Skip to main content Accessibility help
×
Home

Snacking characteristics and patterns and their associations with diet quality and BMI in the Childhood Obesity Prevention and Treatment Research Consortium

  • Madison N LeCroy (a1), Kimberly P Truesdale (a1), Donna M Matheson (a2), Sharon M Karp (a3), Shirley M Moore (a4), Thomas N Robinson (a2), Jerica M Berge (a5), Holly L Nicastro (a6) and Alicia J Thomas (a7)...

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.

Copyright

Corresponding author

*Corresponding author: Email mlecroy@live.unc.edu

References

Hide All
1.Koplan, JP, Liverman, CT, Kraak, VI et al. (2005) Preventing childhood obesity: health in the balance: executive summary. J Am Diet Assoc 105, 131138.
2.Krebs, NF, Himes, JH, Jacobson, D et al. (2007) Assessment of child and adolescent overweight and obesity. Pediatrics 120, Suppl. 4, S193S228.
3.Ogden, CL, Carroll, MD, Lawman, HG et al. (2016) Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. JAMA 315, 22922299.
4.Daniels, SR (2009) Complications of obesity in children and adolescents. Int J Obes (Lond) 33, Suppl. 1, S60S65.
5.Brown, CL, Halvorson, EE, Cohen, GM et al. (2015) Addressing childhood obesity: opportunities for prevention. Pediatr Clin North Am 62, 12411261.
6.Waters, E, de Silva-Sanigorski, A, Hall, BJ et al. (2011) Interventions for preventing obesity in children. Cochrane Database Syst Rev issue 12, CD001871.
7.Hess, J & Slavin, J (2014) Snacking for a cause: nutritional insufficiencies and excesses of US children, a critical review of food consumption patterns and macronutrient and micronutrient intake of US children. Nutrients 6, 47504759.
8.US Department of Agriculture, Agricultural Research Service (2016) Table 29. Snacks: Distribution of Snack Occasions, by Gender and Age in the United States, 2013–2014. What We Eat in America, NHANES 2013–2014. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/1314/Table_29_DSO_GEN_13.pdf (accessed March 2019).
9.US Department of Agriculture, Agricultural Research Service (2016) Table 25. Snacks: Percentages of Selected Nutrients Contributed by Food and Beverages Consumed at Snack Occasions by Gender and Age, in the United States, 2013–2014. What We Eat in America, NHANES 2013–2014. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/1314/Table_25_SNK_GEN_13.pdf (accessed March 2019).
10.Johnson, GH & Anderson, GH (2010) Snacking definitions: impact on interpretation of the literature and dietary recommendations. Crit Rev Food Sci Nutr 50, 848871.
11.Murakami, K & Livingstone, MBE (2016) Meal and snack frequency in relation to diet quality in US children and adolescents: the National Health and Nutrition Examination Survey 2003–2012. Public Health Nutr 19, 16351644.
12.Evans, EW, Jacques, PF, Dallal, GE et al. (2015) The role of eating frequency on total energy intake and diet quality in a low-income, racially diverse sample of schoolchildren. Public Health Nutr 18, 474481.
13.Nicklas, TA, Yang, S-J, Baranowski, T et al. (2003) Eating patterns and obesity in children. The Bogalusa Heart Study. Am J Prev Med 25, 916.
14.Huang, TT-K, Howarth, NC, Lin, B-H et al. (2004) Energy intake and meal portions: associations with BMI percentile in US children. Obes Res 12, 18751885.
15.Murakami, K & Livingstone, MBE (2016) Associations between meal and snack frequency and overweight and abdominal obesity in US children and adolescents from National Health and Nutrition Examination Survey (NHANES) 2003–2012. Br J Nutr 115, 18191829.
16.Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 39.
17.Nicklas, TA, O’Neil, CE & Fulgoni, VL (2014) Snacking patterns, diet quality, and cardiovascular risk factors in adults. BMC Public Health 14, 388.
18.Shin, D, Song, S, Krumhar, K et al. (2015) Snack patterns are associated with biomarkers of glucose metabolism in US men. Int J Food Sci Nutr 66, 595602.
19.Sherwood, NE, French, SA, Veblen-Mortenson, S et al. (2013) NET-Works: linking families, communities and primary care to prevent obesity in preschool-age children. Contemp Clin Trials 36, 544554.
20.Po’e, EK, Heerman, WJ, Mistry, RS et al. (2013) Growing Right Onto Wellness (GROW): a family-centered, community-based obesity prevention randomized controlled trial for preschool child-parent pairs. Contemp Clin Trials 36, 436449.
21.Robinson, TN, Matheson, D, Desai, M et al. (2013) Family, community and clinic collaboration to treat overweight and obese children: Stanford GOALS – a randomized controlled trial of a three-year, multi-component, multi-level, multi-setting intervention. Contemp Clin Trials 36, 421435.
22.Moore, SM, Borawski, EA, Cuttler, L et al. (2013) IMPACT: a multi-level family and school intervention targeting obesity in urban youth. Contemp Clin Trials 36, 574586.
23.Pratt, CA, Boyington, J, Esposito, L et al. (2013) Childhood Obesity Prevention and Treatment Research (COPTR): interventions addressing multiple influences in childhood and adolescent obesity. Contemp Clin Trials 36, 406413.
24.Schakel, SF, Sievert, YA & Buzzard, IM (1988) Sources of data for developing and maintaining a nutrient database. J Am Diet Assoc 88, 12681271.
25.Baxter, SD, Thomspon, WO, Litaker, MS et al. (2003) Accuracy of fourth-graders’ dietary recalls of school breakfast and school lunch validated with observations: in-person versus telephone interviews. J Nutr Educ Behav 35, 124134.
26.Guenther, PM, Casavale, KO, Kirkpatrick, SI et al. (2013) Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet 113, 569580.
27.Centers for Disease Control and Prevention (2016) A SAS program for the CDC growth charts. http://www.cdc.gov/nccdphp/dnpao/growthcharts/resources/sas.htm (accessed October 2016).
28.de Winter, JCF & Dodou, D (2012) Factor recovery by principal axis factoring and maximum likelihood factor analysis as a function of factor pattern and sample size. J Appl Stat 39, 695710.
29.Hair, JFJ, Anderson, RE, Tatham, RL et al. (1995) Multivariate Data Analysis, 4th ed. Upper Saddle River, NJ: Prentice Hall.
30.Northstone, K & Emmett, PM (2008) Are dietary patterns stable throughout early and mid-childhood? A birth cohort study. Br J Nutr 100, 10691076.
31.Ritchie, LD, Spector, P, Stevens, MJ et al. (2007) Dietary patterns in adolescence are related to adiposity in young adulthood in black and white females. J Nutr 137, 399406.
32.Knol, LL, Haughton, B & Fitzhugh, EC (2005) Dietary patterns of young, low-income US children. J Am Diet Assoc 105, 17651773.
33.Gubbels, JS, van Assema, P & Kremers, SPJ (2013) Physical activity, sedentary behavior, and dietary patterns among children. Curr Nutr Rep 2, 105112.
34.Northstone, K, Smith, ADAC, Newby, PK et al. (2013) Longitudinal comparisons of dietary patterns derived by cluster analysis in 7- to 13-year-old children. Br J Nutr 109, 20502058.
35.Mikkilä, V, Räsänen, L, Raitakari, OT et al. (2005) Consistent dietary patterns identified from childhood to adulthood: the Cardiovascular Risk in Young Finns Study. Br J Nutr 93, 923931.
36.Emmett, PM, Jones, LR & Northstone, K (2015) Dietary patterns in the Avon Longitudinal Study of Parents and Children. Nutr Rev 73, Suppl. 3, S207S230.
37.Fiorito, LM, Mitchell, DC, Smiciklas-Wright, H et al. (2006) Dairy and dairy-related nutrient intake during middle childhood. J Am Diet Assoc 106, 534542.
38.Storey, ML, Forshee, RA & Anderson, PA (2006) Beverage consumption in the US population. J Am Diet Assoc 106, 19922000.
39.Avery, A, Anderson, C & McCullough, F (2017) Associations between children’s diet quality and watching television during meal or snack consumption: a systematic review. Matern Child Nutr 13, e12428.
40.Osei-Assibey, G, Dick, S, Macdiarmid, J et al. (2012) The influence of the food environment on overweight and obesity in young children: a systematic review. BMJ Open 2, e001538.
41.Dovey, TM, Taylor, L, Stow, R et al. (2011) Responsiveness to healthy television (TV) food advertisements/commercials is only evident in children under the age of seven with low food neophobia. Appetite 56, 440446.
42.Halford, JCG, Boyland, EJ, Hughes, G et al. (2007) Beyond-brand effect of television (TV) food advertisements/commercials on caloric intake and food choice of 5–7-year-old children. Appetite 49, 263267.
43.Halford, JCG, Gillespie, J, Brown, V et al. (2004) Effect of television advertisements for foods on food consumption in children. Appetite 42, 221225.
44.Halford, JC, Boyland, EJ, Hughes, GM et al. (2008) Beyond-brand effect of television food advertisements on food choice in children: the effects of weight status. Public Health Nutr 11, 897904.
45.Batada, A, Seitz, MD, Wootan, MG et al. (2008) Nine out of 10 food advertisements shown during Saturday morning children’s television programming are for foods high in fat, sodium, or added sugars, or low in nutrients. J Am Diet Assoc 108, 673678.
46.Livingstone, MBE, Robson, PJ & Wallace, JMW (2004) Issues in dietary intake assessment of children and adolescents. Br J Nutr 92, Suppl. 2, S213S222.
47.Baranowski, T, Sprague, D, Baranowski, JH et al. (1991) Accuracy of maternal dietary recall for preschool children. J Am Diet Assoc 91, 669674.
48.Phillips, SM, Bandini, LG, Naumova, EN et al. (2004) Energy-dense snack food intake in adolescence: longitudinal relationship to weight and fatness. Obes Res 12, 461472.
49.Dubois, L, Farmer, A, Girard, M et al. (2008) Social factors and television use during meals and snacks is associated with higher BMI among pre-school children. Public Health Nutr 11, 12671279.
50.Francis, LA, Lee, Y & Birch, LL (2003) Parental weight status and girls’ television viewing, snacking, and body mass indexes. Obes Res 11, 143151.
51.Walker, JL, Ardouin, S & Burrows, T (2018) The validity of dietary assessment methods to accurately measure energy intake in children and adolescents who are overweight or obese: a systematic review. Eur J Clin Nutr 72, 185197.
52.Livingstone, MB & Robson, PJ (2000) Measurement of dietary intake in children. Proc Nutr Soc 59, 279293.
53.Rangan, A, Allman-Farinelli, M, Donohoe, E et al. (2014) Misreporting of energy intake in the 2007 Australian Children’s Survey: differences in the reporting of food types between plausible, under- and over-reporters of energy intake. J Hum Nutr Diet 27, 450458.
54.McGloin, AF, Livingstone, MBE, Greene, LC et al. (2002) Energy and fat intake in obese and lean children at varying risk of obesity. Int J Obes Relat Metab Disord 26, 200207.

Keywords

Type Description Title
WORD
Supplementary materials

LeCroy et al. supplementary material
LeCroy et al. supplementary material 1

 Word (14 KB)
14 KB

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed