Journal Review

Diet Quality Is Lower and

Energy Intake Is Higher on
Weekends Compared with
Weekdays in Midlife Women:
A 1-Year Cohort
Katie Haney
Study
Howard-Big Bang Theory
Objectives
1.) (Identify the problem):
Examine the dissemination in energy and macronutrient intake
reported on weekdays and weekends in midlife women.
2.) (Develop a solution):
Analyze the effectiveness of long-term use of dietary assessment
tools in nutritional interventions.
3.) (Design and implement the solution):
Recognize the importance of an individualized dietary
intervention, its design, and the application techniques used.
4.) (To assess its impact):
Identify modifications and enhancements to dietary interventions
for maintenance of diet quality during both weekdays and
weekends.
Background
Weekday and weekend differences in dietary habits of adults
have been noted in the United States for at least the past 75
years pp.1
1940s
Great Depression: 1929-1939
WWII:1939-1945
Pearl Harbor: 1941
Fast food: 1940s
A&W Root Beer 1919
White Castle: 1921
Carhops:1940s
McDonalds: 1955
The term fast food was added to Merriam-Webster dictionary:
1951
(4)
Background cont.:
Previous studies have shown:
Clinically, weekend eating may be important. While
body weight does not respond immediately to an
excess of energy, body weight does increase during
weekends and may or may not decrease again during
the weekpp.2
Calories count on the weekend!
Is it a constant cycle +/- a few pounds?
Maintenance of eating patterns throughout the
week and modification of weekend dietary patterns
are an important part of weight-loss and obesity
prevention strategies pp. 2
My moms weight loss success over a three month period
Hypothesis
Diet quality would be lower and
energy intake higher on weekends
compared to weekdays pp. 2
Material and Methods
Grand Fork, North Dakota
17th highest obesity rate in the nation
31% population obese
What would this study show if it was done in Colorado? Indiana?
July 2012-July 2014
How does ones eating habits change over the course of a year?
Lipid panel summer vs. winter?
Body fat % summer vs. winter?
Food groups consumed summer vs. winter?
Women 40-60 years old
Does menopause change eating habits?
BMI 18-35
(normal to obese)

(3)
Materials and Methods
Weight stable for 6 months
Ambulatory
High-speed internet
Self-selected
It is important to recognize that self-reported
energy intake has been shown to be prone to
significant measurement of error pp.1
Food frequency questionnaires
Asking patients about usual intake
Include both weekdays and weekend intake
Materials and Methods
Energy expenditure and body composition
was measured 4 times/year
Self reported 24-hour recalls every 10 days
Participants received stipends
Study Variables
Weekend=Friday, Saturday, Sunday
Dietary outcomes were energy and energy-adjusted
macronutrients (percentage of energy), energy-adjusted food
groups, eating location, and diet quality scores pp. 2
Diet quality using HEI-2010
Healthy Eating Index: A measure of diet quality that assess conformance to
the Dietary Guidelines for Americans. USDAs primary use of the HEI is to
monitor the diet quality of the U.S. population and the low-income
populationcollect 24 hour dietary recalls in national surveys. (1)
12 components
9 components: encouraged to eat
3 components: limit
Higher scores=lower intake of that component
Scores equal total diet quality score with max of 100 points
Dietary Assessment
Participants used the Automated Self-Administered 24-Hour
Dietary Assessment Tool
Recall from Midnight-Midnight
Food and drinks
Prompts were used to help them choose corresponding portion
sizes from comparative images
How long did users actually spend on these?
Every 10 days, participants received an e-mail to remind them to
complete the 24-hour recall and they were also sent reminders
36 logs/year
Weekend and weekday logs
Results
Total of 52 women:
Group 1 n=27
Group 2 n=25
96% non-Hispanic
Do we think these results would be different within different
nationalities, in men, in children, in college students?
Different cultures and food intake
33% overweight
23% obese
>99% compliance rate
90% of recalls were completed on the day the email
was sent
Results
Food recall revealed:
33% reported eating at a fast-food or full service
restaurant infrequently (<25% of recall days)
20% reported eating at these establishments
frequently (50% of recall days)
6% reported consuming more than 2 drinks on
weekdays
15% consumed more than 2 drinks per day on
weekends
Results
Total recalls completed:
1080 weekday recalls
786 weekend recalls
Participants weight did not change during the year
Does weekday lifestyle, occupation, and dietary habits during the
week make up for weekend actions?
Mean daily intake: 1929 +/- 56kcal
75% of women consumed more energy on the weekend
days than on weekdays, with the mean intake 158 kcal
higher on weekend days pp.3
Individuals eating more meals away from home on the weekend,
therefore consuming more calories?
Results
% of energy from carbohydrate and protein
Lower on the weekends
%of energy from alcohol
Higher on the weekend
% of energy form fat
No difference between weekends and weekdays
Intake was greatest on Saturday
Do you think people go out to eat for entertainment on
the weekend?
Dinner and a movie?
Intake was lowest on Tuesday
Weekday routine
Results
Food groups consumed:
Foods women consumed more of on weekends:
Alcoholic beverages
Solid fats
Potatoes
Foods women consumed less of on weekends:
Yogurt
Whole fruits
Dark green and orange vegetables
Poultry
Nuts and seeds
Whole grains
Fast food intake was higher during the weekend
HEI-2010 scores lower on weekends
 Discussion
Recognizing the limitations, this analysis of multiple
dietary recalls during 1 year by midlife women
indicating a pronounced weekend to weekday
difference in reported intakes of energy,
macronutrients, energy-adjusted food groups, and
HEI-2010 scores pp.3
Saturday= greatest energy intake
Friday= second greatest energy intake
Does this have anything to do with still going to work on Friday and
being in that food routine?
Sunday= no difference from week day
Tuesday= lowest energy intake
Discussion
In a related study, participants either stopped losing
weight or gained weight on the weekendspotential to
lead to a small, but incremental effect on body
weightcompensation might have contributed to weight
stability pp.3-4
Are we compensating during the week?
How do we help weight loss patients overcome this
Would diet education for weekend intake be helpful?
How do we entertain ourselves on the weekends?
Would providing patients with alternate activities that do
not involve food be helpful?
Ex: Going skating instead of out to dinner for a
birthday
Discussion
Limitations:
women who are willing to participate in a research
study for an entire year may not be representative of
the general population pp 5
Ex: super busy mom, eats fast food for convenience, may opt
out of a time consuming/commitment study
Measurement error when reporting intake over a 24
hour period
Participants not checking their email on weekends to
get the reminder
Anticipating the recall, participating in the study could
have changed their dietary intake as a whole.
Discussion
Time away from occupation leading to more time spend on
food-related activities, and social aspects of weekends often
being paired with eating resulting in greater dietary
intakes.pp 6
Future researchwhy people eat differently on weekends
and to identify potential mechanisms to help people to
achieve and maintain healthy eating patterns. pp 6

THIS IS WHERE WE COME IN!!!

Conclusions

This information is useful for

researchers in planning dietary
assessment for studies and for
registered dietitian nutritionists when
counseling clients to plan a healthy
diet pp.6
Outcomes
1.) (Identify the problem):
Examine the dissemination in energy and macronutrient intake
reported on weekdays and weekends in midlife women.
2.) (Develop a solution):
Analyze the effectiveness of long-term use of dietary assessment
tools in nutritional interventions.
3.) (Design and implement the solution):
Recognize the importance of an individualized dietary
intervention, its design, and the application techniques used.
4.) (To assess its impact):
Identify modifications and enhancements to dietary interventions
for maintenance of diet quality during both weekdays and
weekends.
Resources:
1. Healthy Eating Index. (n.d.). Retrieved March 29, 2017, from
https://www.cnpp.usda.gov/healthyeatingindex
2. Jahns, L., Conrad, Z., Johnson, L. K., Scheett, A. J., Stote, K.
S., & Raatz, S. K. (2017). Diet Quality Is Lower and Energy
Intake Is Higher on Weekends Compared with Weekdays in
Midlife Women: A 1-Year Cohort Study. Journal of the
Academy of Nutrition and Dietetics.
3. North Dakota. (n.d.). Retrieved March 29, 2017, from
http://stateofobesity.org/states/nd/
4. The History of Fast Food in America. (2017). Retrieved
March 29, 2017, from http://www.accupos.com/pos-
articles/history-of-fast-food-in-america/