Associations between eating frequency and energy intake, energy density, diet quality and body weight status in adults from the USA

To investigate associations between eating frequency and energy intake, energy density, diet quality and body weight status in adults from the USA, combined data from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Survey (NHANES) were used in this study. The first 24-h dietary recall data from eligible participants (4017 men and 3774 women) were used to calculate eating frequency, as well as energy intake, energy density and the Healthy Eating Index 2010 (HEI-2010), as a measure of diet quality. BMI and waist circumference were obtained from the NHANES body measures data. Adjusting for confounding socio-demographic characteristics and lifestyle factors, a higher eating frequency was significantly associated with higher energy intake in both men and women (both P < 0.001). A higher eating frequency was also significantly associated with lower energy density in both men and women, regardless of whether beverage or water intake was included in the calculation of energy density (all P < 0.01). Moreover, there was a significant positive association between eating frequency and the HEI-2010 total score in both men and women (both P < 0.001). Eating frequency was inversely associated with BMI in women (P = 0.003), as well as waist circumference in both men (P = 0.032) and women (P = 0.010). Results from the present study suggested that adults with a higher eating frequency in the USA had a healthier diet with lower energy density and better diet quality, and eating frequency was inversely associated with body weight status.