated with higher blood markers, including elevated fasting triglycerides (TG (mmol/L) β; – 0.02, P = 0.02), postprandial TGs (6hiAUC (mmol/L.s); β; – 400, P = 0.01), fasting insulin (mIU/L) (β; – 0.15, P = 0.04), insulin resistance (HOMA-IR; β; – 0.04, P = 0.04) and hunger (scale 0–100) (β; – 0.52, P = 0.02) (P values non-significant after multiple testing adjustments). Late-evening snacking (≥ 9 pm; 31%) was associated with lower blood markers (HbA1c; 5.54 ± 0.42% vs 5.46 ± 0.28%, glucose 2hiAUC; 8212 ± 5559 vs 7321 ± 4928 mmol/L.s, P = 0.01 and TG 6hiAUC; 11,638 ± 8166 vs 9781 ± 6997 mmol/L.s, P = 0.01) compared to all other snacking times (HbA1c remained significant after multiple testing). Conclusion: Snack quality and timing of consumption are simple diet features which may be targeted to improve diet quality, with potential health benefits. Clinical trial registry number and website: NCT03479866, https://clinicaltrials.gov/ct2/show/NCT03479866?term=NCT03479866&draw=2&rank=1.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiometabolic health, Frequency, Quality, Quantity, Snacking, Timing
in
European Journal of Nutrition
volume
63
issue
1
pages
13 pages
publisher
Springer
external identifiers
  • scopus:85171281799
  • pmid:37709944
ISSN
1436-6207
DOI
10.1007/s00394-023-03241-6
language
English
LU publication?
yes
id
ec76dbc7-d18f-4383-841c-006fd8c6d90e
date added to LUP
2023-12-28 09:02:08
date last changed
2025-05-12 07:35:55
@article{ec76dbc7-d18f-4383-841c-006fd8c6d90e,
  abstract     = {{<p>Background: Snacking is a common diet behaviour which accounts for a large proportion of daily energy intake, making it a key determinant of diet quality. However, the relationship between snacking frequency, quality and timing with cardiometabolic health remains unclear. Design: Demography, diet, health (fasting and postprandial cardiometabolic blood and anthropometrics markers) and stool metagenomics data were assessed in the UK PREDICT 1 cohort (N = 1002) (NCT03479866). Snacks (foods or drinks consumed between main meals) were self-reported (weighed records) across 2–4 days. Average snacking frequency and quality [snack diet index (SDI)] were determined (N = 854 after exclusions). Associations between snacking frequency, quality and timing with cardiometabolic blood and anthropometric markers were assessed using regression models (adjusted for age, sex, BMI, education, physical activity level and main meal quality). Results: Participants were aged (mean, SD) 46.1 ± 11.9 years, had a mean BMI of 25.6 ± 4.88 kg/m<sup>2</sup> and were predominantly female (73%). 95% of participants were snackers (≥ 1 snack/day; n = 813); mean daily snack intake was 2.28 snacks/day (24 ± 16% of daily calories; 203 ± 170 kcal); and 44% of participants were discordant for meal and snack quality. In snackers, overall snacking frequency and quantity of snack energy were not associated with cardiometabolic risk markers. However, lower snack quality (SDI range 1–11) was associated with higher blood markers, including elevated fasting triglycerides (TG (mmol/L) β; – 0.02, P = 0.02), postprandial TGs (6hiAUC (mmol/L.s); β; – 400, P = 0.01), fasting insulin (mIU/L) (β; – 0.15, P = 0.04), insulin resistance (HOMA-IR; β; – 0.04, P = 0.04) and hunger (scale 0–100) (β; – 0.52, P = 0.02) (P values non-significant after multiple testing adjustments). Late-evening snacking (≥ 9 pm; 31%) was associated with lower blood markers (HbA1c; 5.54 ± 0.42% vs 5.46 ± 0.28%, glucose 2hiAUC; 8212 ± 5559 vs 7321 ± 4928 mmol/L.s, P = 0.01 and TG 6hiAUC; 11,638 ± 8166 vs 9781 ± 6997 mmol/L.s, P = 0.01) compared to all other snacking times (HbA1c remained significant after multiple testing). Conclusion: Snack quality and timing of consumption are simple diet features which may be targeted to improve diet quality, with potential health benefits. Clinical trial registry number and website: NCT03479866, https://clinicaltrials.gov/ct2/show/NCT03479866?term=NCT03479866&amp;draw=2&amp;rank=1.</p>}},
  author       = {{Bermingham, Kate M. and May, Anna and Asnicar, Francesco and Capdevila, Joan and Leeming, Emily R. and Franks, Paul W. and Valdes, Ana M. and Wolf, Jonathan and Hadjigeorgiou, George and Delahanty, Linda M. and Segata, Nicola and Spector, Tim D. and Berry, Sarah E.}},
  issn         = {{1436-6207}},
  keywords     = {{Cardiometabolic health; Frequency; Quality; Quantity; Snacking; Timing}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{121--133}},
  publisher    = {{Springer}},
  series       = {{European Journal of Nutrition}},
  title        = {{Snack quality and snack timing are associated with cardiometabolic blood markers : the ZOE PREDICT study}},
  url          = {{http://dx.doi.org/10.1007/s00394-023-03241-6}},
  doi          = {{10.1007/s00394-023-03241-6}},
  volume       = {{63}},
  year         = {{2024}},
}