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Prapkree L, Deringer R, Coccia C, Huffman F, Palacios C. Effect of using the snackability app on snack quality among US college students with overweight and obesity: A randomized controlled trial. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-10. [PMID: 38652645 DOI: 10.1080/07448481.2024.2337008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To determine if using the Snackability app improves snack intake among college students. PARTICIPANTS US college students with overweight/obesity were recruited in June 2020-April 2021. METHODS A randomized controlled trial was conducted to test the Snackability app use for 12 wk on snack scores (calculated from the app) compared to controls. We also explored the effect on diet quality (Healthy Eating Index-2015) and weight. Outcomes were compared between the intervention and the control groups at 4, 8, and 12 wk using repeated measures ANOVA. RESULTS Participants in the app group significantly increased snack score at week 4 (p < 0.001) and week 8 (p = 0.015) and increased HEI-2020 score (p < 0.001) at week 4 compared to controls. The first 4 wk had the highest app usage. No significant differences were seen in body weight. CONCLUSIONS The Snackability app can be used as a tool to help improve snack and diet quality in this group.
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Affiliation(s)
- Lukkamol Prapkree
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Rianna Deringer
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Catherine Coccia
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Fatma Huffman
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
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Godden E, Cutello CA, Dens N. The impact of nutritional labeling on adult snack choices: A controlled field experiment in a non-commercial professional setting. Appetite 2024; 193:107167. [PMID: 38113983 DOI: 10.1016/j.appet.2023.107167] [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: 08/21/2023] [Revised: 11/23/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023]
Abstract
Each year, 2.8 million people die because of comorbidities associated with being overweight. Snacking substantially contributes to people's calorie intake. One way to nudge consumers towards healthier alternatives is the implementation of nutritional labeling. This study reports on a controlled field experiment that evaluates the effect of two nutritional labels on free snack choices (n = 739). Participants at a conference could choose between nuts, cookies, and candy bars as a snack, presented at the bar at six different locations across 2 bar counters. The labels were set up in front of each snack in three conditions: no labeling (control), a calorie label, or a traffic light label (i.e., the Nutri-Score). The location of the snacks on the counter (Either side of the counter; Center, Right, Left) and the time-of-day (Morning (=reference) vs Afternoon) were statistically controlled for. The results show that calorie labels could not successfully nudge consumers toward healthier snack choices (nuts instead of candy bars or cookies). In contrast, the Nutri-Score label significantly increased the probability of choosing nuts over candy bars. The Nutri-Score also increased the chance of choosing nuts over cookies, but the difference was not significant. No prior studies to our knowledge have directly compared calorie labels to the Nutri-Score. This study suggests that the Nutri-Score label can be a more successful intervention than calorie labels to nudge consumers towards healthier choices in situations were free snacks are offered, like many modern workplaces. Changing snacking behavior is challenging and naturalistic field experiments like this one are needed to translate the theory from previous laboratory studies to real-life settings.
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Affiliation(s)
- Elke Godden
- University of Antwerp, Faculty of Business and Economics, Prinsstraat 13, 2000, Antwerpen, Belgium.
| | - Clara Alida Cutello
- University of Antwerp, Faculty of Business and Economics, Prinsstraat 13, 2000, Antwerpen, Belgium; University of Basel, Behavioral Marketing Team, Faculty of Business and Economics, Peter Merian-Weg 6 (Postfach), 4002, Basel, Switzerland(1).
| | - Nathalie Dens
- University of Antwerp, Faculty of Business and Economics, Prinsstraat 13, 2000, Antwerpen, Belgium.
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Fu H, Lee CH, Nolden AA, Kinchla AJ. Nutrient Density, Added Sugar, and Fiber Content of Commercially Available Fruit Snacks in the United States from 2017 to 2022. Nutrients 2024; 16:292. [PMID: 38257185 PMCID: PMC10820108 DOI: 10.3390/nu16020292] [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: 12/22/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Fruit snacks have become a popular and convenient snacking choice and have the potential to contribute to a well-balanced diet. However, the nutritional quality of fruit snack products has not yet been studied. The objective of the present study is to provide a nutritional assessment of the fruit snack product category. This study used the Mintel Global New Product Database to collect data about fruit snack products launched in the United States from 2017 to 2022. Fruit snack products (n = 2405) are divided into nine product categories based on product characteristics. Nutrition composition was assessed using a comprehensive score, Nutrient Rich Food (NRF) model, and by examining individual components (added sugar and fiber). The results show that dried fruit has the highest nutrient density, fiber content, and the lowest added sugar content. Conversely, fruit-flavored snacks have the lowest nutrient density, fiber content, and added sugar content. Currently, fruit puree, canned fruit with juice, and dried fruit are the only fruit snacks that meet the current recommendations set by the USDA Dietary Guidelines. Future directions for the fruit snack category should consider decreasing the added sugar content, increasing the fiber content, and enhancing their sensory profile to improve the overall nutrient density.
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Affiliation(s)
- Hao Fu
- Department of Food Science, College of Natural Science, University of Massachusetts, Amherst, MA 01003, USA (A.A.N.)
| | - Chi Hyun Lee
- Department of Biostatistics, School of Public Health, University of Massachusetts, Amherst, MA 01003, USA
| | - Alissa A. Nolden
- Department of Food Science, College of Natural Science, University of Massachusetts, Amherst, MA 01003, USA (A.A.N.)
| | - Amanda J. Kinchla
- Department of Food Science, College of Natural Science, University of Massachusetts, Amherst, MA 01003, USA (A.A.N.)
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Bennett G, O'Hara C, Bardon LA, Gibney ER. Comparison of Meal Patterns Across Common Racial Groups in the UK and the USA, Examining Associations with Weight Status and Diet Quality: a Secondary Analysis of NDNS and NHANES Datasets. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01890-1. [PMID: 38102513 DOI: 10.1007/s40615-023-01890-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Understanding diets of population subgroups is essential for monitoring health of diversifying populations, but currently, meal patterns of many population subgroups are not widely known. This paper aimed to identify meal patterns of racial groups in the UK and USA, considering if racial groups exhibit similar patterns of intake irrespective of location and relationships between meal patterns and health parameters. DESIGN Data were extracted from the UK (National Diet and Nutrition Survey) and the USA (National Health and Nutrition Examination Survey) national dietary surveys. Temporal and content meal patterns among racial groups in the UK and USA (White, Black, Asian and Other, n = 1780 and n = 4339, respectively) were examined. Kruskal-Wallis tests were applied to understand differences across groups. Logistic regression models identified associations between meal patterns and body mass index and diet quality. RESULTS Black groups consumed fewer eating occasions than White and Other groups in both countries, while UK racial groups consumed significantly more snacks than USA groups. Food group contribution to eating occasion consumption was similar across countries where Asian groups in the USA and UK had the lowest meat intake at lunch and dinner. Meal frequency was positively associated with diet quality. CONCLUSIONS Overall, meal patterns differ across racial groups within a single country, and some differences were observed within groups of the same race across countries. Learnings from this research highlight the differences in consumption patterns across racial groups and the importance of considering a meal-based approach to dietary guidelines by racial group.
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Affiliation(s)
- G Bennett
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - C O'Hara
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | - L A Bardon
- Quadram Institute Bioscience, Norwich Research Park, Norwich, UK
| | - E R Gibney
- UCD Institute of Food and Health, University College Dublin, Dublin, Ireland.
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.
- Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.
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5
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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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Okpiaifo GE, Dormoy-Smith B, Kassas B, Gao Z. Perception and demand for healthy snacks/beverages among US consumers vary by product, health benefit, and color. PLoS One 2023; 18:e0287232. [PMID: 37327182 PMCID: PMC10275438 DOI: 10.1371/journal.pone.0287232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/01/2023] [Indexed: 06/18/2023] Open
Abstract
Concerns about the numerous health problems associated with unhealthy snacks prompted recommendations to steer individuals toward healthier eating habits. One such recommendation advises limiting unhealthy snacks and replacing them with more fruits and vegetables with significant health benefits. This study investigates US consumers' perceptions and preferences for healthy (vegetable-based) snacks/beverages. An online survey was designed to estimate consumer perception and willingness-to-pay (WTP) for vegetable-based crackers, spreads, and beverages. A sampling company sent the survey to its national consumer panels in 2020, resulting in a sample of 402 US consumers. Eligible participants were adults, primary grocery shoppers who consumed crackers, spreads, and beverages. Consumer WTP for healthy snacks/beverages, the dependent variable, was elicited using a payment card method. Independent variables include personality traits (Innovativeness and Extraversion) and the important factors affecting healthy snack purchases, health consciousness, and demographic variables. Results show that consumers' preferences for healthy snacking vary by product, even when the products have similar health benefits. Significant positive associations exist between WTP for healthy snacks/beverages and personality traits, health consciousness, and some demographics. This study provides critical insights to policymakers and informs marketing campaigns to promote healthy snacking in the US more effectively.
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Affiliation(s)
- Glory Esohe Okpiaifo
- Food and Resource Economics Department, University of Florida, Gainesville, Florida, United States of America
| | - Bertille Dormoy-Smith
- Food and Resource Economics Department, University of Florida, Gainesville, Florida, United States of America
| | - Bachir Kassas
- Food and Resource Economics Department, University of Florida, Gainesville, Florida, United States of America
| | - Zhifeng Gao
- Food and Resource Economics Department, University of Florida, Gainesville, Florida, United States of America
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7
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Peterson L, Lee H, Huybrechts I, Biessy C, Neuhouser ML, Haaland B, Krick B, Gunter M, Schulze MB, Jannasch F, Coletta AM, Hardikar S, Chaix A, Bauer CX, Xiao Q, Playdon MC. Reliability estimates for assessing meal timing derived from longitudinal repeated 24-hour dietary recalls. Am J Clin Nutr 2023; 117:964-975. [PMID: 36921904 PMCID: PMC10206325 DOI: 10.1016/j.ajcnut.2023.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 02/17/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Regulating meal timing may have efficacy for improving metabolic health for preventing or managing chronic disease. However, the reliability of measuring meal timing with commonly used dietary assessment tools needs characterization prior to investigating meal timing and health outcomes in epidemiologic studies. OBJECTIVES To evaluate the reliability of estimating meal timing parameters, including overnight fasting duration, the midpoint of overnight fasting time, the number of daily eating episodes, the period with the largest percentage of daily caloric intake, and late last eating episode (> 09:00 pm) from repeated 24-h dietary recalls (24HRs). METHODS Intraclass correlation coefficients (ICC), Light's Kappa estimates, and 95% CIs were calculated from repeated 24HR administered in 3 epidemiologic studies: The United States-based Interactive Diet and Activity Tracking in AARP (IDATA) study (n = 996, 6 24HR collected over 12-mo), German EPIC-Potsdam Validation Study (European Prospective Investigation into Cancer and Nutrition Potsdam Germany cohort) (n = 134, 12 24HR collected over 12-mo) and EPIC-Potsdam BMBF-II Study (Federal Ministry of Education and Research, "Bundesministerium für Bildung und Forschung") (n = 725, 4 24HR collected over 36 mo). RESULTS Measurement reliability of overnight fasting duration based on a single 24HR was "poor" in all studies [ICC range: 0.27; 95% CI: 0.23, 0.32 - 0.46; 95% CI: 0.43, 0.50]. Reliability was "moderate" with 3 24HR (ICC range: 0.53; 95% CI: 0.47, 0.58 in IDATA, 0.62; 95% CI: 0.52, 0.69 in the EPIC-Potsdam Validation Study, and 0.72; 95% CI: 0.70-0.75 in the EPIC-Potsdam BMBF-II Study). Results were similar for the midpoint of overnight fasting time and the number of eating episodes. Reliability of measuring late eating was "fair" in IDATA (Light's Kappa: 0.30; 95% CI: 0.21, 0.39) and "slight" in the EPIC-Potsdam Validation study and the EPIC-Potsdam BMBF-II study (Light's Kappa: 0.19; 95% CI: 0.15, 0.25 and 0.09; 95% CI: 0.06, 0.12, respectively). Reliability estimates differed by sex, BMI, weekday, and season of 24HR administration in some studies. CONCLUSIONS Our results show that ≥ 3 24HR over a 1-3-y period are required for reliable estimates of meal timing variables.
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Affiliation(s)
- Lacie Peterson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Hyejung Lee
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Inge Huybrechts
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Carine Biessy
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Marian L Neuhouser
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Benjamin Haaland
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Benjamin Krick
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Marc Gunter
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Adriana M Coletta
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Sheetal Hardikar
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Amandine Chaix
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Cici X Bauer
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Mary C Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States.
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Prapkree L, Uddin R, Jaafar JAA, Baghdadi M, Coccia C, Huffman F, Palacios C. Snacking behavior is associated with snack quality, overall diet quality, and body weight among US college students. Nutr Res 2023; 114:41-49. [PMID: 37182440 DOI: 10.1016/j.nutres.2023.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/16/2023]
Abstract
Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P = .017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P = .001), lower HEI-2015 score (P = .006), and higher BMI (P = .019). Snacking for pleasure was significantly associated with a lower snack score (P = .037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment.
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Affiliation(s)
- Lukkamol Prapkree
- Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA
| | - Rianna Uddin
- Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA
| | - Jafar Ali Ajaj Jaafar
- Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA
| | - Mohammed Baghdadi
- Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA
| | - Catherine Coccia
- Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA
| | - Fatma Huffman
- Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA
| | - Cristina Palacios
- Florida International University, Robert Stempel College of Public Health and Social Work, Miami, FL, USA.
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9
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Enriquez JP, Gollub E. Snacking Consumption among Adults in the United States: A Scoping Review. Nutrients 2023; 15:nu15071596. [PMID: 37049435 PMCID: PMC10097271 DOI: 10.3390/nu15071596] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Snacks are a staple of the American diet, contributing to approximately 20% of energy intake. Most U.S. adults consume one to three snacks/day, yet few reviews have focused on snacking among this population. This scoping review was conducted to characterize snacks and snacking occasions among U.S. adults to further inform healthy eating practices. The protocol was prepared following the PRISMA-Extension for Scoping Reviews. Three web databases were used to identify articles using snacking or eating occasions as primary or secondary outcomes among U.S. adults. A search strategy was developed using subject headings, truncation, and phrase searching in the title and abstract of articles published between 2010 and 2022. A two-stage, multi-step screening process identified 31 of 4795 publications as meeting the inclusion criteria. Findings included identification of snacking themes, e.g., cues and motivations; diet composition; and weight management. Food quality, time of consumption, and convenience emerged as characteristics of snacking; time of day was found to influence food choice. Snacks contribute to or detract from a healthy diet. Strategic selection of healthy snack options can improve diet quality. Applied to nutrition education, this information can help strengthen programs or policies, ultimately contributing to health and wellbeing.
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10
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Heitman K, Fanelli SM, Taylor CA. Contribution of Snacks to Dietary Intakes Stratified by Race/Ethnicity in the United States. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:85-93. [PMID: 34762006 DOI: 10.1080/07315724.2021.1994051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Snacking recommendations do not exist, yet snacks contribute substantially to daily energy intakes. While dietary intakes of adults in the United States vary by race/ethnicity, little is known about their snacking patterns. The aim of this study was to assess the quality of snacks stratified by race/ethnicity in adults who participated in the 2011-2018 National Health and Nutrition Examination Survey (NHANES). METHOD Dietary data from 18,679 adults older than 19 years were assessed to examine differences in intakes from snacking occasions by self-identified race/ethnicity. Mean intakes were estimated for total snacking occasions, percentage of day, nutrient density per 100 kcals, and the average snack. Healthy Eating Index-2015 (HEI) scores were computed for intakes from total day, snack only, and meals only. Analysis of covariance assessed differences between racial/ethnic groups. US Department of Agriculture food categories determined sources of snack foods. Data were weighted to create a nationally representative sample. RESULTS Asians consumed the least amount of daily energy in the form of snacks, while Blacks and Whites consumed the most. Mean intakes of saturated fats and added sugars consumed during snacking occasions were significantly lowest in Asians, and highest in Blacks and Whites. While total and percentage of daily intakes of sodium were lowest in Asians during snacking occasions, they had significantly lowest meal-only HEI sodium subscore, indicating higher sodium consumption of sodium during mealtimes. CONCLUSIONS Diet quality of snacks varies significantly by race/ethnicity. These data support the need for development of snacking recommendations with culturally appropriate dietary interventions.
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Affiliation(s)
- Kristen Heitman
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Stephanie M Fanelli
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Christopher A Taylor
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.,Division of Medical Dietetics, The Ohio State University, Columbus, Ohio, USA
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11
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Monteiro LS, Rodrigues PRM, de Vasconcelos TM, Sperandio N, Yokoo EM, Sichieri R, Pereira RA. Snacking habits of Brazilian adolescents: Brazilian National Dietary Survey, 2017-2018. NUTR BULL 2022; 47:449-460. [PMID: 36317893 DOI: 10.1111/nbu.12586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022]
Abstract
This study was aimed at describing the snack consumption among Brazilian adolescents. The Brazilian National Dietary Survey (2017-2018) is a nationwide representative cross-sectional study that collected food consumption data from 8264 adolescents (10 to 19 years old); data from one 24-h recall were used, in which all foods and beverages consumed throughout the day prior to the interview were described along with the amount, unit of measurement, time, place and occasion of consumption (breakfast, lunch, dinner or snack). Snacks were classified as follows: (a) Morning snack: "Snacks" consumed between 6 AM and 12 PM; (b) Afternoon snack: "Snacks" consumed between 1 PM and 5 PM; (c) Evening snack: "Snacks" consumed between 6 PM and 5 AM. Individuals were categorised according to the number of "Snacks" per day (zero, one, two or three or more). Among the evaluated adolescents, 52.8% were female and 23.0% were overweight. The consumption of at least one snack per day was mentioned by 88.2% of the adolescents, with an average of 2.33 snacks per day. An afternoon snack was consumed by 70.0% of the adolescents. Snack consumption was related to higher mean daily energy intake and a greater contribution of carbohydrates, added sugar and trans fat to the total daily energy intake. 'Cookies & Crackers' and 'Fast Foods' were the groups that contributed the most to the energy intake provided by snacks, showing, therefore, that less healthy foods were relevant components of the snacks consumed. For their important contribution to food intake, snacking habits deserve attention among the topics covered in dietary guidelines.
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Affiliation(s)
- Luana Silva Monteiro
- Instituto de Alimentação e Nutrição, Universidade Federal do Rio de Janeiro, Macaé, Brazil
| | | | | | - Naiara Sperandio
- Instituto de Alimentação e Nutrição, Universidade Federal do Rio de Janeiro, Macaé, Brazil
| | - Edna Massae Yokoo
- Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, Brazil
| | - Rosely Sichieri
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosângela Alves Pereira
- Departamento de Nutrição Social e Aplicada, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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12
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Hess JM. Understanding the link between frequency of eating and cardiometabolic health outcomes in Americans who "snack". JDS COMMUNICATIONS 2022; 3:462-466. [PMID: 36465516 PMCID: PMC9709599 DOI: 10.3168/jdsc.2022-0289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/13/2022] [Indexed: 06/17/2023]
Abstract
On average, Americans ages 2 yr and older eat 5 or more times per day and consume nearly a quarter of their daily energy outside of breakfast, lunch, and dinner. Frequency of eating (FOE) has been identified by both the 2020 Dietary Guidelines for Americans Scientific Advisory Committee and the American Heart Association as an important area of study to improve the dietary patterns and overall health of the American public. However, the current evidence on FOE is conflicting; it does not indicate whether eating more frequently is a healthful behavior or not. Clinical and prospective studies have shown that FOE has an inverse relationship with some cardiometabolic health markers, including total cholesterol and low-density lipoprotein cholesterol concentrations, but the relationship between FOE and other health markers such as high-density lipoprotein cholesterol concentrations, blood pressure, obesity, and coronary heart disease incidence remains unclear. Several factors may affect the relationship between FOE and cardiometabolic health including the types of foods consumed, time of day, motivation to eat, cultural background, age, sex, and food security status. Another factor affecting both the relationship between FOE and health as well as the research on FOE and health is how eating occasions are labeled. Many definitions have been proposed and used in research to delineate between meals and snacks, but a consistent definition is not currently used for "snacks," even in official dietary guidance. With the current limitations in the body of research, conclusions about the healthfulness of frequent eating cannot be drawn. In addition, conclusions cannot be drawn on the healthfulness of eating snacks (as an eating occasion) or more than 3 meals per day. More directed research is required to understand the relationships between the labels used for an eating occasion and cardiometabolic health outcomes as well as the health impacts of frequent food and beverage consumption and how and why they may vary among different population groups.
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13
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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.
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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
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Taylor JC, Allman-Farinelli M, Chen J, Gauglitz JM, Hamideh D, Jankowska MM, Johnson AJ, Rangan A, Spruijt-Metz D, Yang JA, Hekler E. Perspective: A Framework for Addressing Dynamic Food Consumption Processes. Adv Nutr 2022; 13:992-1008. [PMID: 34999744 PMCID: PMC9340970 DOI: 10.1093/advances/nmab156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/12/2021] [Indexed: 11/22/2022] Open
Abstract
The study of food consumption, diet, and related concepts is motivated by diverse goals, including understanding why food consumption impacts our health, and why we eat the foods we do. These varied motivations can make it challenging to define and measure consumption, as it can be specified across nearly infinite dimensions-from micronutrients to carbon footprint to food preparation. This challenge is amplified by the dynamic nature of food consumption processes, with the underlying phenomena of interest often based on the nature of repeated interactions with food occurring over time. This complexity underscores a need to not only improve how we measure food consumption but is also a call to support theoreticians in better specifying what, how, and why food consumption occurs as part of processes, as a prerequisite step to rigorous measurement. The purpose of this Perspective article is to offer a framework, the consumption process framework, as a tool that researchers in a theoretician role can use to support these more robust definitions of consumption processes. In doing so, the framework invites theoreticians to be a bridge between practitioners who wish to measure various aspects of food consumption and methodologists who can develop measurement protocols and technologies that can support measurement when consumption processes are clearly defined. In the paper we justify the need for such a framework, introduce the consumption process framework, illustrate the framework via a use case, and discuss existing technologies that enable the use of this framework and, by extension, more rigorous study of consumption. This consumption process framework demonstrates how theoreticians could fundamentally shift how food consumption is defined and measured towards more rigorous study of what, how, and why food is eaten as part of dynamic processes and a deeper understanding of linkages between behavior, food, and health.
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Affiliation(s)
| | | | - Juliana Chen
- Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Julia M Gauglitz
- Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California, San Diego, San Diego, CA, USA
| | - Dina Hamideh
- Skaggs School of Pharmacy & Pharmaceutical Sciences, University of California, San Diego, San Diego, CA, USA
| | - Marta M Jankowska
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Abigail J Johnson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Anna Rangan
- Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Donna Spruijt-Metz
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
| | - Jiue-An Yang
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Eric Hekler
- The Design Lab, University of California, San Diego, San Diego, CA, USA,Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
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15
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Skoczek-Rubińska A, Bajerska J. The consumption of energy dense snacks and some contextual factors of snacking may contribute to higher energy intake and body weight in adults. Nutr Res 2021; 96:20-36. [PMID: 34890856 DOI: 10.1016/j.nutres.2021.11.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/18/2021] [Accepted: 11/05/2021] [Indexed: 12/12/2022]
Abstract
Preventing obesity (OB) among adults is a public health priority. One factor that seems to contribute to OB, due to the extra energy intake it involves, is the greater consumption of snacks. Whether snacking promotes OB in adults is however a source of controversy in the literature at present. The aim of this paper was to evaluate the effects of snacking on body weight status, along with contextual factors such as snacking location, food source, timing, and social context of snacking. To better understand the nature of snacking behavior, seven currently used definitions of snacking were described. Studies published prior to November 2020 were identified by searching the PubMed and Scopus databases, with thirty-three observational studies being identified and included. The consumption of energy-dense snacks may contribute to higher energy intake and weight in adult populations. The context in which adults snacks-such as eating alone, outside home or work, late in the day, in front of a TV or computer-is also important for this behavior. However, the lack of consensus on the definition of snacks in the literature makes these considerations suggestive rather than objective. Better-designed research is needed to determine the prospective association between snacking behavior and weight status in adults. Snacking may be an important behavior that can be modified to prevent obesity on the population level. Social education focused on promoting morning snacks and replacing energy-dense snacks by more nutritious ones, e.g. fruit and vegetables, may thus be beneficial.
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Affiliation(s)
- Aleksandra Skoczek-Rubińska
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań
| | - Joanna Bajerska
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań.
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16
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Damen FWM, Steenbekkers BLPA. Added value of physical food products as a stimulus during interviewing. Appetite 2021; 169:105819. [PMID: 34808272 DOI: 10.1016/j.appet.2021.105819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/17/2021] [Accepted: 11/18/2021] [Indexed: 12/31/2022]
Abstract
Semi-structured interviews are an often-used method for researching consumer perceptions of food products. However, understanding detailed and in-depth how consumers perceive food products is challenging for researchers because it could be difficult for consumers to express their motives and perceptions. In our previous studies using semi-structured interviews, this difficulty to express perceptions was also recognized, especially when concepts like naturalness, sustainability and healthiness were discussed. However, in both studies physical food products were used as stimuli and there was an indication that there might be differences in the number and type of answers given before and after the use of these stimuli products. Therefore, the current research aimed at showing effects and the possible value of using physical food stimuli products during semi-structured interviews. Two different studies were used to reach this aim, one study about the health perception of mothers and the other study about the naturalness, sustainability and healthiness perception of adolescents, both using snack products as physical stimuli. In both studies, the use of physical stimuli products appeared to be effective and useful. The comparison of the answers with and without stimuli products showed that using stimuli products provides more, and more detailed answers on the perception of the products. Therefore, the results of this study could serve as a guideline on the use of food stimuli products during semi-structured interviews.
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Affiliation(s)
- Femke W M Damen
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University & Research, P.O. Box 17, Wageningen, Netherlands; Isi GmbH, Ascherberg, 2, 37124 Rosdorf, Gӧttingen, Germany.
| | - Bea L P A Steenbekkers
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University & Research, P.O. Box 17, Wageningen, Netherlands
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17
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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: 36] [Impact Index Per Article: 12.0] [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.
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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
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