1
|
Bermingham KM, May A, Asnicar F, Capdevila J, Leeming ER, Franks PW, Valdes AM, Wolf J, Hadjigeorgiou G, Delahanty LM, Segata N, Spector TD, Berry SE. Snack quality and snack timing are associated with cardiometabolic blood markers: the ZOE PREDICT study. Eur J Nutr 2024; 63:121-133. [PMID: 37709944 PMCID: PMC10799113 DOI: 10.1007/s00394-023-03241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/16/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Snacking is a common diet behaviour which accounts for a large proportion of daily energy intake, making it a key determinant of diet quality. However, the relationship between snacking frequency, quality and timing with cardiometabolic health remains unclear. DESIGN Demography, diet, health (fasting and postprandial cardiometabolic blood and anthropometrics markers) and stool metagenomics data were assessed in the UK PREDICT 1 cohort (N = 1002) (NCT03479866). Snacks (foods or drinks consumed between main meals) were self-reported (weighed records) across 2-4 days. Average snacking frequency and quality [snack diet index (SDI)] were determined (N = 854 after exclusions). Associations between snacking frequency, quality and timing with cardiometabolic blood and anthropometric markers were assessed using regression models (adjusted for age, sex, BMI, education, physical activity level and main meal quality). RESULTS Participants were aged (mean, SD) 46.1 ± 11.9 years, had a mean BMI of 25.6 ± 4.88 kg/m2 and were predominantly female (73%). 95% of participants were snackers (≥ 1 snack/day; n = 813); mean daily snack intake was 2.28 snacks/day (24 ± 16% of daily calories; 203 ± 170 kcal); and 44% of participants were discordant for meal and snack quality. In snackers, overall snacking frequency and quantity of snack energy were not associated with cardiometabolic risk markers. However, lower snack quality (SDI range 1-11) was associated with higher blood markers, including elevated fasting triglycerides (TG (mmol/L) β; - 0.02, P = 0.02), postprandial TGs (6hiAUC (mmol/L.s); β; - 400, P = 0.01), fasting insulin (mIU/L) (β; - 0.15, P = 0.04), insulin resistance (HOMA-IR; β; - 0.04, P = 0.04) and hunger (scale 0-100) (β; - 0.52, P = 0.02) (P values non-significant after multiple testing adjustments). Late-evening snacking (≥ 9 pm; 31%) was associated with lower blood markers (HbA1c; 5.54 ± 0.42% vs 5.46 ± 0.28%, glucose 2hiAUC; 8212 ± 5559 vs 7321 ± 4928 mmol/L.s, P = 0.01 and TG 6hiAUC; 11,638 ± 8166 vs 9781 ± 6997 mmol/L.s, P = 0.01) compared to all other snacking times (HbA1c remained significant after multiple testing). CONCLUSION Snack quality and timing of consumption are simple diet features which may be targeted to improve diet quality, with potential health benefits. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE NCT03479866, https://clinicaltrials.gov/ct2/show/NCT03479866?term=NCT03479866&draw=2&rank=1.
Collapse
Affiliation(s)
- Kate M Bermingham
- Department of Nutritional Sciences, King's College London, London, UK
- ZOE Ltd, London, UK
| | | | | | | | - Emily R Leeming
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Paul W Franks
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Ana M Valdes
- School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham NIHR Biomedical Research Centre, Nottingham, UK
| | | | | | - Linda M Delahanty
- Diabetes Center, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Nicola Segata
- Department CIBIO, University of Trento, Trento, Italy
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Sarah E Berry
- Department of Nutritional Sciences, King's College London, London, UK.
| |
Collapse
|
2
|
Tripicchio GL, Bailey RL, Davey A, Croce CM, Fisher JO. Snack frequency, size, and energy density are associated with diet quality among US adolescents. Public Health Nutr 2023; 26:2374-2382. [PMID: 37548183 DOI: 10.1017/s1368980023001635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
OBJECTIVE To evaluate snacking and diet quality among US adolescents. DESIGN Cross-sectional analysis examined snack frequency (snacks/day), size (kcal/snack) and energy density (kcal/g/snack) as predictors of diet quality using the mean of two 24-h dietary recalls. Diet quality was assessed using the Healthy Eating Index (HEI-2015, 0-100), a mean adequacy ratio (MAR, 0-100) for under-consumed nutrients (potassium, fibre, Ca, vitamin D) and mean percentage of recommended limits for over-consumed nutrients (added sugar, saturated fat, Na). Linear regression models examined total snacks, food only snacks and beverage only snacks, as predictors of diet quality adjusting for demographic characteristics and estimated energy reporting accuracy. SETTING 2007-2018 National Health and Nutrition Examination Survey. PARTICIPANTS Adolescents 12-19 years (n 4985). RESULTS Snack frequency was associated with higher HEI-2015 (β = 0·7 (0·3), P < 0·05) but also with higher intake of over-consumed nutrients (β = 3·0 (0·8), P ≤ 0·001). Snack size was associated with lower HEI (β = -0·005 (0·001), P ≤ 0·001) and MAR (β = -0·005 (0·002), P < 0·05) and higher intake of over-consumed nutrients (β = 0·03 (0·005), P ≤ 0·001). Associations differed for food only and beverage only snacks. Food only snack frequency was associated with higher HEI-2015 (β = 1·7 (0·03), P ≤ 0·001), while food only snack size (β = -0·006 (0·0009), P ≤ 0·001) and food only snack energy density (β = -1·1 (0·2), P ≤ 0·001) were associated with lower HEI-2015. Conversely, beverage only snack frequency (β = 4·4 (2·1) P < 0·05) and beverage only snack size (β = 0·03 (0·01), P ≤ 0·001) were associated with higher intake of over-consumed nutrients. CONCLUSIONS Smaller, frequent, less energy-dense food only snacks are associated with higher diet quality in adolescents; beverages consumed as snacks are associated with greater intake of over-consumed nutrients.
Collapse
Affiliation(s)
- Gina L Tripicchio
- Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | - Regan L Bailey
- Institute for Advancing Health through Agriculture, Department of Nutrition, Texas A&M University, College Station, TX, USA
| | - Adam Davey
- Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Christina M Croce
- Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | | |
Collapse
|
3
|
Magalhães P, Pereira B, Garcia F, Vilas C, Moreira T, Rosário P. Changes in Student's Breakfast and Snack Consumption during the Second COVID-19 Lockdown in Portugal: A Five-Wave Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3034. [PMID: 36833732 PMCID: PMC9960398 DOI: 10.3390/ijerph20043034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The circumstances of the COVID-19 lockdown affected many students' life spheres, including their feeding patterns and snack intake. The main goals of the present study were to: (a) analyze the changes in students' breakfast and snacking consumption during lockdown, and (b) analyze changes in the content of the students' snacks using the Healthy Eating Index. This study analyzed data from a sample of 726 students from 36 classes from the late elementary (i.e., fifth grade) through high school (i.e., twelfth grade) from two public schools in the north of Portugal. Data were collected in five moments during the 2020/2021 school year, pre-, during, and post-second lockdown moments. Throughout the five moments, almost 90% of the students ate breakfast, and the majority brought snacks from home to eat in school. Surprisingly, there was an increase in the quality of the snacks consumed during lockdown compared to the pre-lockdown moments (e.g., consumption of more whole and total fruits and less consumption of food with added sugar, saturated fats, refined grains, and fatty acids). Suggestions for healthy behavior promotion will be discussed, such as improving the school food environment and teaching children to prepare healthy lunch boxes.
Collapse
Affiliation(s)
- Paula Magalhães
- School of Psychology, University of Minho, 4710-052 Braga, Portugal
| | | | | | | | | | | |
Collapse
|
4
|
Juton C, Berruezo P, Torres S, Castañer O, Según G, Fitó M, Homs C, Gómez SF, Schröder H. Association between Meal Frequency and Weight Status in Spanish Children: A Prospective Cohort Study. Nutrients 2023; 15:nu15040870. [PMID: 36839228 PMCID: PMC9960333 DOI: 10.3390/nu15040870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/13/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Childhood obesity is a major international problem, and unhealthy eating habits remain widespread. Increasing the frequency of meals of nutritious food can help children to regulate their appetite and maintain a healthy weight. However, there is scarce prospective evidence on the relationship between the meal frequency and weight outcomes. Therefore, the objective of the present study was to determine the prospective association between the meal frequency, body mass index, and waist circumference in Spanish children. Additionally, we analyzed the impact of the meal frequency on the incidence of excessive weight and abdominal obesity. The study included 1400 children with a mean (SD) age of 10.1 (0.6) and an average follow-up of 15 months. Anthropometric measurements, including the body weight, height, and waist circumference, were measured by trained personnel, and children were asked about whether they usually had the following meals: breakfast, a mid-morning snack, lunch, an afternoon snack, and dinner. Multiple linear regression models revealed a significant (p < 0.05) inverse association between the meal frequency with a standardized BMI (zBMI) and the waist-to-height ratio (WHtR) after adjusting for sex, age, allocation to an intervention group, school, maternal education, physical activity, diet quality, and for the corresponding outcome variable at the baseline. Furthermore, the odds of developing abdominal obesity or excessive weight during the follow-up significantly decreased with an increase in the meal frequency after controlling for the same confounders. In conclusion, a higher meal frequency at the baseline was predictive for a lower zBMI, WHtR, and odds of the incidence of excessive weight and abdominal obesity.
Collapse
Affiliation(s)
- Charlotte Juton
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
| | - Paula Berruezo
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Silvia Torres
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Faculty of Health Science and Wellbeing, University of Vic-University Central of Catalonia, 08500 Barcelona, Spain
| | - Olga Castañer
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Genís Según
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
- University of Lleida, 25003 Lleida, Spain
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Clara Homs
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Sciences, University Ramon Llull, 08025 Barcelona, Spain
| | - Santiago F. Gómez
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, 25008 Lleida, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence: (S.F.G.); (H.S.)
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence: (S.F.G.); (H.S.)
| |
Collapse
|
5
|
A Higher Healthy Eating Index Is Associated with Decreased Markers of Inflammation and Lower Odds for Being Overweight/Obese Based on a Case-Control Study. Nutrients 2022; 14:nu14235127. [PMID: 36501156 PMCID: PMC9738448 DOI: 10.3390/nu14235127] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/22/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022] Open
Abstract
Obesity is a health risk characterized by chronic inflammation, and food choices are strongly associated with its etiology. Our objective was to investigate the association between dietary patterns and the healthy eating index (HEI) with the odds of overweight/obesity and related inflammatory markers. Within a population-based case-control study, we collected data and samples from 793 normal-weight and 812 overweight/obese Iranian people (based on either body mass index (BMI) or body surface area (BSA)). Dietary intake and HEI scores were obtained via a validated 124-item food frequency questionnaire. Anthropometric and socioeconomic parameters, as well as blood inflammatory markers, were measured. Participants with higher HEI scores had higher serum high-density lipoprotein-cholesterol (HDL-C) and significantly lower energy intake. Water consumption in the overweight/obese group was significantly lower than in the control group. In the final models using partial correlation and controlling for multiple confounders, there was a significant inverse correlation between HEI and interleukin-4 (IL-4, R = -0.063), IL-1β (R = -0.054), and high-sensitivity C-reactive protein (hs-CRP, R = -0.069). Based on multivariable logistic regression models adjusted for multiple confounders, there was a significant association between HEI as a continuous variable (OR = 0.993, 95% CI: 0.988-0.999) and categorical variable (OR = 0.801, 95% CI: 0.658-0.977) and odds of overweight/obesity across BMI groups. The dietary patterns in the case and control groups however were similar, and we failed to find a significant association between HEI and odds of overweight/obesity based on BSA. Adherence to healthy eating recommendations may be a prudent recommendation to prevent overweight/obesity and keeping inflammatory indicators low.
Collapse
|
6
|
Bailey RL, Leidy HJ, Mattes RD, Heymsfield SB, Boushey CJ, Ahluwalia N, Cowan AE, Pannucci T, Moshfegh AJ, Goldman JD, Rhodes DG, Stoody EE, de Jesus J, Casavale KO. Frequency of Eating in the US Population: A Narrative Review of the 2020 Dietary Guidelines Advisory Committee Report. Curr Dev Nutr 2022; 6:nzac132. [PMID: 36110105 PMCID: PMC9469881 DOI: 10.1093/cdn/nzac132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/22/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background A person's daily nutrient intake and overall nutritional status are determined by a complex interplay of the types and amounts of foods ingested in combination with the timing and frequency of eating. Objectives The aim was to summarize frequency of eating occasion data examined by the 2020 Dietary Guidelines Advisory Committee, the macronutrient contributions they provide, and meal frequency relative to dietary quality among the US population (≥2 y), with a focus on sex, age, race/Hispanic origin, and income. Methods Demographic and 24-h recall data from the 2013-2016 NHANES were examined. An eating occasion was defined as "any ingestive event (e.g., solid food, beverage, water) that is either energy yielding or non-energy yielding"; all eating occasions were further divided into discrete meals and snacks. Frequency of meals and snacks was defined as "the number of daily EOs [eating occasions]," respectively. Diet quality was assessed via the Healthy Eating Index (HEI)-2015. Results Most Americans consume 2 (28%) to 3 (64%) meals on a given day and >90% consume 2 to 3 snacks on that day. Adult, Hispanic, and non-Hispanic Black and lower-income (<131% family poverty-to-income ratio) Americans had a lower frequency of eating than children or adolescents, non-Hispanic White, and non-Hispanic Asian Americans and higher-income Americans, respectively. Americans who reported 3 meals on a given day consumed a diet higher in dietary quality than Americans who consumed 2 meals on a given day (HEI-2015: 61.0 vs. 55.0), regardless of population subgroup. Conclusions The frequency of the types of eating occasions differs according to age, race and Hispanic origin, and income. Dietary quality is associated with the number of meals consumed. Healthy dietary patterns can be constructed in a variety of ways to suit different life stages, cultural practices, and income levels; improved diet quality and careful consideration of nutrient density when planning meals are warranted.
Collapse
Affiliation(s)
- Regan L Bailey
- Institute for Advancing Health through Agriculture, Texas A&M University, College Station, TX, USA
| | - Heather J Leidy
- Departments of Nutritional Sciences and Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Richard D Mattes
- Institute for Advancing Health through Agriculture, Texas A&M University, College Station, TX, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Namanjeet Ahluwalia
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Alexandra E Cowan
- Institute for Advancing Health through Agriculture, Texas A&M University, College Station, TX, USA
| | - TusaRebecca Pannucci
- Center for Nutrition Policy and Promotion, Food and Nutrition Services, US Department of Agriculture, Alexandria, VA, USA
| | - Alanna J Moshfegh
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Joseph D Goldman
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Donna G Rhodes
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Eve E Stoody
- Center for Nutrition Policy and Promotion, Food and Nutrition Services, US Department of Agriculture, Alexandria, VA, USA
| | - Janet de Jesus
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA
| | - Kellie O Casavale
- Office of Nutrition and Food Labeling, Center for Food Safety and Applies Nutrition, Food and Drug Administration, US Department of Health and Human Services, College Park, MD, USA
| |
Collapse
|
7
|
Ramadhani F, Hatta H, Nuryani N, Maesarah M, Adam D, Sillehu S, Nugroho HSW. Correlation of Energy, Protein, Carbohydrate, and Physical Activity Intake with Nutritional Status of Adolescents. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Adolescence is a period of growth and development. So that adolescents must get a balanced intake of nutrients and in accordance with the needs to achieve optimal growth and development. Balance of intake with development can cause nutritional problems.
AIM: The purpose of this study was to determine the relationship between energy intake, protein, carbohydrates, and physical activity with the nutritional status of adolescents.
METHODS: This study used an analytical survey method with a cross-sectional approach. The sample is 115 respondents. The sampling technique is using simple random sampling. Research variables include energy intake, protein, carbohydrates, physical activity, and nutritional status. Data were collected using a questionnaire, form recall, PAL, and nutritional status using anthropometric measurements.
RESULTS: The results of the study using the Chi-square test showed that the intake of energy (p = 0.179 protein (p = 0.529), carbohydrates (p = 0.081), and physical activity (0.065). This shows that there is no significant relationship between energy intake, protein, carbohydrates, and physical activity with the nutritional status of adolescents at SMPN Bulango Selatan and SMPN Tapa in Bone Bolango Regency.
CONCLUSION: Teenagers are expected to get used to consumption patterns according to the balanced nutrition guidelines. In addition, the role of parents is also needed to pay attention to the food consumed by members’ food intake family at home, especially teenagers, so that optimal nutritional status is achieved.
Collapse
|
8
|
Gangrade N, St Fleur K, Leak TM. What is a "Snack"? Perspectives from Adolescents in Urban Communities. Ecol Food Nutr 2021; 61:442-459. [PMID: 34957882 DOI: 10.1080/03670244.2021.2020114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Snacking contributes significantly to U.S. adolescents' dietary intake and is a particularly significant eating occasion for urban adolescents, who have high amounts of food autonomy and access to corner stores. Consequently, research has focused on understanding and improving snacking among urban adolescents. However, the word "snack" possesses several definitions in the literature, leading to inconsistences in research efforts. As such, the aim of this study was to explore the definition of a snack among urban adolescents by conducting phone interviews with 30 adolescents from a Boys & Girls Club in New York City. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Overall, adolescents defined a snack as a small, unhealthy food item that can be quickly eaten to reduce hunger between meals. Future directions include using the definition of a snack that emerged from this study to improve subsequent adolescent snacking interventions.
Collapse
Affiliation(s)
- Navika Gangrade
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Kimberly St Fleur
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Tashara M Leak
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| |
Collapse
|
9
|
Roy D, Boss R, Saroj S, Karandikar B, Pradhan M, Pandey H. Snack Food Consumption across the Pune Transect in India: A Comparison of Dietary Behaviors Based on Consumer Characteristics and Locations. Nutrients 2021; 13:nu13124325. [PMID: 34959878 PMCID: PMC8707810 DOI: 10.3390/nu13124325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/28/2021] [Accepted: 11/28/2021] [Indexed: 12/01/2022] Open
Abstract
This study examines patterns of snack food consumption (SFC) in the rural-urban-slum transect (RUST) of a large city Pune and its precincts (population 10 million) in India. The transect structure aims to mimic a representative survey for the location capturing differences by age, gender, urbanicity, and socio-economic levels. Dietary data from 1405 individuals were used to describe snacking patterns and other food consumed at different frequencies; extent of physical activity; and Body Mass Index (BMI) and waist circumference of children, adolescents, and adults. Our results indicate high incidence of SFC across all population age groups, gender, socio-economic levels, and locations. A distinctive finding in relation to studies in high income countries is the prevalence of hunger snacking with 70% identifying hunger as the primary reason for SFC. Apart from hunger, particularly for adolescents, peer influence and social interactions played a significant role in SFC. Dietary behaviors of slum dwellers were characterized by three-quarters of them having SFC together with family members at home. SFC supplemented calories for low-income consumers and complemented calorie intake for high income ones. No significant association with BMI is possibly due to obesogenic SFC being likely offset by lower consumption of non-snack food and higher physical activity among poor and slum dwellers. Promoting awareness about diets and lifestyles, improving physical and economic access to healthier snacks and nutrient dense foods can improve diet quality in a large and heterogeneous population such as Pune.
Collapse
Affiliation(s)
- Devesh Roy
- International Food Policy Research Institute (IFPRI), Agriculture for Nutrition and Health (A4NH), New Delhi 110012, India;
- Correspondence:
| | - Ruchira Boss
- International Food Policy Research Institute (IFPRI), Agriculture for Nutrition and Health (A4NH), New Delhi 110012, India;
| | - Sunil Saroj
- International Food Policy Research Institute (IFPRI), South-Asia Office (SAO), New Delhi 110012, India; (S.S.); (M.P.)
| | | | - Mamata Pradhan
- International Food Policy Research Institute (IFPRI), South-Asia Office (SAO), New Delhi 110012, India; (S.S.); (M.P.)
| | - Himanshi Pandey
- Centre for Chronic Disease Control (CCDC), New Delhi 110016, India;
| |
Collapse
|
10
|
Bedtime Routine Characteristics and Activities in Families with Young Children in the North of England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178983. [PMID: 34501576 PMCID: PMC8431293 DOI: 10.3390/ijerph18178983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/18/2022]
Abstract
Bedtime routines have been shown to have significant associations with health, wellbeing and development outcomes for children and parents. Despite the importance of bedtime routines, most research has been carried out in the United States, with little information on bedtime routine characteristics and activities for families in other countries such as the United Kingdom and England in particular. Additionally, little is known about the possible effects of weekends vs. weekdays on the quality of bedtime routines. Finally, traditional, retrospective approaches have been most used in capturing data on bedtime routines, limiting our understanding of a dynamic and complex behaviour. The aim of this study was to explore bedtime routine characteristics and activities in families in the North of England with a real-time, dynamic data collection approach and to examine possible effects of weekend nights on the quality of bedtime routines. In total, 185 parents with children ages 3 to 7 years old provided data around their bedtime routine activities using an automated text-survey assessment over a 7-night period. Information on socio-economic and demographic characteristics were also gathered during recruitment. A small majority of parents managed to achieve all crucial elements of an optimal bedtime routine every night, with 53% reporting brushing their children’s teeth every night, 25% reading to their children every night and 30% consistently putting their children to bed at the same time each night. Results showed significant differences between weekend (especially Saturday) and weekday routines (F(1, 100) = 97.584, p < 0.001), with an additional effect for parental employment (F(1, 175) = 7.151, p < 0.05). Results highlight variability in bedtime routine activities and characteristics between families. Many families undertook, in a consistent manner, activities that are closely aligned with good practices and recommendations on what constitutes an optimal bedtime routine, while others struggled. Routines remained relatively stable during weekdays but showed signs of change over the weekend. Additional studies on mechanisms and elements affecting the formation, development and maintenance of bedtime routines are needed alongside studies on supporting and assisting families to achieve optimal routines.
Collapse
|
11
|
Development of a stand-alone index for the assessment of diet quality in elementary school-aged children. Public Health Nutr 2021; 24:5629-5640. [PMID: 34420540 DOI: 10.1017/s1368980021003657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To develop and evaluate a stand-alone Elementary School-aged Children's Index of Diet Quality (ES-CIDQ). DESIGN In this cross-sectional study, children filled in a food frequency questionnaire (FFQ) with twenty-nine multiple-item questions on the consumption of foods, portion sizes and eating frequency and a 5-d food diary. Nutrient intakes were calculated with nutrient analysis software. FFQ questions best reflecting a health-promoting diet with reference to dietary recommendations were identified by correlations, logistic regression modelling and receiver-operating characteristics curve analysis. SETTING Southwest and Eastern Finland. PARTICIPANTS Healthy elementary school-aged volunteers [n 266, mean (sd) age 9·7 (1·7) years] were recruited between March 2017 and February 2018. RESULTS A set of questions was identified from the FFQ that best depicted the children's diet quality as defined in the dietary recommendations. These fifteen questions were scored and formulated into a stand-alone index as a continuous index score (range 0-16·5 points) and a two-category score: good and poor diet quality. The cut-off score of six points for a good diet quality had a sensitivity of 0·60 and a specificity of 0·78. Children with a good diet quality (49·8 % of the children) had higher intakes of protein, dietary fibre, and several vitamins and minerals, and lower intakes of sucrose, total fat, SFA and cholesterol compared to children with a poor diet quality. CONCLUSIONS The developed short stand-alone index depicted diet quality as defined in the dietary recommendations. Thus, ES-CIDQ may be used for assessing diet quality in Finnish elementary school-aged children in school health care and nutrition research.
Collapse
|
12
|
Koning M, Vink JM, Renders C, Notten N, Eisinga R, Larsen JK. Is the Prospective Link between Parental Stress and Adolescent Snack Intake or Weight Outcome Mediated by Food Parenting Practices? Nutrients 2021; 13:nu13082485. [PMID: 34444649 PMCID: PMC8401057 DOI: 10.3390/nu13082485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 01/09/2023] Open
Abstract
Parental stress may influence adolescents’ food intake and weight development over time, however, it is largely unknown why this is the case. This study examines whether the link between parental stress and adolescents’ snack intake and weight outcome is mediated by food parenting practices (FPPs). Participants included 400 parents and their adolescent children (aged 12–16) who completed questionnaires. The Perceived Stress Scale (PSS) was used to assess parental general stress levels and the Adolescent Food Parenting Questionnaire (AFPQ) to assess FPPs. Multiple mediation analyses with parallel mediators were performed, with parental general stress as an independent variable and adolescent snack intake and zBMI as dependent variables. FPPs (autonomy support, coercive control, modeling, healthy structure, snack structure) were entered as mediators in the model, adjusted for covariates. Autonomy support mediated the link between parental general stress and adolescent savory snack and sweet snack intake at follow-up. Parents who reported higher stress levels provided less autonomy support, which resulted in more adolescent snacking. None of the other FPPs mediated any link between parental stress and intake or weight outcome, and no significant indirect effects were observed with zBMI as an outcome variable. Further research should replicate this finding and may further examine underlying mechanisms.
Collapse
Affiliation(s)
- Maaike Koning
- Knowledge Centre for Health and Social Work, Department of Healthy Society, Windesheim University of Applied Sciences, P.O. Box 10090, 8000 GB Zwolle, The Netherlands;
- Behavioural Science Institute, Radboud University, P.O. BOX 9104, 6500 HE Nijmegen, The Netherlands; (J.M.V.); (R.E.); (J.K.L.)
- Correspondence:
| | - Jacqueline M. Vink
- Behavioural Science Institute, Radboud University, P.O. BOX 9104, 6500 HE Nijmegen, The Netherlands; (J.M.V.); (R.E.); (J.K.L.)
| | - Carry Renders
- Department of Health Sciences, Vrije Universiteit, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands;
| | - Natascha Notten
- Knowledge Centre for Health and Social Work, Department of Healthy Society, Windesheim University of Applied Sciences, P.O. Box 10090, 8000 GB Zwolle, The Netherlands;
| | - Rob Eisinga
- Behavioural Science Institute, Radboud University, P.O. BOX 9104, 6500 HE Nijmegen, The Netherlands; (J.M.V.); (R.E.); (J.K.L.)
| | - Junilla K. Larsen
- Behavioural Science Institute, Radboud University, P.O. BOX 9104, 6500 HE Nijmegen, The Netherlands; (J.M.V.); (R.E.); (J.K.L.)
| |
Collapse
|
13
|
Almoraie NM, Saqaan R, Alharthi R, Alamoudi A, Badh L, Shatwan IM. Snacking patterns throughout the life span: potential implications on health. Nutr Res 2021; 91:81-94. [PMID: 34144310 DOI: 10.1016/j.nutres.2021.05.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/02/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022]
Abstract
Eating outside the three main meals - in other words, snacking - is a part of the dietary pattern of individuals in all stages of life. The quality and pattern of snacking have an impact on health during the life span. Thus, the aim of this review was to evaluate various patterns and health outcomes of the snacking habits of different demographical groups, from children to the elderly, throughout their life span. We discuss the snacking pattern among children and adolescents, which is characterized by consuming high energy foods with low nutrient value, and which is associated with increased risk of obesity. During university years, study stress and lack of time were obstacles to a healthy dietary pattern involving nutritious snacks, although awareness of the importance of healthy snacks was higher in this group than among younger age groups. Employment status and skipping regular meals were important factors affecting snacking quality and patterns in adulthood. Unhealthy snacks, high in energy, sugar, and salt and low in nutrients, were demonstrated to have a negative impact on individuals' health, such as oral health, blood pressure, obesity, and diabetes. In conclusion, encouraging individuals to consume healthy snacks that are high in nutrients through education to help them plan for their snacks is important to enhance health and reduce disease risk.
Collapse
Affiliation(s)
- Noha M Almoraie
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Rula Saqaan
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Razan Alharthi
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amal Alamoudi
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Lujain Badh
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Israa M Shatwan
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
14
|
Garcidueñas-Fimbres TE, Paz-Graniel I, Nishi SK, Salas-Salvadó J, Babio N. Eating Speed, Eating Frequency, and Their Relationships with Diet Quality, Adiposity, and Metabolic Syndrome, or Its Components. Nutrients 2021; 13:1687. [PMID: 34063439 PMCID: PMC8156274 DOI: 10.3390/nu13051687] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 02/06/2023] Open
Abstract
Excess body weight is a major global health concern, particularly due to its associated increased health risks. Several strategies have been proposed to prevent overweight and obesity onset. In the past decade, it has been suggested that eating speed/rate and eating frequency might be related to obesity. The main aim of this narrative review was to summarize existing evidence regarding the impact of eating speed/rate and eating frequency on adiposity, metabolic syndrome (MetS), or diet quality (DQ). For this purpose, a literature search of observational and interventional trials was conducted between June and September 2020 in PubMed and Web of Sciences databases, without any data filters and no limitations for publication date. Results suggest that children and adults with a faster eating speed/rate may be associated with a higher risk of developing adiposity, MetS or its components. Furthermore, a higher eating frequency could be associated with diet quality improvement, lower adiposity, and lower risk of developing MetS or its components. Further interventional trials are warranted to clarify the mechanism by which these eating behaviors might have a potential impact on health.
Collapse
Affiliation(s)
- Tany E. Garcidueñas-Fimbres
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (T.E.G.-F.); (I.P.-G.); (S.K.N.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
| | - Indira Paz-Graniel
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (T.E.G.-F.); (I.P.-G.); (S.K.N.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
| | - Stephanie K. Nishi
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (T.E.G.-F.); (I.P.-G.); (S.K.N.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (T.E.G.-F.); (I.P.-G.); (S.K.N.)
| | - Nancy Babio
- Universitat Rovira i Virgili, Departament de Bioquimica i Biotecnologia, Unitat de Nutrició Humana, 43201 Reus, Spain; (T.E.G.-F.); (I.P.-G.); (S.K.N.)
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- CIBER Physiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
| |
Collapse
|
15
|
Sawh MC, Wallace M, Shapiro E, Goyal NP, Newton KP, Yu EL, Bross C, Durelle J, Knott C, Gangoiti JA, Barshop BA, Gengatharan JM, Meurs N, Schlein A, Middleton MS, Sirlin CB, Metallo CM, Schwimmer JB. Dairy Fat Intake, Plasma Pentadecanoic Acid, and Plasma Iso-heptadecanoic Acid Are Inversely Associated With Liver Fat in Children. J Pediatr Gastroenterol Nutr 2021; 72:e90-e96. [PMID: 33399331 PMCID: PMC8842839 DOI: 10.1097/mpg.0000000000003040] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES We sought to evaluate the relevance of pediatric dairy fat recommendations for children at risk for nonalcoholic fatty liver disease (NAFLD) by studying the association between dairy fat intake and the amount of liver fat. The effects of dairy fat may be mediated by odd chain fatty acids (OCFA), such as pentadecanoic acid (C15:0), and monomethyl branched chain fatty acids (BCFA), such as iso-heptadecanoic acid (iso-C17:0). Therefore, we also evaluated the association between plasma levels of OCFA and BCFA with the amount of liver fat. METHODS Observational, cross-sectional, community-based sample of 237 children ages 8 to 17. Dairy fat intake was assessed by 3 24-hour dietary recalls. Plasma fatty acids were measured by gas chromatography-mass spectrometry. Main outcome was hepatic steatosis measured by whole liver magnetic resonance imaging proton density fat fraction (MRI-PDFF). RESULTS Median dairy fat intake was 10.6 grams/day (range 0.0--44.5 g/day). Median liver MRI-PDFF was 4.5% (range 0.9%-45.1%). Dairy fat intake was inversely correlated with liver MRI-PDFF (r = -0.162; P = .012). In multivariable log linear regression, plasma C15:0 and iso-C17:0 were inverse predictors of liver MRI-PDFF (B = -0.247, P = 0.048; and B = -0.234, P = 0.009). CONCLUSIONS Dairy fat intake, plasma C15:0, and plasma iso-C17:0 were inversely correlated with hepatic steatosis in children. These hypothesis-generating findings should be tested through clinical trials to better inform dietary guidelines.
Collapse
Affiliation(s)
- Mary Catherine Sawh
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Martina Wallace
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Emma Shapiro
- Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, Massachusetts
| | - Nidhi P. Goyal
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Kimberly P. Newton
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Elizabeth L. Yu
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| | - Craig Bross
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Janis Durelle
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Cynthia Knott
- Altman Clinical and Translational Research Institute, School of Medicine, University of California, San Diego, La Jolla
| | - Jon A. Gangoiti
- Division of Genetics, Biochemical Genetics and Metabolomics Laboratory, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Bruce A. Barshop
- Division of Genetics, Biochemical Genetics and Metabolomics Laboratory, Department of Pediatrics; University of California San Diego; La Jolla, California
| | - Jivani M. Gengatharan
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Noah Meurs
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Alexandra Schlein
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Michael S. Middleton
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Claude B. Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego, La Jolla, California
| | - Christian M. Metallo
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Jeffrey B. Schwimmer
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics; University of California San Diego; La Jolla, California
- Department of Gastroenterology, Rady Children’s Hospital San Diego, San Diego, California
| |
Collapse
|
16
|
Raptou E. The Role of Snack Choices, Body Weight Stereotypes and Smoking Behavior in Assessing Risk Factors for Adolescent Overweight and Obesity. Foods 2021; 10:foods10030557. [PMID: 33800293 PMCID: PMC8001685 DOI: 10.3390/foods10030557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/24/2021] [Accepted: 03/03/2021] [Indexed: 11/26/2022] Open
Abstract
This study investigated the relationship of behavioral factors, such as snack choices, obesity stereotypes and smoking with adolescents’ body weight. Individual-level data for 1254 Greek youths were selected via a formal questionnaire. Snack choices seem to be gender specific with girls showing a stronger preference for healthier snacks. Frequent consumption of high-calorie and more filling snacks was found to increase Body Mass Index (BMI) in both genders. Fruit/vegetable snacks were associated with lower body weight in females, whereas cereal/nut snacks had a negative influence in males’ BMI. The majority of participants expressed anti-fat attitudes and more boys than girls assigned positive attributes to lean peers. The endorsement of the thin-ideal was positively associated with the BMI of both adolescent boys and girls. This study also revealed that neglecting potential endogeneity issues can lead to biased estimates of smoking. Gender may be a crucial moderator of smoking–BMI relationships. Male smokers presented a higher obesity risk, whereas female smokers were more likely to be underweight. Nutrition professionals should pay attention to increase the acceptance of healthy snack options. Gender differences in the influence of weight stereotypes and smoking on BMI should be considered in order to enhance the efficacy of obesity prevention interventions.
Collapse
Affiliation(s)
- Elena Raptou
- Laboratory of Management and Marketing, Department of Agricultural Development, Democritus University of Thrace, 68200 Orestiada, Greece
| |
Collapse
|
17
|
The impact of a higher eating frequency on the diet quality and nutritional status of women with breast cancer undergoing chemotherapy. Br J Nutr 2019; 123:410-418. [PMID: 31762435 DOI: 10.1017/s0007114519002952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The present study investigated the association between eating frequency (EF), diet quality and nutritional status of fifty-five women with breast cancer (BC) undergoing chemotherapy (CT), with three follow-ups, before the first cycle (T0), after the intermediate cycle (T1) and after the last cycle of CT (T2). Dietary data were obtained by nine 24-h dietary recalls (24HR), and the Brazilian Healthy Eating Index Revised (BHEI-R) was used for qualitative analysis of diet. The average EF was established by adding the number of daily eating episodes in the three 24HR of each time. Anthropometric variables were obtained at three times. Women who reported higher EF (equal to or above median value (T0 and T1: 4·67; T2: 4·33 eating episodes)) presented better anthropometric parameters, in T0 and T1, as well as higher scores for BHEI-R specific groups and BHEI-R Total score in T1 and T2. In generalised linear models, the continuous variable EF was negatively associated with all the anthropometric variables in T0 and with the waist:height ratio in T1. There were positive associations for the BHEI-R groups at the three times: Total Fruit; Whole Fruit; Total Vegetables; Dark Green and Orange Vegetables and Legumes. At T1 and T2 the EF was positively associated with the BHEI-R Total score, and also with Whole Grains in T1. The results suggest that a higher EF was associated with a better diet quality during CT in women with BC. In contrast, an inverse association was observed between EF and anthropometric parameters before the first cycle of treatment.
Collapse
|
18
|
Moore AM, Vadiveloo M, Tovar A, McCurdy K, Østbye T, Benjamin-Neelon SE. Associations of Less Healthy Snack Food Consumption with Infant Weight-for-Length Z-Score Trajectories: Findings from the Nurture Cohort Study. Nutrients 2019; 11:nu11112752. [PMID: 31766167 PMCID: PMC6893797 DOI: 10.3390/nu11112752] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/03/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022] Open
Abstract
Little is known about the impact of less healthy snack foods on weight trajectories during infancy. This secondary analysis of data from the Nurture cohort explored prospective associations of less healthy snack foods with infant weight trajectories. Pregnant women were recruited and, upon delivery of a single live infant, 666 mothers agreed to participate. Mothers completed sociodemographic and infant feeding questionnaires, and infant anthropometrics were collected during home visits at 3, 6, 9, and 12 months. Less healthy snack food consumption was assessed by asking how frequently baby snacks and sweets were consumed each day during the previous three months. Multilevel growth curve models explored associations of baby snacks and sweets with infant weight-for-length (WFL) z-scores. On average, mothers were 27 years old, 71.5% were non-Hispanic Black, and 55.4% had household incomes of ≤$20,000/year. Consumption of less healthy snack foods increased during infancy with a median intake of 3.0 baby snacks/day and 0.7 sweets/day between 10 and 12 months. Growth curve models showed that infants who consumed sweets >2 times/day had significantly higher WFL z-scores during the second half of infancy compared to infants who never consumed sweets. Less healthy snacks may contribute to the risk of obesity during infancy and promoting healthy snack food choices during this critical time is important.
Collapse
Affiliation(s)
- Amy M. Moore
- Department of Nutrition and Food Sciences, University of Rhode Island, 41 Lower College Rd., Kingston, RI 02881, USA
- Correspondence: ; Tel.: +1-(740)-591-7984
| | - Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, 41 Lower College Rd., Kingston, RI 02881, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, 41 Lower College Rd., Kingston, RI 02881, USA
| | - Karen McCurdy
- Department of Human Development and Family Studies, University of Rhode Island, 2 Lower College Rd., Kingston, RI 02881, USA
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University Medical Center, DUMC 2914, Durham, NC 27710, USA
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
| |
Collapse
|
19
|
Xue H, Maguire RL, Liu J, Kollins SH, Murphy SK, Hoyo C, Fuemmeler BF. Snacking frequency and dietary intake in toddlers and preschool children. Appetite 2019; 142:104369. [PMID: 31302102 DOI: 10.1016/j.appet.2019.104369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 06/24/2019] [Accepted: 07/10/2019] [Indexed: 01/26/2023]
Abstract
Understanding the relationship between snacking and dietary intake in early life years is one key but understudied area. In this study, we examined snacking patterns in toddlers and preschool children and the associations between snacking frequency and daily energy intake. We analyzed data from children aged 12-72 months (N = 1186) in the Newborn Epigenetic STudy (NEST). We used Bonferroni multiple comparison methods to examine the differences in snacking patterns across subgroups. Linear and quantile regression models were fit to investigate the association between dietary intake and snacking frequency. Our estimates suggest that Non-Hispanic blacks had the highest total daily energy intake from snacks (334 kcal/day) compared to non-Hispanic whites (270 kcal/day) and Hispanics (274 kcal/day) in 12-to-24-month-olds. In 2-to-6-year-olds, mean energy intake from snacks was 296 kcal/day without a significant racial/ethnic difference. Carbohydrate, fat and protein from snacks contributed about 17%, 9% and 4% respectively of the total energy intake in 12-to-24-month-olds while they contributed about 15%, 7% and 2% respectively of the total energy intake in the other age group. Snacking frequency was positively and significantly associated with total daily energy intake in both 12-to-24-month-olds and 2-to-6-year-olds as indicated by regression coefficient estimates of snacking frequency (β = 31.3 kcal/day with P = 0.027 and β = 175.4 kcal/day with P < 0.0001, respectively, indicating a higher snacking frequency was associated with a greater total daily energy intake). In conclusion, snacking frequency was positively associated with daily energy intake. Carbohydrates and fats from snacks are significant energy contributors. Age differentiation was apparent regarding the relationship between snacking frequency and dietary intake. Differentiated interventions that are age-specific and focus on the dietary quality of snacks instead of quantity are needed.
Collapse
Affiliation(s)
- Hong Xue
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
| | - Rachel L Maguire
- Department of Biological Sciences, College of Sciences, North Carolina State University, Raleigh, NC, USA
| | - Jin Liu
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA
| | - Susan K Murphy
- Department of Obstetrics and Gynecology, School of Medicine, Duke University, Durham, NC, USA
| | - Cathrine Hoyo
- Department of Biological Sciences, College of Sciences, North Carolina State University, Raleigh, NC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
| |
Collapse
|
20
|
Snacking characteristics and patterns and their associations with diet quality and BMI in the Childhood Obesity Prevention and Treatment Research Consortium. Public Health Nutr 2019; 22:3189-3199. [PMID: 31112114 DOI: 10.1017/s1368980019000958] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe snacking characteristics and patterns in children and examine associations with diet quality and BMI. DESIGN Children's weight and height were measured. Participants/adult proxies completed multiple 24 h dietary recalls. Snack occasions were self-identified. Snack patterns were derived for each sample using exploratory factor analysis. Associations of snacking characteristics and patterns with Healthy Eating Index-2010 (HEI-2010) score and BMI were examined using multivariable linear regression models. SETTING Childhood Obesity Prevention and Treatment Research (COPTR) Consortium, USA: NET-Works, GROW, GOALS and IMPACT studies. PARTICIPANTS Predominantly low-income, racial/ethnic minorities: NET-Works (n 534, 2-4-year-olds); GROW (n 610, 3-5-year-olds); GOALS (n 241, 7-11-year-olds); IMPACT (n 360, 10-13-year-olds). RESULTS Two snack patterns were derived for three studies: a meal-like pattern and a beverage pattern. The IMPACT study had a similar meal-like pattern and a dairy/grains pattern. A positive association was observed between meal-like pattern adherence and HEI-2010 score (P for trend < 0⋅01) and snack occasion frequency and HEI-2010 score (β coefficient (95 % CI): NET-Works, 0⋅14 (0⋅04, 0⋅23); GROW, 0⋅12 (0⋅02, 0⋅21)) among younger children. A preference for snacking while using a screen was inversely associated with HEI-2010 score in all studies except IMPACT (β coefficient (95 % CI): NET-Works, -3⋅15 (-5⋅37, -0⋅92); GROW, -2⋅44 (-4⋅27, -0⋅61); GOALS, -5⋅80 (-8⋅74, -2⋅86)). Associations with BMI were almost all null. CONCLUSIONS Meal-like and beverage patterns described most children's snack intake, although patterns for non-Hispanic Blacks or adolescents may differ. Diets of 2-5-year-olds may benefit from frequent meal-like pattern snack consumption and diets of all children may benefit from decreasing screen use during eating occasions.
Collapse
|
21
|
Marangoni F, Martini D, Scaglioni S, Sculati M, Donini LM, Leonardi F, Agostoni C, Castelnuovo G, Ferrara N, Ghiselli A, Giampietro M, Maffeis C, Porrini M, Barbi B, Poli A. Snacking in nutrition and health. Int J Food Sci Nutr 2019; 70:909-923. [PMID: 30969153 DOI: 10.1080/09637486.2019.1595543] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Many studies suggest that distributing energy and nutrient intake across 4-5 eating occasions/day (rather than across three standard meals) could favourably affect human health. The inclusion of 1-2 snacks in the daily pattern alleviates the potential digestive and metabolic overload caused by fewer heavier meals and might contribute to meet recommendations for food groups (e.g. fruits, dairy) and nutrients like fibre and vitamins. The snack composition should be evaluated taking into account the whole day's diet. In early and late ages, and for specific population groups, snacking may need to follow particular characteristics in order to be optimal, both in terms of composition and timing. This document, which is the result of a collaboration of experts across several fields of research, intends to provide a review of the current scientific literature on meal frequency and health, highlighting the beneficial effects of correct snack consumption across the human lifespan.
Collapse
Affiliation(s)
| | - Daniela Martini
- Nutrition Foundation of Italy , Milan , Italy.,Department of Veterinary Sciences, The Laboratory of Phytochemicals in Physiology, Human Nutrition Unit, University of Parma , Parma , Italy
| | - Silvia Scaglioni
- Fondazione De Marchi-Department of Pediatrics, IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy
| | - Michele Sculati
- School of Medicine and Surgery, University of Milano Bicocca , Milan , Italy
| | | | | | - Carlo Agostoni
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy.,DISCCO (Department of Clinical Sciences and Community Health), University of Milan , Milan , Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory , Verbania , Italy.,Department of Psychology, Catholic University of Milan , Milan , Italy
| | - Nicola Ferrara
- Italian Society of Gerontology and Geriatrics and Department of Translational Medical Science, University of Naples Federico II , Naples , Italy
| | - Andrea Ghiselli
- Consiglio per la ricerca in agricoltura e l'analisi dell'economia agraria, CREA-Alimenti e Nutrizione , Rome , Italy
| | | | - Claudio Maffeis
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Verona University , Verona , Italy
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, University of Milan , Milan , Italy
| | | | - Andrea Poli
- Nutrition Foundation of Italy , Milan , Italy
| |
Collapse
|
22
|
Teng CY, Chin YS, Taib MNM, Chan YM. Evaluation of the Effectiveness of a 3-Year, Teacher-Led Healthy Lifestyle Program on Eating Behaviors Among Adolescents Living in Day School Hostels in Malaysia. Food Nutr Bull 2018; 39:595-607. [PMID: 30407077 DOI: 10.1177/0379572118795358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Independence gained during adolescence may be associated with unhealthy eating behaviors. Although malnutrition among adolescents is evident, studies on eating behaviors among adolescents are scarce. OBJECTIVE To determine the effectiveness of a teacher-led Healthy Lifestyle Program on eating behaviors among adolescents in Malaysia. METHODS This was a cluster randomized controlled trial (conducted in 2012 to 2014), with 100 schools randomly selected from 721 schools, then assigned to 50 intervention schools and 50 control schools. A Healthy Eating and Be Active among Teens (HEBAT) module was developed for pretrained teachers to deliver a Healthy Lifestyle Program on eating behaviors among adolescents. Eating behaviors of the respondents was determined using Eating Behaviors Questionnaire. Linear Mixed Model analysis and χ2 test were used to determine within- and between-group effects of studied variables. RESULTS A total of 4277 respondents participated in this study, with 2635 samples involved in the final analysis, comprised of 921 intervention and 1714 control respondents. There were 32.4% (36.4%) males and 67.6% (63.6%) females in the intervention (control) group. Mean age was comparable between the groups (intervention = 12.98 years; control = 12.97 years). Majority of the respondents skipped meals at baseline (intervention = 74.7%; control = 79.5%). After the program, intervention respondents had higher consumption frequency of lunch, dinner, and mid-morning snack but a lower consumption frequency of late-evening snack and meal skipping behaviors than their control counterparts. CONCLUSION The teacher-led Healthy Lifestyle Program was effective in reducing meal-skipping behaviors among Malaysian adolescents.
Collapse
Affiliation(s)
- Chian Yi Teng
- 1 Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Yit Siew Chin
- 1 Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.,2 Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Mohd Nasir Mohd Taib
- 1 Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.,2 Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Yoke Mun Chan
- 1 Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.,2 Research Centre of Excellence, Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.,3 Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Selangor, Malaysia
| |
Collapse
|
23
|
Reale S, Kearney CM, Hetherington MM, Croden F, Cecil JE, Carstairs SA, Rolls BJ, Caton SJ. The Feasibility and Acceptability of Two Methods of Snack Portion Control in United Kingdom (UK) Preschool Children: Reduction and Replacement. Nutrients 2018; 10:E1493. [PMID: 30322090 PMCID: PMC6212871 DOI: 10.3390/nu10101493] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 01/23/2023] Open
Abstract
Large portions of high energy dense (HED) snacks are offered to children from a young age and are pervasive in our food environment. This study aimed to explore the feasibility, acceptability, and preliminary efficacy of two strategies of snack portion control: reduction and replacement. Forty-six mother-child dyads aged 22⁻56 months (36.6 ± 9.5 m, 48% female) completed a three-week intervention. In week 1 (baseline) no changes were made to the child's diet; week 2 (acclimation) children received a standardised selection of HED snacks, and in week 3 (intervention) participants were randomly assigned to snack replacement (n = 24) or snack reduction (n = 22). Snack replacement involved swapping HED snacks for fruits and vegetables, whilst snack reduction involved reducing the size of HED snacks by 50%. Food and energy intake were measured using a weighed food diary for four consecutive days. Snack replacement resulted in more positive changes to children's diets; vegetable intake increased (p < 0.01), and total daily energy intake decreased when compared to snack reduction (p < 0.05). Mothers expressed a more favourable attitude to snack replacement, although snack reduction was also well received by mothers. Despite increased preliminary efficacy of snack replacement on dietary intake, both strategies were feasible and acceptable. The current pilot study provides the necessary information to inform the design of future interventions.
Collapse
Affiliation(s)
- Sophie Reale
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
| | - Colette M Kearney
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
| | | | - Fiona Croden
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK.
| | - Joanne E Cecil
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
| | - Sharon A Carstairs
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
| | - Barbara J Rolls
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Samantha J Caton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
| |
Collapse
|
24
|
Tan ML, Laraia B, Madsen KA, Au LE, Frongillo EA, Ritchie LD. Child Food Insecurity Is Associated with Energy Intake among Fourth- and Fifth-Grade Girls. J Acad Nutr Diet 2018; 119:1722-1731.e2. [PMID: 30318250 DOI: 10.1016/j.jand.2018.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 07/11/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Food insecurity is associated with poor diet and obesity among adult women, but evidence among children is mixed, and few studies have examined differences between boys and girls. OBJECTIVE This study examined the relationship between self-reported food insecurity and dietary intake among boys and girls. DESIGN Cross-sectional survey data were used from the Children's PowerPlay! Campaign evaluation. PARTICIPANTS AND SETTING In all, 3,547 fourth- and fifth-grade students (9 to 11 years old) from 44 San Diego-area elementary schools in 2012 completed diary-assisted 24-hour recalls and a questionnaire that included five questions from the Child Food Security Assessment. MAIN OUTCOME MEASURES Individual dietary components (including total energy, nutrients, and sugar-sweetened beverages), Healthy Eating Index-2010 scores, and meal patterns (such as meal sizes and missed meals) were derived from 24-hour recalls. STATISTICAL ANALYSES Multivariable linear and logistic regression models were used to estimate the relationships between food insecurity and diet characteristics. RESULTS Girls with the highest food insecurity consumed 135 total kilocalories (P<0.005) and 60 snack kilocalories (P<0.05) more per day than girls with no food insecurity. These relationships were absent among boys. CONCLUSIONS Food insecurity among girls in grades 4 and 5 was associated with higher energy intake. Findings support the need for further research to better understand the nature of this relationship and its implications for energy balance.
Collapse
|
25
|
Bawaked RA, Gomez SF, Homs C, Casas Esteve R, Cardenas G, Fíto M, Schröder H. Association of eating behaviors, lifestyle, and maternal education with adherence to the Mediterranean diet in Spanish children. Appetite 2018; 130:279-285. [PMID: 30130543 DOI: 10.1016/j.appet.2018.08.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND The Mediterranean diet serves as a proxy of a high-quality diet. Although several factors are known to affect a child's ability to follow a high-quality diet, no prospective data are available on factors that influence adherence to a Mediterranean diet among children. Our objective was to investigate the association of Mediterranean diet adherence with eating behaviors, lifestyle habits, and maternal education in a prospective cohort of children. METHODS The present prospective cohort analysis included 1639 children aged 8-10 years. The study was carried out during two academic years, 2012/2014, with an average follow-up of 15 months. Eating behaviors, physical activity, and adherence to Mediterranean diet were estimated by the Dutch Eating Behavior Questionnaire for Children, the Physical Activity Questionnaire for Children, and the KIDMED index, respectively. RESULTS Multivariate linear regression analysis adjusted for sex, age, maternal education, baseline adherence to the Mediterranean diet, and intervention group revealed a significant (p < 0.01) inverse association of external eating and screen time with adherence to the Mediterranean diet at follow-up (mean of 15 months). The opposite association was found for meal frequency and physical activity (p < 0.02). A high level of maternal education increased the odds of a child's high adherence to the Mediterranean diet (OR = 1.56 CI 1.13; 2.14) compared to peers whose mothers had only a primary education. CONCLUSIONS Screen time, physical activity, meal frequency, and external eating predict adherence to the Mediterranean diet independently of baseline diet quality. Maternal education level is an important prospective determinant for the adherence to the Mediterranean diet. TRIAL REGISTRATION NUMBER ISRCTN68403446.
Collapse
Affiliation(s)
- Rowaedh Ahmed Bawaked
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Santiago Felipe Gomez
- Gasol Foundation, Sant Boi de Llobregat, Spain; GREpS. Health Education Research Group, Nursing and Phisiotherapy Department, University of Lleida, Lleida, Spain
| | - Clara Homs
- Gasol Foundation, Sant Boi de Llobregat, Spain
| | | | - Gabriela Cardenas
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Montserrat Fíto
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|
26
|
Mindell JA, Williamson AA. Benefits of a bedtime routine in young children: Sleep, development, and beyond. Sleep Med Rev 2018; 40:93-108. [PMID: 29195725 PMCID: PMC6587181 DOI: 10.1016/j.smrv.2017.10.007] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 09/03/2017] [Accepted: 10/30/2017] [Indexed: 12/11/2022]
Abstract
This paper presents a conceptual model and reviews the empirical evidence to support a nightly bedtime routine as a key factor in the promotion of not only healthy sleep, but also of broad development and wellbeing in early childhood. A bedtime routine embodies the characteristics of nurturing care and early child stimulation, which are deemed to be essential for positive outcomes, especially for at-risk children. Furthermore, common, adaptive components of a bedtime routine can contribute to an array of positive developmental outcomes beyond improved sleep, inclusive of language development, literacy, child emotional and behavioral regulation, parent-child attachment, and family functioning, among other outcomes. These bedtime routine components include activities in the broad domains of nutrition (e.g., feeding, healthy snack), hygiene (e.g., bathing, oral care), communication (e.g., reading, singing/lullabies) and physical contact (e.g., massage, cuddling/rocking). A bedtime routine can provide multiple benefits to child and family functioning at a time of day that many parents are present with their children. Although additional research on hypothesized routine-related child outcomes and mechanisms of action are needed, promoting a bedtime routine may be a feasible and cost-effective method to promote positive early childhood development worldwide, particularly for socioeconomically disadvantaged and other at-risk young children.
Collapse
Affiliation(s)
- Jodi A Mindell
- Department of Psychology, Saint Joseph's University, Philadelphia, PA, USA; Sleep Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Ariel A Williamson
- Sleep Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
27
|
De Cock N, Van Lippevelde W, Vangeel J, Notebaert M, Beullens K, Eggermont S, Deforche B, Maes L, Goossens L, Verbeken S, Moens E, Vervoort L, Braet C, Huybregts L, Kolsteren P, Van Camp J, Lachat C. Feasibility and impact study of a reward-based mobile application to improve adolescents' snacking habits. Public Health Nutr 2018; 21:2329-2344. [PMID: 29607800 PMCID: PMC11106033 DOI: 10.1017/s1368980018000678] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/12/2018] [Accepted: 02/22/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Adolescents' snacking habits are driven by both explicit reflective and implicit hedonic processes. Hedonic pathways and differences in sensitivity to food rewards in addition to reflective determinants should be considered. The present study evaluated the feasibility and impact of a mobile phone-delivered intervention, incorporating explicit reflective and implicit rewarding strategies, on adolescents' snack intake. DESIGN Adolescents (n 988; mean age 14·9 (sd 0·70) years, 59·4 % boys) completed a non-randomized clustered controlled trial. Adolescents (n 416) in the intervention schools (n 3) were provided with the intervention application for four weeks, while adolescents (n 572) in the control schools (n 3) followed the regular curriculum. Outcomes were differences in healthy snacking ratio and key determinants (awareness, intention, attitude, self-efficacy, habits and knowledge). Process evaluation data were collected via questionnaires and through log data of the app. RESULTS No significant positive intervention effects on the healthy snack ratio (b=-3·52 (se 1·82), P>0·05) or targeted determinants were observed. Only 268 adolescents started using the app, of whom only fifty-five (20·5 %) still logged in after four weeks. Within the group of users, higher exposure to the app was not significantly associated with positive intervention effects. App satisfaction ratings were low in both high and low user groups. Moderation analyses revealed small positive intervention effects on the healthy snack ratio in high compared with low reward-sensitive boys (b=1·38 (se 0·59), P<0·05). CONCLUSIONS The intervention was not able to improve adolescents' snack choices, due to low reach and exposure. Future interventions should consider multicomponent interventions, teacher engagement, exhaustive participatory app content development and tailoring.
Collapse
Affiliation(s)
- Nathalie De Cock
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, Ghent 9000, Belgium
| | | | - Jolien Vangeel
- Leuven School for Mass Communication Research, KU Leuven, Leuven, Belgium
| | - Melissa Notebaert
- Leuven School for Mass Communication Research, KU Leuven, Leuven, Belgium
| | - Kathleen Beullens
- Leuven School for Mass Communication Research, KU Leuven, Leuven, Belgium
| | - Steven Eggermont
- Leuven School for Mass Communication Research, KU Leuven, Leuven, Belgium
| | - Benedicte Deforche
- Department of Public Health, Ghent University, Ghent, Belgium
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lea Maes
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Lien Goossens
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Ellen Moens
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Leentje Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Lieven Huybregts
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington DC, USA
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, Ghent 9000, Belgium
| | - John Van Camp
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, Ghent 9000, Belgium
| | - Carl Lachat
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, Ghent 9000, Belgium
| |
Collapse
|
28
|
Jacquier EF, Deming DM, Eldridge AL. Location influences snacking behavior of US infants, toddlers and preschool children. BMC Public Health 2018; 18:725. [PMID: 29895277 PMCID: PMC5998573 DOI: 10.1186/s12889-018-5576-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 05/18/2018] [Indexed: 11/10/2022] Open
Abstract
Background Compare at-home and away-from-home snacking patterns of US infants and young children. Methods A secondary analysis was conducted using nationwide, cross-sectional dietary survey data from the US Feeding Infants and Toddlers Study (FITS) 2008. The sample included infants (6–11.9 months, n = 505), toddlers (12–23.9 months, n = 925), preschool children (24–47.9 months, n = 1461). Weighted population descriptive statistics (means and standard errors) were calculated using SAS. Significance was determined at P ≤ 0.05. The main outcome measures of the analyses were the percent of children consuming snacks by location (at home, away from home) and snacking period (morning, afternoon and evening), energy and food groups consumed during snacks. Results Snacking at home was more prevalent than snacking away from home (toddlers, 73% vs 27%; preschoolers, 67% vs 33%). Away-from-home snacks provided about 50 additional calories per day for toddlers (346 vs 298 kcal/day, P ≤ 0.05) and preschoolers (371 vs 326 kcal/day, P ≤ 0.05) versus snacks consumed at home. Caregivers made similar snack choices for toddlers and preschoolers (milk/milk products, fruit/juice, grains and sweets) but differed in frequency of consumption by location. Among toddlers, milk/milk products were the most frequently consumed snacks at home (66%), while sweets were the top snacks consumed away from home (69%). Among preschoolers, sweets were the top snacks both at home (60%) and away (83%). Conclusions Location is an important factor influencing snacking patterns of young children and should be considered when developing feeding guidelines. This data may be of use in the upcoming development of dietary guidelines in the U.S. for the population aged 0–2 years.
Collapse
Affiliation(s)
- Emma F Jacquier
- Nestlé Research Center, Vers-Chez-les-Blanc, Case postale 44, 1000, Lausanne, Vaud, Switzerland.
| | - Denise M Deming
- Nestlé Nutrition, 12 Vreeland Rd, Florham Park, New Jersey, NJ, 07962, USA
| | - Alison L Eldridge
- Nestlé Research Center, Vers-Chez-les-Blanc, Case postale 44, 1000, Lausanne, Vaud, Switzerland
| |
Collapse
|
29
|
Snacking Patterns in Children: A Comparison between Australia, China, Mexico, and the US. Nutrients 2018; 10:nu10020198. [PMID: 29439472 PMCID: PMC5852774 DOI: 10.3390/nu10020198] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/03/2018] [Accepted: 02/07/2018] [Indexed: 11/16/2022] Open
Abstract
Snacking is common in children and influenced by many factors. The aim of this study is to provide insight of both common and country-specific characteristics of snacking among 4–13 year old children. We analyzed snacking prevalence, energy and nutrient contributions from snacking across diverse cultures and regions, represented by Australia, China, Mexico, and the US using data from respective national surveys. We found that the highest prevalence of snacking was in Australia and the US (over 95%) where snacking provided one-third and one-quarter of total energy intake (TEI), respectively, followed by Mexico (76%, provided 15% TEI) and China (65%, provided 10% TEI). Compared to 4–8 year-olds, the consumption of fruits and milk was lower in 9–13 year-old children, with a trend of increasing savory snacks consumption in China, Mexico, and the US. The nutrient density index of added sugars and saturated fat was higher, especially in Australia, Mexico, and the US. Results suggested that snacking could be an occasion to promote fruit and vegetable consumption in all countries, especially for older children. Snacking guidelines should focus on reducing consumption of snacks high in saturated fat and added sugars for Australia, Mexico, and the US, whereas improving dairy consumption is important in China.
Collapse
|
30
|
Toffano RBD, Hillesheim E, Mathias MG, Coelho-Landell CA, Salomão RG, Almada MORV, Camarneiro JM, Barros TT, Camelo-Junior JS, Rezzi S, Goulet L, Giner MP, Silva LD, Martin FP, Montoliu I, Moco S, Collino S, Kaput J, Monteiro JP. Validation of the Brazilian Healthy Eating Index-Revised Using Biomarkers in Children and Adolescents. Nutrients 2018; 10:E154. [PMID: 29385742 PMCID: PMC5852730 DOI: 10.3390/nu10020154] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 12/26/2017] [Accepted: 01/08/2018] [Indexed: 12/22/2022] Open
Abstract
The Brazilian Healthy Eating Index-Revised (BHEI-R) can be used to determine overall dietary patterns. We assessed the BHEI-R scores in children and adolescents, aged from 9 to 13 years old, and associated its component scores with biomarkers of health and dietary exposure. Three 24-h recalls were used to generate BHEI-R. Biomarkers were analyzed in plasma and red blood cells. Correlation tests, agreement, and covariance analyses were used to associate BHEI-R components with biomarkers. Data from 167 subjects were used. The strongest correlations were between fruits, vegetables and legumes with omega-6 and omega-3 fatty acids, and β-carotene intakes. Milk and dairy correlated with plasma retinol and pyridoxine. All components rich in vegetable and animal protein sources correlated with plasma creatine. Total BHEI-R scores were positively associated with intakes of omega-6, omega-3, fiber and vitamin C, and inversely associated with energy and saturated fat intakes of individuals. Plasma β-carotene and riboflavin biomarkers were positively associated with total BHEI-R. An inadequate food consumption pattern was captured by both biomarkers of health and dietary exposure. BHEI-R was validated for the above dietary components and can be associated with metabolomics and nutritional epidemiological data in future pediatric studies.
Collapse
Affiliation(s)
- Roseli B D Toffano
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Elaine Hillesheim
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Mariana G Mathias
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Carolina A Coelho-Landell
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Roberta G Salomão
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Maria O R V Almada
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Joyce M Camarneiro
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Tamiris T Barros
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - José S Camelo-Junior
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| | - Serge Rezzi
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Laurence Goulet
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Maria P Giner
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Laeticia Da Silva
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Francois-Pierre Martin
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Ivan Montoliu
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Sofia Moco
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Sebastiano Collino
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Jim Kaput
- Nestlé Institute of Health Sciences, Innovation Square, École Polytechnique Fédérale de Lausanne, Campus, 1015 Lausanne, Switzerland.
| | - Jacqueline P Monteiro
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto 14049-900, Brazil.
| |
Collapse
|
31
|
Duarte IAE, Botelho RBA, Akutsu RDC. Regional Food Consumption in the Northeast of Brazil by the Low-Income Population. JOURNAL OF CULINARY SCIENCE & TECHNOLOGY 2017. [DOI: 10.1080/15428052.2017.1406833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Isabella Araújo Esteves Duarte
- Graduate Program in Human Nutrition, Faculty of Health Sciences, Campus Universitário Darcy Ribeiro, Universidade de Brasília, Brasília, Brazil
| | | | | |
Collapse
|
32
|
Food parenting and child snacking: a systematic review. Int J Behav Nutr Phys Act 2017; 14:146. [PMID: 29096640 PMCID: PMC5668962 DOI: 10.1186/s12966-017-0593-9] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/03/2017] [Indexed: 01/10/2023] Open
Abstract
Background While the role of parenting in children’s eating behaviors has been studied extensively, less attention has been given to its potential association with children’s snacking habits. To address this gap, we conducted a systematic review to describe associations between food parenting and child snacking, or consuming energy dense foods/foods in between meals. Methods Six electronic databases were searched using standardized language to identify quantitative studies describing associations of general and feeding-specific parenting styles as well as food parenting practices with snacking behaviors of children aged 2–18 years. Eligible peer-reviewed journal articles published between 1980 and 2017 were included. Data were extracted using a standard protocol by three coders; all items were double coded to ensure consistency. Results Forty-seven studies met inclusion criteria. Few studies focused on general feeding (n = 3) or parenting styles (n = 10). Most studies focused on controlling food parenting practices (n = 39) that were not specific to snacking. Parental restriction of food was positively associated with child snack intake in 13/23 studies, while pressure to eat and monitoring yielded inconsistent results. Home availability of unhealthy foods was positively associated with snack intake in 10/11 studies. Findings related to positive parent behaviors (e.g. role modeling) were limited and yielded mixed results (n = 9). Snacking was often assessed using food frequency items and defined post-hoc based on nutritional characteristics (e.g. energy-dense, sugary foods, unhealthy, etc.). Timing was rarely included in the definition of a snack (i.e. chips eaten between meals vs. with lunch). Conclusions Restrictive feeding and home access to unhealthy foods were most consistently associated with snacking among young children. Research is needed to identify positive parenting behaviors around child snacking that may be used as targets for health promotion. Detailed definitions of snacking that address food type, context, and purpose are needed to advance findings within the field. We provide suggested standardized terminology for future research. Electronic supplementary material The online version of this article (10.1186/s12966-017-0593-9) contains supplementary material, which is available to authorized users.
Collapse
|
33
|
Fayet-Moore F, Peters V, McConnell A, Petocz P, Eldridge AL. Weekday snacking prevalence, frequency, and energy contribution have increased while foods consumed during snacking have shifted among Australian children and adolescents: 1995, 2007 and 2011-12 National Nutrition Surveys. Nutr J 2017; 16:65. [PMID: 28974206 PMCID: PMC5627470 DOI: 10.1186/s12937-017-0288-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/21/2017] [Indexed: 11/24/2022] Open
Abstract
Background There are limited data on the evolution of eating habits, including snacking, in Australia. This study aimed to understand snacking trends among Australian children over three previous National Nutrition Surveys. Methods Data were analysed from a single weekday 24-h recall in the National Nutrition Surveys 1995, 2007, 2011–12 among children 2-16y (n = 8258). A snacking occasion was defined as an eating occasion that occurred between meals based on time of day. Results The percentage of children snacking increased over time (92.5 ± 0.5(SE) % in 1995, 98.1 ± 0.3% in 2007, and 95.8 ± 0.4% in 2011–12) (P < 0.001), particularly among those having four or more snacking occasions (7.1 ± 0.5% in 1995, 17.9 ± 0.6% in 2007, and 18.5 ± 0.8% in 2011–2) (P < 0.001). The mean number of snacking occasions increased from 2.0 ± 0.0 in 1995, to 2.5 ± 0.0 in 2007 and 2011–12 (P < 0.001). The energy contribution from snacking increased from 24.1 ± 0.3% in 1995 to 27.7 ± 0.3% in 2007 and 30.5 ± 0.4% in 2011–12 (P < 0.001), while the energy from discretionary food during snacking decreased from 56.5 ± 0.7% in 1995 to 47.3 ± 0.5% in 2007 and 47.9 ± 0.7% in 2011–12 (P < 0.001). There were differences in the top foods consumed during snacking: non-alcoholic beverages were prominent contributors in 1995 but not in 2007 or 2011, and pome fruit was the second top energy contributor during snacking in 2007 and 2011 but only fourth in 1995. Conclusions Snacking is a prominent dietary pattern that has increased over time in frequency and energy contribution. Foods and beverages consumed during snacking occasions include a mix of core foods and discretionary foods, and while the contribution of discretionary foods has decreased, there is still an opportunity to encourage consumption of more nutrient dense foods during snacking. Electronic supplementary material The online version of this article (10.1186/s12937-017-0288-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Flávia Fayet-Moore
- Nutrition Research Australia, Level 13 167 Macquarie St, Sydney, NSW, 2000, Australia.
| | | | - Andrew McConnell
- Nutrition Research Australia, Level 13 167 Macquarie St, Sydney, NSW, 2000, Australia
| | | | | |
Collapse
|
34
|
Shriver LH, Marriage BJ, Bloch TD, Spees CK, Ramsay SA, Watowicz RP, Taylor CA. Contribution of snacks to dietary intakes of young children in the United States. MATERNAL AND CHILD NUTRITION 2017; 14. [PMID: 28337856 DOI: 10.1111/mcn.12454] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 02/24/2017] [Indexed: 01/24/2023]
Abstract
Nutritional quality of children's diets is a public health priority in the fight against childhood obesity and chronic diseases. The main purpose of this study was to determine contribution of snacks to energy and nutrient intakes and to identify leading snack food sources of energy, total fat, and added sugars amongst young children in the United States. Using the 2005-2012 NHANES data, dietary intakes of 2- to 5-year-old children were analysed from a parent-reported 24-hour dietary recall (n = 3,429). Snacking occasions were aggregated to determine the proportion of total food/beverage intake obtained from snacks, estimate energy, and nutrient intakes, and identify the leading snack food sources of energy, added sugars, and total fat. Nearly all children consumed a snack on the reported day (62% morning, 84% afternoon, and 72% evening). Snacks accounted for 28% of total energy intake, 32% of carbohydrates, 39% of added sugars, and 26% of total fat and dietary fiber intakes for the day. Snacking occasions accounted for 46.6% of all beverages consumed on the reported day. Snacks and sweets food category (i.e., cookies and pastries) were the leading sources of energy (44%), total fat (52%), and added sugars (53%) consumed during snacking occasions. Sweetened beverages (e.g., fruit and sport drinks) contributed 1-quarter of all added sugars obtained from snacks. Snacks contribute considerable amount of energy and nutrients to young children's diets, with a heavy reliance on energy-dense foods and beverages. Targeted interventions are needed to improve the nutritional quality of snacks consumed by young children.
Collapse
Affiliation(s)
- Lenka H Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | | | | | - Colleen K Spees
- Medical Dietetics, The Ohio State University, Columbus, Ohio, USA
| | | | | | | |
Collapse
|
35
|
Cross-sectional analysis of eating patterns and snacking in the US Feeding Infants and Toddlers Study 2008. Public Health Nutr 2017; 20:1584-1592. [DOI: 10.1017/s136898001700043x] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AbstractObjectiveTo explore eating patterns and snacking among US infants, toddlers and pre-school children.DesignThe Feeding Infants and Toddlers Study (FITS) 2008 was a cross-sectional national survey of children aged 6–47 months, weighted to reflect US age and racial/ethnic distributions. Dietary data were collected using one multiple-pass 24h recall. Eating occasions were categorized as meals, snacks or other (comprised of all feedings of breast milk and/or infant formula). The percentage of children consuming meals and snacks and their contribution to total energy, the number of snacks consumed per day, energy and nutrients coming from snacks and the most commonly consumed snacks were evaluated by age.SettingA national sample of US infants, toddlers and pre-school children.SubjectsA total of 2891 children in five age groups: 6–8 months (n 249), 9–11 months (n 256), 12–23 months (n 925), 24–35 months (n 736) and 36–47 months (n 725).ResultsSnacks were already consumed by 37 % of infants beginning at 6 months; by 12 months of age, nearly 95 % were consuming at least one snack per day. Snacks provided 25 % of daily energy from the age of 12 months. Approximately 40 % of toddlers and pre-school children consumed fruit and cow’s milk during snacks; about 25 % consumed 100 % fruit juice. Cookies were introduced early; by 24 months, 57 % consumed cookies or candy in a given day.ConclusionsSnacking is common, contributing significantly to daily energy and nutrient needs of toddlers and pre-school children. There is room for improvement, however, with many popular snacking choices contributing to excess sugar.
Collapse
|
36
|
Rehm CD, Drewnowski A. Replacing American snacks with tree nuts increases consumption of key nutrients among US children and adults: results of an NHANES modeling study. Nutr J 2017; 16:17. [PMID: 28270158 PMCID: PMC5341477 DOI: 10.1186/s12937-017-0238-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 02/28/2017] [Indexed: 12/21/2022] Open
Abstract
Background Replacing typical American snacks with tree nuts may be an effective way to improve diet quality and compliance with the 2015–2020 Dietary Guidelines for Americans (DGAs). Objective To assess and quantify the impact of replacing typical snacks with composite tree nuts or almonds on diet metrics, including empty calories (i.e., added sugars and solid fats), individual fatty acids, macronutrients, nutrients of public health concern, including sodium, fiber and potassium, and summary measures of diet quality. Methods Food pattern modeling was implemented in the nationally representative 2009–2012 National Health and Examination Survey (NHANES) in a population of 17,444 children and adults. All between-meal snacks, excluding beverages, were replaced on a per calorie basis with a weighted tree nut composite, reflecting consumption patterns in the population. Model 1 replaced all snacks with tree nuts, while Model 2 exempted whole fruits, non-starchy vegetables, and whole grains (>50% of total grain content). Additional analyses were conducted using almonds only. Outcomes of interest were empty calories (i.e., solid fats and added sugars), saturated and mono- and polyunsaturated fatty acids, fiber, protein, sodium, potassium and magnesium. The Healthy Eating Index-2010, which measures adherence to the 2010 Dietary Guidelines for Americans, was used as a summary measure of diet quality. Results Compared to observed diets, modeled food patterns were significantly lower in empty calories (−20.1% and −18.7% in Model 1 and Model 2, respectively), added sugars (−17.8% and −16.9%), solid fats (−21.0% and −19.3%), saturated fat (−6.6% and −7.1%)., and sodium (−12.3% and −11.2%). Modeled patterns were higher in oils (65.3% and 55.2%), monounsaturated (35.4% and 26.9%) and polyunsaturated fats (42.0% and 35.7%), plant omega 3 s (53.1% and 44.7%), dietary fiber (11.1% and 14.8%), and magnesium (29.9% and 27.0%), and were modestly higher in potassium (1.5% and 2.9%). HEI-2010 scores were significantly higher in Model 1 (67.8) and in Model 2 (69.7) compared to observed diets (58.5). Replacing snacks with almonds only produced similar results; the decrease in sodium was more modest and no increase in plant omega-3 fats was observed. Conclusion Replacing between-meal snacks with tree nuts or almonds led to more nutrient-rich diets that were lower in empty calories and sodium and had more favorable fatty acid profiles. Food pattern modeling using NHANES data can be used to assess the likely nutritional impact of dietary guidance.
Collapse
Affiliation(s)
- Colin D Rehm
- Center for Public Health Nutrition, University of Washington, Seattle, WA, 98195-3410, USA.
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, 98195-3410, USA
| |
Collapse
|
37
|
Charvet A, Brogan Hartlieb K, Yeh Y, Jen KLC. A comparison of snack serving sizes to USDA guidelines in healthy weight and overweight minority preschool children enrolled in Head Start. BMC OBESITY 2016; 3:36. [PMID: 27602232 PMCID: PMC5002112 DOI: 10.1186/s40608-016-0116-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 08/14/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Obesity disproportionately affects children from low-income families and those from racial and ethnic minorities. The relationship between snacking and weight status remains unclear, although snacking is known to be an important eating episode for energy and nutrient intake particularly in young children. The purpose of this pilot study was to examine the snack intake of minority preschool children enrolled in the Head Start Program in four centers in Detroit, Michigan, and investigate differences by child weight status. METHODS This secondary data analysis used snack time food observation and anthropometric data from a convenience sample of 55 African American children (44 % girls, mean age = 3.8 years). Snack intake data was obtained over a mean of 5 days through direct observation of children by dietetic interns, and later converted into food group servings according to the United States Department of Agriculture (USDA) meal patterns and averaged for each child. Height and weight measurements were systematically collected and BMI-for-age percentiles were used to classify children into weight categories. One sample, paired samples and independent samples t-tests were performed to test for differences within and between means. RESULTS Based on BMI-for-age percentiles, 72.7 % of the sample was under/healthy weight and 27.3 % was overweight/obese. Average (mean ± SD) intake of milk (0.76 ± 0.34) and overall fruits/vegetables (0.77 ± 0.34) was significantly lower than one USDA serving, while average intake of grains and breads (2.04 ± 0.89), meat/meat alternates (2.20 ± 1.89) and other foods (1.43 ± 1.08) was significantly higher than one USDA serving (p ≤ 0.05). Children ate more when offered canned versus fresh fruits (0.93 ± 0.57 vs. 0.65 ± 0.37, p = 0.007). Except for a significantly higher milk intake in the overweight/obese group compared to the under/healthy weight group (0.86 ± 0.48 vs. 0.72 ± 0.27, p = 0.021], no relationship was found between snack food intake and weight category. Only in the overweight/obese group was the intake of milk and fresh fruits not significantly different than one USDA serving. CONCLUSIONS Findings suggest that regardless of weight status low-income minority preschool children are consuming larger serving sizes when offered less healthy versus healthier snack foods. Continued efforts should be made to provide healthful snack foods at preschool settings to prevent obesity and promote healthier food habits.
Collapse
Affiliation(s)
- Andrea Charvet
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Kathryn Brogan Hartlieb
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Yulyu Yeh
- Department of Nutrition and Food Science, College of Liberal Arts and Sciences, Wayne State University, 3009 Science Hall, Detroit, MI 48202 USA
| | - K-L Catherine Jen
- Department of Nutrition and Food Science, College of Liberal Arts and Sciences, Wayne State University, 3009 Science Hall, Detroit, MI 48202 USA
| |
Collapse
|
38
|
Murakami K, Livingstone MBE. Associations between Meal and Snack Frequency and Diet Quality in US Adults: National Health and Nutrition Examination Survey 2003-2012. J Acad Nutr Diet 2016; 116:1101-13. [DOI: 10.1016/j.jand.2015.12.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 12/03/2015] [Indexed: 10/22/2022]
|
39
|
Taillie LS, Wang D, Popkin BM. Snacking Is Longitudinally Associated with Declines in Body Mass Index z Scores for Overweight Children, but Increases for Underweight Children. J Nutr 2016; 146:1268-75. [PMID: 27146917 PMCID: PMC4926857 DOI: 10.3945/jn.115.226803] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 03/21/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Few studies, to our knowledge, have examined the longitudinal association of snacking with child body mass index (BMI), especially in China, where the incidence of overweight and obesity has increased rapidly. OBJECTIVES Our objective was to examine the longitudinal association between snacking and BMI z score and to test whether this association differs by baseline weight status. METHODS Using data from the China Health and Nutrition Survey (2006, 2009, and 2011), we characterized snack intake for 9 provinces and 3 megacities. We used linear mixed-effects models to examine longitudinally the association between snacking (none, low, medium, and high tertiles according to energy) and BMI z score in children aged 2-13 y at baseline, controlling for sex, urbanicity, parental education, physical activity, and foods consumed at meals (n = 2277 observations). We tested whether this association differed by baseline underweight, normal weight, or overweight/obese. RESULTS Snacking is prevalent in Chinese children, with fruit being the most common snack. Snacking was not associated with meaningful BMI z score changes in normal-weight children. However, in children who were underweight at baseline, snacking in the top tertiles was associated with increases in BMI z scores from 2006 to 2011 (+1.2 and +1.1 BMI z score units for ages 2-6 and 7-13 y, respectively) (P < 0.05). In overweight/obese 2- to 6-y-old children at baseline, being in the lowest snacking tertile was associated with declines in BMI z score (-3.3), whereas in overweight 7- to 13-y-old children, being in the top tertile of snacking was associated with the greatest decline in BMI z score (-2.1) (P < 0.05). The direction and magnitude of associations did not vary regardless of adjustment for total energy intake. CONCLUSIONS Snacking in China, dominated by fruit consumption, is associated with decreased BMI in overweight/obese children and increased BMI in underweight children. More work will be needed to monitor this relation as Chinese diets continue to westernize.
Collapse
Affiliation(s)
| | | | - Barry M Popkin
- Department of Nutrition, University of North Carolina, Chapel Hill, NC; and
| |
Collapse
|
40
|
Meal and snack frequency in relation to diet quality in US children and adolescents: the National Health and Nutrition Examination Survey 2003-2012. Public Health Nutr 2016; 19:1635-44. [PMID: 26916962 DOI: 10.1017/s1368980016000069] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the associations of meal frequency (MF) and snack frequency (SF) with diet quality. DESIGN Dietary intake was assessed using two 24 h dietary recalls. All eating occasions providing ≥210 kJ of energy were divided into meals or snacks on the basis of contribution to energy intake (≥15 % or <15 %), self-report and time (06.00-09.00, 12.00-14.00 and 17.00-20.00 hours, or others). Diet quality was assessed using the Healthy Eating Index (HEI)-2010. SETTING Nationally representative sample of the US population. SUBJECTS Children aged 6-11 years (n 4269) and adolescents aged 12-19 years (n 6193) in the National Health and Nutrition Examination Survey 2003-2012. RESULTS Irrespective of the definition of meals, higher MF was associated with higher HEI-2010 in both children and adolescents. One additional meal per day increased HEI-2010 by 1·45-3·59 points (all P<0·005). Conversely, the associations for SF were inconsistent. While SF based on energy contribution was positively associated with HEI-2010 in both children and adolescents (0·70 (P=0·001) and 1·00 (P<0·0001) point increase by one additional snack, respectively), there were no associations for SF based on self-report or time. In analyses in which only plausible energy reporters (3425 children and 3753 adolescents) were included, similar results were obtained. CONCLUSIONS In a representative sample of US children and adolescents, MF was associated with better diet quality, while the associations for SF varied depending on the definition of snacks. The findings highlight the importance of applying different definitions of meals and snacks when assessing the impact of dietary patterns on health.
Collapse
|
41
|
Decreasing the number of small eating occasions (<15 % of total energy intake) regardless of the time of day may be important to improve diet quality but not adiposity: a cross-sectional study in British children and adolescents. Br J Nutr 2015; 115:332-41. [PMID: 26568443 DOI: 10.1017/s0007114515004420] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Evidence of associations between meal frequency (MF) and snack frequency (SF) and diet and obesity in young populations is limited. This cross-sectional study examined MF and SF in relation to dietary intake and adiposity measures in British children aged 4-10 years (n 818) and adolescents aged 11-18 years (n 818). Based on data from a 7-d weighed dietary record, all eating occasions were divided into meals or snacks on the basis of contribution to energy intake (≥15 or <15 %) or time (06.00-10.00, 12.00-15.00 and 18.00-21.00 hours or others). All measures of MF and SF showed positive associations with energy intake, except for MF based on energy contribution in children. Irrespective of the definition of snacks, SF was associated with higher intakes of soft drinks, confectionery and total sugar, lower intakes of cereals, fish, meat, protein, PUFA, starch and dietary fibre, and a lower diet quality (assessed by the Mediterranean diet score, except for SF based on energy contribution in adolescents). MF based on time, but not based on energy contribution, was associated with higher intakes of confectionery and total sugar, lower intakes of fish, protein, PUFA and starch, and, only in children, a lower diet quality. All measures of MF and SF showed no association with adiposity measures. In conclusion, this cross-sectional study in British children and adolescents suggests that decreasing the number of small eating occasions (<15 % of total energy intake) regardless of the time of day may be important to improve diet quality but not adiposity.
Collapse
|
42
|
Taillie LS, Afeiche MC, Eldridge AL, Popkin BM. Increased Snacking and Eating Occasions Are Associated with Higher Energy Intake among Mexican Children Aged 2-13 Years. J Nutr 2015; 145:2570-7. [PMID: 26377759 PMCID: PMC6457092 DOI: 10.3945/jn.115.213165] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 05/31/2015] [Accepted: 08/17/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Little is known about the dietary behaviors of Mexican children with regard to frequency, amount, and quality of foods consumed at eating occasions and their impact on total daily energy intake. OBJECTIVES The objectives were to 1) describe foods consumed across eating occasions and 2) examine whether the number or type of total eating occasions was associated with increased total daily energy intake and differed between 2- to 5-y-old and 6- to 13-y-old Mexican children. METHODS A nationally representative sample of 5031 children from the 2012 ENSANUT (Encuesta Nacional de Salud y Nutrición) was used to examine the percentage of meals and snacks consumed, mean energy intake from meals and snacks, and the top food groups contributing to meals and snacks. Multivariate linear regression was used to examine the association between meals, snacks, and total eating occasions with daily energy intake for 2- to 5-y-old and 6- to 13-y-old children. RESULTS Eating patterns were similar across age groups (per capita mean intake of 3 meals and 1.4-1.6 snacks/d). Each additional snack was associated with greater increases in mean daily energy for older children (+191-289 kcal/d; P < 0.01) relative to younger children (+102-130 kcal/d; P < 0.01). Likewise, each additional eating occasion was associated with greater increases in mean daily energy for older children (+323 kcal/d; P < 0.01) relative to younger children (+166-261 kcal/d; P < 0.01). In both younger and older children, snacking was prevalent (75% and 68%, respectively). Top food contributors to snacks included fruit, salty snacks, candy, sweetened breads, and cookies. Among older children, whole milk as a snack was partially replaced with soda and sweetened fruit drinks. CONCLUSION Snacks represent an area for potential improvement in the diets of Mexican children, especially among those aged 6 to 13 y, for whom each additional snack or eating occasion was linked to even greater increases in total daily energy intake.
Collapse
Affiliation(s)
| | | | | | - Barry M Popkin
- Department of Nutrition, University of North Carolina, Chapel Hill, NC; and
| |
Collapse
|
43
|
Reicks M, Banna J, Cluskey M, Gunther C, Hongu N, Richards R, Topham G, Wong SS. Influence of Parenting Practices on Eating Behaviors of Early Adolescents during Independent Eating Occasions: Implications for Obesity Prevention. Nutrients 2015; 7:8783-801. [PMID: 26506384 PMCID: PMC4632451 DOI: 10.3390/nu7105431] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 09/22/2015] [Accepted: 10/12/2015] [Indexed: 12/16/2022] Open
Abstract
Among early adolescents (10-14 years), poor diet quality along with physical inactivity can contribute to an increased risk of obesity and associated biomarkers for chronic disease. Approximately one-third of United States (USA) children in this age group are overweight or obese. Therefore, attention to factors affecting dietary intake as one of the primary contributors to obesity is important. Early adolescents consume foods and beverages during eating occasions that occur with and without parental supervision. Parents may influence eating behaviors of early adolescents during eating occasions when they are present or during independent eating occasions by engaging in practices that affect availability of foods and beverages, and through perceived normative beliefs and expectations for intake. Therefore, the purpose of this article was to describe the influence of parenting practices on eating behaviors in general and when specifically applied to independent eating occasions of early adolescents. This information may be helpful to inform parenting interventions targeting obesity prevention among early adolescents focusing on independent eating occasions.
Collapse
Affiliation(s)
- Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Ave., St. Paul, MN 55108-6099, USA.
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, Agricultural Sciences 216, University of Hawaii at Manoa, 1955 East-West Rd, Honolulu, HI 96822, USA.
| | - Mary Cluskey
- College of Public Health and Human Sciences, Nutrition, Oregon State University, 101 Milam Hall, Corvallis, OR 97331-3303, USA.
| | - Carolyn Gunther
- Department of Human Sciences, the Ohio State University, 313 Campbell Hall, 1787 Neil Ave, Columbus, OH 43210, USA.
| | - Nobuko Hongu
- Department of Nutritional Sciences, University of Arizona, 406 Shantz Building, 1177 E. 4th Street, Tucson, AZ 85721-0038, USA.
| | - Rickelle Richards
- Department of Nutrition, Dietetics & Food Science, Brigham Young University, S233 Eyring Science Center, Provo, UT 84602, USA.
| | - Glade Topham
- Department of Human Development and Family Science, Oklahoma State University, 243 Human Sciences, Stillwater, OK 74078, USA.
| | - Siew Sun Wong
- College of Public Health and Human Sciences, School of Biological and Population Health Sciences, Hallie E. Ford Center for Healthy Children and Families, Extension Family and Community Health Program, Nutrition, Oregon State University, Ballard Hall 105E, Corvallis, OR 97331-3303, USA.
| |
Collapse
|
44
|
Abstract
PURPOSE To describe the effects of number of eating occasions and snacks on dietary quality (DQ), defined as adherence to dietary recommendations. METHODS A sample of 884 adolescents (11-18 years) in the UK National Diet and Nutrition Survey (NDNS) were included. The Diet Quality Index for Adolescents (DQI-A) was implemented. The total number of eating occasions and snacks was frequency of food or beverages consumed over 24 h and frequency of foods or beverages consumed outside of the three mealtimes, respectively. Results were generated with and without low-energy food under 210 kJ (50 kcal). Regression models were generated with DQ score as the outcome variable and number of eating occasions and snacks as predictors. RESULTS The mean (95 % CI) DQ score was 31.1 % (30.2, 32.0). The mean number of eating occasions and snacks was 7.5 (7.3, 7.7) and 2.6 (2.6, 2.7) times/day, respectively. When low-energy events were excluded, the mean number of eating occasions and snacks reduced to 6.2 (6.1, 6.4) and 2.0 (2.0, 2.1) times/day, respectively. DQ score increased by 0.74 points (0.42, 1.05; p < 0.01) and 0.55 points (-0.08, 0.69; p = 0.17) for total eating occasions and snacks, respectively. When low-energy events were excluded, DQ score increased by 0.30 points (-0.84, 0.69; p = 0.13) for each eating occasion and decreased by 1.20 points (-2.1, -0.3; p < 0.01) for each snack. CONCLUSION Eating more frequently improves dietary quality especially if some eating occasions are low in energy. A focus on replacing high-energy snacks with low-energy alternatives rather than reducing the number of eating occasions may result in improved dietary quality in adolescents.
Collapse
|
45
|
Snacking for a cause: nutritional insufficiencies and excesses of U.S. children, a critical review of food consumption patterns and macronutrient and micronutrient intake of U.S. children. Nutrients 2014; 6:4750-9. [PMID: 25360509 PMCID: PMC4245561 DOI: 10.3390/nu6114750] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 09/04/2014] [Accepted: 10/16/2014] [Indexed: 11/17/2022] Open
Abstract
The objective of this review was to identify dietary insufficiencies and excesses in children aged two to 11 in the United States (U.S.) and eating habits that merit concern in terms of nutrient and energy density to improve overall diet quality. Data from the What We Eat in America (WWEIA) tables from the National Health and Nutrition Examination Survey (NHANES) were examined as well as survey data from the School Nutrition Dietary Assessment Study (SNDA). Analysis of survey data revealed that children consume insufficient Vitamin D, calcium, and potassium and excess energy, carbohydrates, and sodium. Dietary modifications are necessary to prevent serious deficiencies and the development of chronic illness. Snacking has steadily increased in this population since the 1970s, and snacks provide necessary nutrients. However, carbohydrates and added sugars tend to be over-consumed at snacking occasions. Replacement of current snack choices with nutrient-dense foods could lower the risks of nutrient deficiencies and help lower excess nutrient consumption. Increased consumption of low sugar dairy foods, especially yogurt, at snack times could increase intake of important micronutrients without contributing to dietary excesses.
Collapse
|