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Sisay BG, Lacy KE, McNaughton SA, Leech RM. Comparison of snack characteristics by diet quality findings from a nationally representative study of Australian adolescents. Sci Rep 2024; 14:23663. [PMID: 39390215 PMCID: PMC11466951 DOI: 10.1038/s41598-024-75386-1] [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: 04/07/2024] [Accepted: 10/04/2024] [Indexed: 10/12/2024] Open
Abstract
Snacking is a common dietary behaviour among adolescents contributing to more than one quarter of their total energy intake; however, the relationship between snacks and diet quality remains unclear. Hence, this study aimed to examine the characteristics of snacks among adolescents with different levels of diet quality. Dietary data collected from a nationally representative sample of Australian adolescents (12-18 years old, n = 935) using one 24-hour dietary recall in the National Nutrition and Physical Activity Survey were analysed. Snacks were defined based on participant-identified eating occasions, and diet quality was assessed using the Dietary Guideline Index for Children and Adolescents (DGI-CA). Marginal means and proportion of snack characteristics including snack frequency, snack energy density (ED), and commonly consumed foods at snack from the five food groups and discretionary foods at snack across DGI-CA tertiles (highest tertile indicating high guideline adherence) were estimated for both boys and girls using linear regression and logistic regression. Differences in means were tested using the F-test. The results showed no significant differences in the mean frequency of snacks across tertiles of DGI-CA scores. The mean ED of snacks decreased as DGI-CA scores increased in both boys (lowest tertile = 8.4, 95% CI [7.1, 10.0] kJ/g, highest tertile = 6.3 [5.4, 7.4] kJ/g) and girls (lowest tertile = 9.0 [7.8, 10.3] kJ/g, highest tertile = 5.9 [5.1, 6.9] kJ/g). As diet quality improved, the proportion of adolescents consuming discretionary (i.e., unhealthy) foods and foods from the five food group foods as snacks decreased and increased, respectively. In conclusion, adolescents with higher diet quality consumed snacks with a lower ED while lower proportion of them consume discretionary foods, and higher proportion of them consume from the five food groups. Encouraging the consumption of foods from the five food groups with lower ED as snacks presents an opportunity to enhance adolescent diet quality.
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Affiliation(s)
- Binyam Girma Sisay
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, 221 Burwood Highway, 3125, Burwood, VIC, Australia.
| | - Kathleen E Lacy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, 221 Burwood Highway, 3125, Burwood, VIC, Australia
| | - Sarah A McNaughton
- Health and Well-Being Centre for Research Innovation, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, 4067, Australia
| | - Rebecca M Leech
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, 221 Burwood Highway, 3125, Burwood, VIC, Australia
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Leak TM, Overcash F, Reicks M, Leung CW, Barr-Anderson DJ, Censani M. Diet and Physical Activity by Prediabetes Status Among U.S. Adolescents: National Health and Nutrition Examination Survey, 2007-2018. Child Obes 2024; 20:543-548. [PMID: 38346326 DOI: 10.1089/chi.2023.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2024]
Abstract
Background: Prediabetes among adolescents is on the rise, yet it is unclear if modifiable risk factors vary by prediabetes status. Methods: This study examined associations between diet (primary objective) and physical activity (secondary objective) by prediabetes status among U.S. adolescents (12-19 years) who participated in the National Health and Nutrition Examination Survey from 2007-2018. Differences in Healthy Eating Index (HEI)-2015-2020 scores (total and 13 component scores), nutrients of public health concern, and physical activity were examined by prediabetes status (no prediabetes vs. prediabetes). Results: Adolescents (n = 2,487) with prediabetes had significantly lower whole grains component scores and intakes of vitamin D, phosphorus, and potassium (all p < .05), than adolescents without prediabetes. Physical activity levels were not optimal for either group, there were no differences by prediabetes status (n = 2,188). Conclusion: Diabetes prevention interventions for adolescents are needed and should promote a healthy diet target and encourage physical activity.
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Affiliation(s)
- Tashara M Leak
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Francine Overcash
- Department of Food Science and Nutrition, University of Minnesota, Twin Cities, Saint Paul, MN, USA
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, Twin Cities, Saint Paul, MN, USA
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | | | - Marisa Censani
- Division of Pediatric Endocrinology, Weill Cornell Medicine, New York, NY, USA
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Sisay BG, McNaughton SA, Lacy KE, Leech RM. Associations between the nutritional quality of snacks, overall diet quality and adiposity: findings from a nationally representative study of Australian adolescents. Br J Nutr 2024:1-10. [PMID: 39290093 DOI: 10.1017/s0007114524001727] [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: 09/19/2024]
Abstract
The primary aim of this study was to examine the association between snack nutritional quality, overall diet quality and adiposity among Australian adolescents. The secondary aim was to assess the distribution of discretionary foods (i.e. energy-dense and nutrient-poor foods and beverages) and intakes from the five food groups at different levels of snack nutritional quality. Dietary data collected from nationally representative adolescents (12-18 years old) during a 24-h dietary recall in the National Nutrition and Physical Activity Survey were analysed (n 784). Snacks were defined based on participant-identified eating occasions. Snack nutritional quality was assessed using the Nutrient Profiling Scoring Criterion (NPSC), whereas diet quality was evaluated using the Dietary Guideline Index for Children and Adolescents. Adiposity was assessed through BMI Z-score waist circumference and waist:height ratio (WHtR). Higher nutritional quality of snacks, as assessed by the NPSC, has been associated with higher diet quality among both boys and girls (P < 0·001). However, there is no association between snacks nutritional quality with BMI Z-score, waist circumference and WHtR. Among both boys and girls, the consumption of fruits, vegetables and legumes/beans at snacks increased with improvement in snack nutritional quality. Conversely, the consumption of discretionary foods at snack decreased with improvement in snack nutritional quality. In conclusion, improved snack quality was associated with better diet quality in adolescents. However, there was no association between snack nutritional quality and adiposity. Future, snack nutrition quality indices should consider optimum snack characteristics related with adiposity and diet quality.
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Affiliation(s)
- Binyam Girma Sisay
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC3125, Australia
| | - Sarah A McNaughton
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
- Health and Well-Being Centre for Research Innovation, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD4067, Australia
| | - Kathleen E Lacy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC3125, Australia
| | - Rebecca M Leech
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC3125, Australia
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Saltaouras G, Kyrkili A, Bathrellou E, Georgoulis M, Yannakoulia M, Bountziouka V, Smrke U, Dimitrakopoulos G, Kontogianni MD. Associations between Meal Patterns and Risk of Overweight/Obesity in Children and Adolescents in Western Countries: A Systematic Review of Longitudinal Studies and Randomised Controlled Trials. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1100. [PMID: 39334632 PMCID: PMC11430606 DOI: 10.3390/children11091100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/30/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024]
Abstract
Childhood overweight/obesity (OV/OB) is a major public health problem in Western countries, often accompanied with comorbidities (e.g., hypertension and insulin resistance) (i.e., metabolically unhealthy obesity-MUO). Among diet-related risk factors of OV/OB risk and MUO, meal patterns remain limitedly studied. The aim of this systematic review was to explore associations between meal patterns and the risk of childhood OV/OB and MUO in children/adolescents aged 2-19 years. Longitudinal studies and randomised controlled trials from PUBMED and Scopus published between January 2013 and April 2024 were retrieved. Twenty-eight studies were included, all of which reported on OV/OB risk, with none on MUO risk. Regular consumption of breakfast (n = 3) and family meals (n = 4) and avoiding dining while watching TV (n = 4) may be protective factors against childhood OV/OB, whereas meal skipping (primarily breakfast; n = 4) may be a detrimental factor. Mixed effects of meal frequency on OV/OB risk were observed; no effects of frequency of lunch or of fast-food consumption and of meals served at school were found. There was insufficient evidence to support the role of other patterns (meal timing, eating in other social contexts). Meals were mainly participant-identified, leading to increased heterogeneity. Research focusing on childhood MUO and the use of harmonised definitions regarding the assessment of meal patterns are highly warranted.
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Affiliation(s)
- Georgios Saltaouras
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Athanasia Kyrkili
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Eirini Bathrellou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
| | - Vasiliki Bountziouka
- Computer Simulation, Genomics and Data Analysis Laboratory, Department of Food Science and Nutrition, University of the Aegean, 81400 Lemnos, Greece;
- Department of Cardiovascular Science, College of Life Science, University of Leicester, Leicester LE1 7RH, UK
- NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester LE3 9QP, UK
- Population, Policy and Practice Research and Teaching Department, GOS Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Urška Smrke
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia;
| | - George Dimitrakopoulos
- Department of Informatics and Telematics, School of Digital Technology, Harokopio University of Athens, 17671 Athens, Greece;
| | - Meropi D. Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17671 Athens, Greece; (G.S.); (A.K.); (E.B.); (M.G.); (M.Y.)
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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.
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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
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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.
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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.)
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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.
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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
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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: 29] [Impact Index Per Article: 9.7] [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.
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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
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Setiono FJ, Guerra LA, Leung C, Leak TM. Sociodemographic characteristics are associated with prevalence of high-risk waist circumference and high-risk waist-to-height ratio in U.S. adolescents. BMC Pediatr 2021; 21:215. [PMID: 33941130 PMCID: PMC8091763 DOI: 10.1186/s12887-021-02685-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adiposity status in adolescence is associated with various health outcomes in adulthood. Waist circumference [WC] and waist-to-height ratio [WHtR] are measures of abdominal obesity and have shown to be valid predictors of future chronic diseases. However, the relationship between sociodemographic characteristics and WC, as well as WHtR in U.S. adolescents remain unclear. Thus, the study aims to examine associations between sociodemographic characteristics and abdominal obesity among a nationally representative sample of U.S. adolescents. METHODS The sample included 4712 adolescents (12-19 years) in the 2007-2016 National Health and Nutrition Examination Survey. Associations between sociodemographic characteristics and abdominal obesity (WC and WHtR) were examined using multiple logistic regression models, adjusted for age, physical activity level, and sedentary activity. RESULTS Around 18% of adolescents had high-risk WC (≥90th percentile) and 34% had high-risk WHtR (≥0.5). Females had higher odds of high-risk WHtR compared to males (OR = 1.46, 95%CI = 1.23-1.72). Mexican American adolescents had higher odds of high-risk WHtR compared to non-Hispanic White (OR = 1.66, 95%CI = 1.24-2.20), non-Hispanic Black (OR = 1.73, 95%CI = 1.26-2.36), and other race/multi-racial adolescents (OR = 1.84, 95%CI = 1.21-2.80). When their parent were college graduates, adolescents had lower odds for high-risk WC compared to when the parent had some college education (OR = 0.68, 95%CI = 0.49-0.93) or a high school degree or less (OR = 0.70, 95%CI = 0.51-0.97). Similar associations were seen between parental education level and high-risk WHtR, as well as between household income and high-risk WHtR. CONCLUSIONS Measures of abdominal obesity should be considered to assess burden of adiposity, especially among female adolescents, adolescents from racial/ethnic minority and low socioeconomic status backgrounds. Additionally, future health interventions should consider including changes in WC and WHtR to measure the impact of these interventions.
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Affiliation(s)
- Felicia J Setiono
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14853, USA.
| | - Laura A Guerra
- Department of Health & Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Cindy Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Tashara M Leak
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14853, USA
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10
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Snacking in Japanese nursery school children aged 3-6 years: its characteristics and contribution to overall dietary intake. Public Health Nutr 2020; 24:1042-1051. [PMID: 32390580 DOI: 10.1017/s1368980019005007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This cross-sectional study evaluated the dietary characteristics of snacks, the contribution of snacks to daily nutrient intake and the association of energy intake (EI) from snacks with the prevalence of nutritional inadequacy in Japanese nursery school children. DESIGN Foods and nutrients consumed in each eating occasion were assessed by 3-d dietary records. The prevalence of inadequate intake of twenty nutrients assessed by the age- and sex-specific reference values in the Japanese Dietary Reference Intakes was compared according to tertile categories of EI from snacks. SETTING A multi-regional dietary survey based on nursery schools in Japan. PARTICIPANTS A total of 187 boys and 191 girls aged 3-6 years. RESULTS EI from snacks accounted for 19·5 % (sd 6·9) of total daily EI. Confectionaries accounted for the largest part of EI from snacks (35·3 %), followed by milk (19·5 %). Relative to their energy contribution, snacks accounted for a small proportion for all nutrients examined, except for free sugar, calcium, SFA and riboflavin. Although a higher EI from snacks was associated with favourable profiles for intakes of calcium, iron, thiamine and riboflavin, excessive intakes of free sugar and Na were more prevalent among children with a higher EI from snacks. CONCLUSIONS Although snacks are effective in meeting the requirement of some nutrients among Japanese nursery school children, snacks are generally not nutrient-dense and have an impact on excessive intake of some nutrients. There is hence room for improvement in food choices at snack time.
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Tripicchio GL, Kachurak A, Davey A, Bailey RL, Dabritz LJ, Fisher JO. Associations between Snacking and Weight Status among Adolescents 12-19 Years in the United States. Nutrients 2019; 11:nu11071486. [PMID: 31261906 PMCID: PMC6682988 DOI: 10.3390/nu11071486] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/14/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022] Open
Abstract
Snacking is a significant contributor to energy intake among adolescents, but its association with weight status is unclear. To elucidate this association, data from 6545 adolescents (12-19 years) in the 2005-2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. The mean number of daily snack occasions, mean snack size, and mean snack energy density were examined by weight classification (body mass index (BMI)-for-age percentiles: normal weight (NW) <85th; overweight (OW) ≥85th to <95th; obese (OB) ≥95th). Models included all snacking parameters, mean meal size, demographic characteristics, survey cycle year, and dietary reporting accuracy. Adolescents with NW consumed fewer snacks daily (1.69 (0.02) snacks/day) and smaller snacks per occasion (262.32 (4.41) calories (kcal)/snack) compared to adolescents with OW (1.85 (0.05) snacks/day, p = 0.005; 305.41 (8.84) kcal/snack, p < 0.001), and OB (1.97 (0.05) snacks/day; 339.60 (10.12) kcal/snack, both p < 0.001). Adolescents with OW and OB also consumed more added sugar, saturated fat and sodium from snacks, but had lower mean energy density per snack compared to snacks consumed by NW adolescents. US adolescents with OW and OB consume more snacks daily and more calories at each snacking occasion compared to adolescents with NW. Future studies should examine the prospective associations between snacking and weight status and impact on overall diet quality.
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Affiliation(s)
- Gina L Tripicchio
- Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA.
| | - Alexandria Kachurak
- Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA
| | - Adam Davey
- Behavioral Health and Nutrition, University of Delaware, Newark, DE 19716, USA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Lauren J Dabritz
- Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA
| | - Jennifer O Fisher
- Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA
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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.
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Barrera CM, Moore LV, Perrine CG, Hamner HC. Number of Eating Occasions and Source of Foods and Drinks Among Young Children in the United States: NHANES, 2009⁻2014. Nutrients 2019; 11:E897. [PMID: 31010096 PMCID: PMC6521130 DOI: 10.3390/nu11040897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 11/16/2022] Open
Abstract
An understanding of the source of children's foods and drinks is needed to identify the best intervention points for programs and policies aimed at improving children's diets. The mean number and type of eating occasions and the relative proportions of foods and drinks consumed from different sources were calculated among children aged 1-4 years (n = 2640) using data from the 2009-2014 National Health and Nutrition Examination Surveys. Children consumed 2.9 meals and 2.4 snacks each day. Among children who received anything from childcare, childcare provided 36.2% of their foods and drinks. The majority of foods and drinks came from stores for all children (53.2% among those receiving anything from childcare and 84.9% among those not). Among children receiving food from childcare, childcare is an important source of foods and drinks. Because most foods and drinks consumed by children come from stores, parents and caregivers may benefit from nutrition education to promote healthful choices when buying foods.
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Affiliation(s)
- Chloe M Barrera
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop F-77 Atlanta, GA 30341, USA.
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop F-77 Atlanta, GA 30341, USA.
| | - Cria G Perrine
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop F-77 Atlanta, GA 30341, USA.
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop F-77 Atlanta, GA 30341, USA.
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Potter M, Vlassopoulos A, Lehmann U. Snacking Recommendations Worldwide: A Scoping Review. Adv Nutr 2018; 9:86-98. [PMID: 29659681 PMCID: PMC5962965 DOI: 10.1093/advances/nmx003] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/16/2017] [Accepted: 10/12/2017] [Indexed: 10/17/2022] Open
Abstract
Across the globe, dietary habits include the consumption of foods and drinks between main meals. Although often described as "snacks" or "snacking," there is no scientific consensus of what constitutes a snack, either as an eating occasion or as a snack food. Nonetheless, food-based dietary guidelines, compiled at national or regional levels by governments, learned societies, and health organizations, frequently refer to snacking habits and desirable or undesirable snack food choices. This review aims to provide a comprehensive snapshot of snacking recommendations worldwide. From a search of 207 countries and organizations, 49 countries and 7 regional or global organizations were identified that referred to snacks, snack foods, or snacking. A total of 136 snacking-specific recommendations or examples were identified, which varied in nature whereby some provided advice on the quality of the snack food choice and others focused on the frequency or energy and nutrient composition of such snacks. Guidelines varied in terms of the detail of foods and drinks identified, wherein some recommendations focused only on foods or food categories to include (e.g., fruit or dairy) or to exclude (e.g., processed foods), whereas other recommendations made reference to both. Both individual foods (e.g., apples) and food categories (e.g., fruit) were mentioned. Reasons or rationales to support the snacking choices were less frequently identified and varied across regions. It is hoped that this analysis will stimulate discussion on the need for a consensus in the scientific community and beyond with regard to snacking. An agreed-upon definition of snacks, snacking, and snack foods could be used to inform a number of stakeholders and ultimately help consumers adhere to healthful diets as defined locally.
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Affiliation(s)
- Monika Potter
- Nutrient Profiling, Consumer Science and Applied Nutrition, Institute of Material Sciences, Nestlé Research Center, Lausanne, Switzerland
| | - Antonis Vlassopoulos
- Nutrient Profiling, Consumer Science and Applied Nutrition, Institute of Material Sciences, Nestlé Research Center, Lausanne, Switzerland
| | - Undine Lehmann
- Nutrient Profiling, Consumer Science and Applied Nutrition, Institute of Material Sciences, Nestlé Research Center, Lausanne, Switzerland
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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.
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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
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Abstract
OBJECTIVE Eating less frequently is associated with increased obesity risk in older children but data are potentially confounded by reverse causation, where bigger children eat less often in an effort to control their weight. Longitudinal data, particularly in younger children, are scarce. We aimed to determine whether eating frequency (meals and snacks) at 2 years of age is associated with past, current or subsequent BMI. DESIGN Cohort analysis of a randomised controlled trial. Eating frequency at 2 years of age was estimated using 48 h diaries that recorded when each child ate meals and snacks (parent-defined) in five-minute blocks. Body length/height and weight were measured at 1, 2 and 3·5 years of age. Linear regression assessed associations between the number of eating occasions and BMI Z-score, before and after adjustment for potential confounding variables. SETTING Prevention of Overweight in Infancy (POI) study, Dunedin, New Zealand. SUBJECTS Children (n 371) aged 1-3·5 years. RESULTS On average, children ate 5·5 (sd 1·2) times/d at 2 years of age, with most children (88-89 %) eating 4-7 times/d. Eating frequency at 2 years was not associated with current (difference in BMI Z-score per additional eating occasion; 95 % CI: -0·02; -0·10, 0·05) or subsequent change (0·02; -0·03, 0·06) in BMI. Similarly, BMI at age 1 year did not predict eating frequency at 2 years of age (difference in eating frequency per additional BMI Z-score unit; 95 % CI: -0·03; -0·19, 0·13). CONCLUSIONS Number of eating occasions per day was not associated with BMI in young children in the present study.
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