Relationship between Snacking Patterns, Diet Quality and Risk of Overweight and Abdominal Obesity in Children
DOI:
https://doi.org/10.6000/1929-4247.2013.02.03.1Keywords:
Children, Snacking Patterns, Overweight, Abdominal Obesity, Diet QualityAbstract
Snacking is very common among Americans; the impact of variety of snacking patterns on nutrient intake and weight status is unclear. This study examined the associations of snacking patterns on nutrient intake and weight in U.S. children 2-18 years (n=14,220) participating in the 2001-2008 National Health and Nutrition Examination Survey. Cluster analysis generated 12 distinct snacking patterns, explaining 57% of variance in total calories consumed. Only 8% of the children did not consume snacks on the day of the 24-hour recall. Cakes, cookies and pastries was the most common snacking pattern (16%) followed by miscellaneous snacks (e.g. whole milk, orange juice and meat/fish/poultry; 13%), and crackers and salty snacks (10%). Most snacking patterns resulted in higher total energy intake than the no snack pattern. After controlling for energy intake, most snacking patterns resulted in higher intakes of fiber; vitamins A, C, B12, and K; riboflavin; folate; potassium; calcium; zinc; and magnesium than the no snack pattern. However, most of the snacking patterns resulted in higher total intake of saturated fatty acids, solid fats, added sugars, and sodium (nutrients to limit). Several of the snacking patterns (i.e. cakes/cookies/pastries, crackers/salty snacks, sweets, and other grains) were associated with a reduced risk of overweight and abdominal obesity. Overall, several snacking patterns compared with non-snackers had better diet quality and were less likely to be overweight or obese and less likely to have abdominal obesity. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet.
References
Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA 2012; 307: 483-90. http://dx.doi.org/10.1001/jama.2012.40
Skelton J, Cook S, Auinger P, Klein J, Barlow S. Prevalence and Trends of Severe Obesity Among U.S. Children and Adolescents. Academic Pediatrics 2009; 9: 322-9. http://dx.doi.org/10.1016/j.acap.2009.04.005
Singh A, Mulder C, Twisk J, Van M, Chinapaw M. Tracking of childhood overweight into adulthood: A systematic review of literature. Obes Rev 2008; 9: 474-88. http://dx.doi.org/10.1111/j.1467-789X.2008.00475.x
Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: The Bogalusa Heart Study. J Pediatr 2007; 150: 12-7.e2.
Piernas C, Popkin B. Trends in snacking among U.S. children. Health Affairs 2010; 29: 398-404. http://dx.doi.org/10.1377/hlthaff.2009.0666
Nicklas TA, Yang SJ, Baranowski T, Zakeri I, Berenson G. Eating patterns and obesity in children: The Bogalusa Heart Study. Am J Prev Med 2003; 25: 9-16. http://dx.doi.org/10.1016/S0749-3797(03)00098-9
Nicklas TA, Baranowski T, Cullen KW, Berenson G. Eating patterns, dietary quality, and obesity. J Am Coll Nutr 2001; 20: 598-608. http://dx.doi.org/10.1080/07315724.2001.10719064
Keast D, Nicklas T, O'Neil C. Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: NHANES 1999-2004. Am J Clin Nutr 2010; 92: 428-35. http://dx.doi.org/10.3945/ajcn.2009.28421
Jacques PF, Tucker KL. Are dietary patterns useful for understanding the role of diet in chronic disease? Am J Clin Nutr 2001; 73: 1-2.
McCrory M, Campbell W. Effects of Eating Frequency, Snacking, and Breakfast Skipping on Energy Regulation: Symposium Overview. J Nutr 2011; 141: 144-7. http://dx.doi.org/10.3945/jn.109.114918
Hampl JS, Heaton CL, Taylor CA. Snacking patterns influence energy and nutrient intakes but not body mass index. J Hum Nutr Dietet 2003; 16: 3-11. http://dx.doi.org/10.1046/j.1365-277X.2003.00417.x
Kerver JM, Yang EJ, Obayashi S, Bianchi L, Song WO. Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults. J Am Diet Assoc 2006; 106: 46-53. http://dx.doi.org/10.1016/j.jada.2005.09.045
Sebastian RS, Cleveland LE, Goldman JD. Effect of snacking frequency on adolescents' dietary intakes and meeting national recommendations. J Adolesc Health 2008; 42: 503-11. http://dx.doi.org/10.1016/j.jadohealth.2007.10.002
Nielsen SJ, Popkin BM. Patterns and trends in food portion sizes, 1977-1998. JAMA 2003; 289: 450-3. http://dx.doi.org/10.1001/jama.289.4.450
Cross AT, Babicz D, Cushman LF. Snacking patterns among 1,800 adults and children. J Am Diet Assoc 1994; 94: 1398-403. http://dx.doi.org/10.1016/0002-8223(94)92542-9
Zizza C, Xu B. Snacking is associated with overall diet quality among adults. J Acad Nutr Diet 2012; 112: 291-6. http://dx.doi.org/10.1016/j.jada.2011.08.046
Jahns L, Siega-Riz AM, Popkin BM. The increasing prevalence of snacking among US children from 1977 to 1996. J Pediatr 2001; 138: 493-8. http://dx.doi.org/10.1067/mpd.2001.112162
Kerr MA, Rennie KL, McCaffrey TA, Wallace JM, Hannon-Fletcher MP, Livingstone MB. Snacking patterns among adolescents: a comparison of type, frequency and portion size between Britain in 1997 and Northern Ireland in 2005. Br J Nutr 2009; 101: 122-31. http://dx.doi.org/10.1017/S0007114508994769
Booth DA. Mechanisms from models--actual effects from real life: the zero-calorie drink-break option. Appetite 1988; 11: 94-102.
Fabry P, Fodo J, Hejl Z, Braun T, Zvolankova K. The frequency of meals: Its relation to overweight, hypercho-lesterolaemia, and decreased glucose tolerance. Lancet 1964; 2: 614-5. http://dx.doi.org/10.1016/S0140-6736(64)90510-0
Summerbell CD, Moody RC, Shanks J, Stock MJ, Geissler C. Relationship between feeding pattern and body mass index in 220 free-living people in four age groups. Eur J Clin Nutr 1996; 50: 513-9.
Phillips SM, Bandini LG, Naumova EN, Cyr H, Colclough S, Dietz WH, et al. Energy-dense snack food intake in adolescence: longitudinal relationship to weight and fatness. Obes Res 2004; 12: 461-72. http://dx.doi.org/10.1038/oby.2004.52
Field AE, Austin SB, Gillman MW, Rosner B, Rockett HR, Colditz GA. Snack food intake does not predict weight change among children and adolescents. Int J Obes Relat Metab Disord 2004; 28: 1210-6. http://dx.doi.org/10.1038/sj.ijo.0802762
Kant AK, Graubard BI. Secular trends in patterns of self-reported food consumption of adult Americans: NHANES 1971-1975 to NHANES 1999-2002. Am J Clin Nutr 2006; 84: 1215-23.
Howarth NC, Huang TT, Roberts SB, Lin BH, McCrory MA. Eating patterns and dietary composition in relation to BMI in younger and older adults. Int J Obes (Lond) 2007; 31: 675-84.
Summerbell CD, Moody RC, Shanks J, Stock MJ, Geissler C. Sources of energy from meals versus snacks in 220 people in four age groups. Eur J Clin Nutr 1995; 49: 33-41.
National Center for Health Statistics: About the National Health and Nutrition Examination Survey.
Moshfegh AJ, Rhodes DG, Baer DJ, Murayi T, Clemens JC, Rumpler WV, et al. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr 2008; 88: 324-32.
(Feb 2003) NHANES Dietary Interview Component.
U.S. Department of Agriculture, Agricultural Research Service. USDA Food and Nutrient Database for Dietary Studies, Versions 1.0 - 4.1 Documentation and User Guide, 2004, 2006, and 2008.
Dietary Guidelines for Americans 2010.
Friday J, Bowman S, MyPyramid Equivalents Database for USDA Survey Food Codes, 1994-2002 Version 1.0. Beltsville, MD: USDA, Agricultural Research Service, Beltsville Human Nutrition Research Center, Community Nutrition Research Group 2006.
Bowman SA, Friday JE, Moshfegh A. My Pyramid Equivalents Database, 2.0 for USDA Survey Foods, 2003-2004 Food Surveys Research Group. Beltsville, MD. Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture 2008.
Healthy Eating Index-2005 Reports. United States Department of Agriculture. Center for Nutrition Policy and Promotion.
Kennedy E, Ohls J, Carlson S, Fleming K. The Healthy Eating Index: design and applications. J Am Diet Assoc 1995; 95: 1103-8. http://dx.doi.org/10.1016/S0002-8223(95)00300-2
Guenther PM, Reedy J, Krebs-Smith SM. Development of the Healthy Eating Index-2005. J Am Diet Assoc 2008; 108: 1896-901. http://dx.doi.org/10.1016/j.jada.2008.08.016
Guenther PM, Reedy J, Krebs-Smith SM, Reeve BB. Evaluation of the Healthy Eating Index-2005. J Am Diet Assoc 2008; 108: 1854-64. http://dx.doi.org/10.1016/j.jada.2008.08.011
United States Department of Agriculture. Center for Nutrition Policy and Promotion. Calculation of the Healthy Eating Index-2005 component and total scores for a population, subpopulation, or group.
National Center for Health Statistics. The NHANES Anthropometry Procedures Manual.
National Cholesterol Education Program. National Heart, Lung, and Blood Institute. National Institutes of Health. Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). NIH 2002; Publication No. 02-5215 ed.
Centers for Disease Control and Prevention. Computer programs. Growth charts.
Li C, Ford ES, Mokdad AH, Cook S. Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics 2006; 118: e1390-8.
Guenther PM, Reedy J, Krebs-Smith SM, Reeve BB, Basiotis PP, Development and Evaluation of the Healthy Eating Index-2005: Technical Report.]. Center for Nutrition Policy and Promotion, U.S. Department of Agriculture 2007.
Gregori D, Maffeis C. Snacking and Obesity: Urgency of a Definition to Explore such a Relationship. J Am Diet Assoc 2007; 107: 562. http://dx.doi.org/10.1016/j.jada.2007.02.025
Nicklas TA, Qu H, Hughes SO, He M, Wagner SE, Foushee HR, et al. Self-perceived lactose intolerance results in lower intakes of calcium and dairy foods and is associated with hypertension and diabetes in adults. Am J Clin Nutr 2011; 94: 191-8. http://dx.doi.org/10.3945/ajcn.110.009860
Gorley T, Marshall S, Biddle S. Couch kids: correlates of television viewing among youth. Int J Behav Med 2004; 11: 152-63. http://dx.doi.org/10.1207/s15327558ijbm1103_4
Gore S, Foster J, DiLillo V, Kirk KA, Smith-West D. Television viewing and snacking. Eating Behavior 2003; 4: 399-405. http://dx.doi.org/10.1016/S1471-0153(03)00053-9
Savige G, Macfarlane A, Ball K, Worsley A, Crawford D. Snacking behaviours of adolescents and their association with skipping meals. Int J Behav Nutr Phys Act 2007; 4: 36. http://dx.doi.org/10.1186/1479-5868-4-36
Drummond SE, Crombie NE, Cursiter MC, Kirk TR. Evidence that eating frequency is inversely related to body weight status in male, but not female, non-obese adults reporting valid dietary intakes. Int J Obes Relat Metab Disord 1998; 22: 105-12. http://dx.doi.org/10.1038/sj.ijo.0800552
Food and Nutrition Board. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Institute of Medicine of the National Academies 2002.
Schunk J, McArthur L, Maahs-Fladung C. Correlates for Healthful Snacking among Middle-income Midwestern Women. J Nutr Educ Behav 2009; 41: 274-80. http://dx.doi.org/10.1016/j.jneb.2008.02.007
Ritchie L. Less frequent eating predicts greater BMI and waist circumference in female adolescents. Am J Clin Nutr 2012; 95: 290-6. http://dx.doi.org/10.3945/ajcn.111.016881
Gibson S. Sugar-sweetened soft drinks and obesity: a systematic review of the evidence from observational studies and interventions. Nutr Res Rev 2008; 21: 134-47. http://dx.doi.org/10.1017/S0954422408110976
Mattes RD, Shikany JM, Kaiser KA, Allison DB. Nutritively sweetened beverage consumption and body weight: a systematic review and meta-analysis of randomized experiments. Obes Rev 2011; 12: 346-65. http://dx.doi.org/10.1111/j.1467-789X.2010.00755.x
Libuda L, Kersting M. Soft drinks and body weight development in childhood: is there a relationship? Curr Opin Clin Nutr Metab Care 2009; 12: 596-600. http://dx.doi.org/10.1097/MCO.0b013e32833189f6
Van Baak M, Astrup A. Consumption of sugars and body weight. Obesity Rev 2009; 10: 9-23. http://dx.doi.org/10.1111/j.1467-789X.2008.00561.x
Monasta L, Batty G, Cattaneo A, Lutje V, Ronfani L, van Lenthe F, et al. Early-life determinanats of overweight and obesity: a review of systematic reviews. Obes Rev 2010; 11.
O'Neil C, Nicklas T, Rampersaud G, Fulgoni Vr. One hundred percent orange juice consumption is associated with better diet quality, improved nutrient adequacy, and no increased risk for overweight/obesity in children. Nutr Res 2011; 31: 673-82. http://dx.doi.org/10.1016/j.nutres.2011.09.002
Ovaskainen ML, Reinivuo H, Tapanainen H, Hannila ML, Korhonen T, Pakkala H. Snacks as an element of energy intake and food consumption. Eur J Clin Nutr 2006; 60: 494-501. http://dx.doi.org/10.1038/sj.ejcn.1602343
Thompson FE, Byers T. Dietary assessment resource manual. J Nutr 1994; 124: 2245S-317S.
Basch CE, Shea S, Arliss R, Contento IR, Rips J, Gutin B, et al. Validation of mothers' reports of dietary intake by four to seven year- old children. Am J Public Health 1990; 80: 1314-7. http://dx.doi.org/10.2105/AJPH.80.11.1314
Baranowski T, Sprague D, Baranowski JH, Harrison JA. Accuracy of maternal dietary recall for preschool children: socioeconomic status and daycare factors. J Am Diet Assoc 1991; 91: 669-74.
Schoeller DA. How accurate is self-reported dietary energy intake? Nutr Rev 1990; 48: 373-9. http://dx.doi.org/10.1111/j.1753-4887.1990.tb02882.x
Poslusna K, Ruprich J, de Vries J, Jakubikova M, van't Veer P. Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice. Br J Nutr 2009; 101: S73-S85. http://dx.doi.org/10.1017/S0007114509990602
Champagne CM, Baker NB, DeLany JP, Harsha DW, Bray GA. Assessment of energy intake underreporting by doubly labeled water and observations on reported nutrient intakes in children. J Am Diet Assoc 1998; 98: 426-33. http://dx.doi.org/10.1016/S0002-8223(98)00097-2
Published
How to Cite
Issue
Section
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
