The epidemiology of berry consumption and association of berry consumption with diet quality and cardiometabolic risk factors in US adults: the National Health and Nutrition Examination Survey, 2003-2018

Berries are rich in important nutrients and bioactive compounds, which could potentially contribute to maintenance of normal lipid and glucose profiles.We reported the epidemiology of berry consumption and examined associations of berry consumption with diet quality (measured by healthy eating index: HEI-2015) and levels of cardiometabolic risk factors, including body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol (HDL-cholesterol), glycated hemoglobin (HbA1c), and fasting biomarkers: triglycerides, low-density lipoprotein cholesterol (LDL-cholesterol), glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR).We evaluated 33,082 adults (aged ≥ 20 y) using two 24-hour diet recalls from NHANES (2003 to 2018). Multivariable linear regression models were applied to examine the associations of total and individual berry intake with diet quality and cardiometabolic risk factors using appropriate sample weights.About 25% of the US adults consumed berries (0.08 ± 0.003 cup-equivalents/day), representing about 10% of the daily mean total fruit intake. Among berry consumers, the mean intake of strawberries (0.31 ± 0.01 cup-equivalents) was higher than for other berries. Berry consumers had a significantly higher HEI-2015 score than nonconsumers (mean HEI-2015 score =58.8 vs 52.3, p <0.0001). Berry consumers had significantly lower levels of cardiometabolic indices than nonconsumers including BMI, WC, SBP, total cholesterol, LDL-cholesterol, triglycerides, fasting insulin, HOMA-IR, and higher mean HDL-cholesterol, after adjusting for sociodemographic, lifestyle, and dietary confounders (all P <0.05).US adult berry consumers had a higher diet quality and lower levels of cardiometabolic risk factors, suggesting a favorable role for berries in diets and cardiometabolic disease prevention in US adult population.