Consumption of Dried Fruits Is Associated with Greater Intakes of Underconsumed Nutrients, Higher Total Energy Intakes, and Better Diet Quality in US Adults: A Cross-Sectional Analysis of the National Health and Nutrition Examination Survey, 2007-2016

Abstract

Background: Dried fruits are shelf-stable alternatives to fresh fruit that avert common barriers to consuming fruit. Consumption of dried fruits may facilitate greater fruit consumption and contribute to better diet quality and nutrient intakes.

Objective: Our aims were to assess differences in diet quality and cardiometabolic health between dried fruit consumers and nonconsumers, and evaluate differences in nutrient intakes on days when dried fruits were consumed vs not consumed.

Design: This is a cross-sectional analysis of data from the National Health and Nutrition Examination Survey 2007-2016.

Participants/setting: Mean dried fruit intakes were estimated in adults 20 years and older (n = 25,590) who completed a dietary recall. Dried fruit consumers (one-quarter cup-equivalent/day or more) were defined in respondents with 2 complete dietary recalls (n = 22,311). Within-person differences in nutrient intakes were assessed in respondents who consumed dried fruit on 1 of 2 dietary recalls (n = 1,233).

Main outcome measures: Cardiometabolic risk factors, diet quality scored using the Healthy Eating Index 2015, and nutrient intakes were assessed.

Statistical analyses: Diet quality and cardiometabolic health were compared in consumers vs nonconsumers using multivariate linear regression, adjusted for demographic and lifestyle factors. Within-person differences in nutrient intakes on days when dried fruits were consumed vs not were assessed using multivariate linear regression.

Results: Mean ± standard error dried fruit intake was 0.04 ± 0.001 cup-equivalents and represented 3.7% of total fruit consumed. Consumers (7.2% of adults) had higher quality diets than nonconsumers (mean ± standard error Healthy Eating Index 2015 score = 60.6 ± 0.5 vs 52.6 ± 0.3; P < 0.001) and lower mean body mass index, waist circumference, and systolic blood pressure (P < 0.01). Total carbohydrate, dietary fiber, potassium, and polyunsaturated fat intakes were greater on days when dried fruits were consumed vs not consumed (P < 0.001). Total calorie intakes were also greater (208-215 kcal; P ≤ 0.002) when dried fruits were consumed.

Conclusions: Dried fruit consumption is associated with higher diet quality and greater intakes of underconsumed nutrients. However, dried fruits do not appear to displace other calorie sources on days when consumed.

Keywords: Cardiometabolic risk; Diet quality; Dried fruit; NHANES; Nutrient intakes.