The contribution of specific dietary patterns to energy and nutrient intakes in 7–8-year-old Scottish schoolchildren. III. Snacking habits

The contribution of snacks to dietary intakes was investigated in a sample of 136 7–8-year-old children. Mean daily energy and nutrient intakes were estimated using the 7-day weighed inventory method and the contribution of snacks was analysed separately. Snacks contributed 26% of energy intake and a large proportion of macronutrient intakes. The influence of a high intake of snacks on overall diet was investigated by classifying children as low or high snackers based on the proportion of daily energy intakes from snacks. There were no significant differences in anthropometry, and few significant differences in energy and nutrient intakes between children classified as 'low' and 'high' snackers. This was partly because 'high' snackers had a lower energy and macronutrient intake from meals, although this does not explain the lack of significant differences in micronutrient intakes between the snacking groups given that snacks were less nutrient dense than meals. It is concluded that snacks made an important contribution to energy and nutrient intakes in this sample but that further research is required to investigate how a high intake of snacks affects the quality of children's diets.     

Snacks are important for fat and vitamin intakes among rural African women: a cross-sectional study from Malawi

OBJECTIVE: To estimate the contribution of energy and selected nutrients from foods eaten as snacks and as meals. SUBJECTS AND METHODS: Forty-four nonpregnant women in the reproductive age, of whom 20 were lactating, participated in this study. Women from rural households were randomly selected and energy and nutrient intakes were estimated using 2 days' observed weighed food record. Snacks eaten between meals were estimated by weighed food record as well as recall, thrice per day. RESULTS: The largest proportions (mean+/-s.e.) of fat (33+/-3.6%), vitamin C (36+/-4.1%) and a large proportion of vitamin A (30+/-4.4%) intakes were from snacks. Furthermore, snacks provided 20% of the energy intakes. CONCLUSION: Snacks are important for energy and nutrient intakes and adequacies in rural African women and have the potential to combat energy and nutrient deficiencies in low-income countries.     

Shape of snack foods does not predict snack intake in a sample of preschoolers: a cross-over study

ABSTRACT: BACKGROUND: In the past decade, the proportion snacking has increased. Snack foods consumed are predominantly not nutritious foods. One potential venue to increase children's diet quality is to offer healthy snack foods and we explored if shaped snack foods would lead to increased consumption. METHODS: We investigated the consumption of high-fiber snacks (banana bread, pancakes, and sandwiches) served either in normal (round, square) or shaped (heart, hands, animals) form to preschoolers 2-5 years old attending a local child care center (n=21). The 9 weeks long, prospective, cross-over intervention study was designed to expose each child repeatedly to each snack in each shape (4 times per snack). Snacks were served as morning or afternoon snack and caretakers' reports were used to account for the child's consumption of a meal preceding the study snack (breakfast or lunch). RESULTS: There was no significant difference in snack consumption between the shaped and normal snacks. However, the mean energy intake from snacks was significantly greater for Caucasian children compared with Asian children. Further, Asian children consumed much less banana bread than the other two snacks. Overall, children who had not eaten breakfast or lunch prior to the morning or afternoon snack ate significantly more calories from the snacks (84.1 kcal, p-value<0.0001). CONCLUSION: Findings of this study confirm previous research that the shape of the foods does not affect snack consumption in children. However, we also report two unexpected findings: a) the strong interaction between ethnicity and snack consumption and b) that Asian children consumed much less banana bread than Caucasian children. The role of children's ethnic background profoundly affects snack preference and must be considered in the study of children's eating behaviors and in interventions to promote healthy eating habits.     

Comparison of energy and nutrient intakes among meals and snacks of adolescent males

BACKGROUND: Eating behaviors developed during adolescence can have immediate health implications and influence future chronic disease risk. The objectives of this study were to determine and compare the distribution of energy and nutrient intakes among meals and snacks, and relate eating occasion frequency to body mass index (BMI) of adolescent males. METHODS: Healthy adolescent males (n = 180) completed 3-day food records. Following analysis for energy and nutrient intakes, 3-day averages and frequencies were computed for all meals and snacks. RESULTS: Dinner was the largest contributor of energy, macronutrients, cholesterol, dietary fiber, and sodium, whereas both dinner and breakfast were the largest contributors of calcium and iron. On average, subjects consumed 1.63 snacks/day, with 77% consuming > or = 1 snack/day. BMI was significantly greater and energy intake was significantly lower in subjects having < or = 3 eating occasions/day relative to 4 or > or = 6 eating occasions/day. The 26% of subjects classified as inconsistent breakfast consumers had significantly higher BMIs and lower iron intakes relative to consistent breakfast consumers. CONCLUSIONS: This study provides valuable information regarding eating occasion frequency and contribution of meals and snacks to energy and nutrient intakes in adolescent males. Such information could be used to improve nutrition education programs for adolescents aimed at chronic disease prevention.     

Designing snacks to address micronutrient deficiencies in rural Kenyan schoolchildren

Three snacks were designed to improve nutrient intakes among school-age children living in rural Kenya. Snacks containing animal-source foods (milk and meat) provided more nutrients than an equicaloric vegetarian snack. The vegetarian snack provided extra vitamin A (primarily from fortified cooking fat; the milk snack was rich in calcium, vitamin A, and vitamin B-12; and the meat snack supplied vitamin B-12, iron, and zinc. When changes in intakes from baseline to the feeding period were compared across the 4 groups, total energy intake increased the most for children in the meat group and the least for children in the control group. Differences in energy intakes across the 3 feeding groups were primarily caused by decreases in home intake for the vegetarian and milk snack groups. It is important to evaluate the change in home intakes as well as intakes from the foods provided by the study when evaluating the effect of feeding programs on nutrient adequacy.     

Monitoring of dietary quality in outpatients by qualitative meal classification method

Background: The aim of this study was to evaluate whether qualitative meal-classification used as a dietary evaluation tool reflects eating frequency and key nutrients in the diet, and whether it could be used to monitor the dietary quality in elderly outpatients. The qualitative meal-classification tool used was based on eight food categories combined into four types of meals: Complete, Incomplete, Less Balanced and Vegetarian Meals, and three types of snacks: High-, Mixed- and Low-Quality Snacks. Methods: Dietary intake was assessed during 7 consecutive days by use of an estimated food record in nine elderly women with leg ulcers. Mean 7-day dietary intakes of energy, macronutrients, beta-carotene, retinol, vitamin E, ascorbic acid, calcium, iron, zinc and dietary fibre were calculated. Each eating event was classified in accordance with the food-based classification method. The frequency of the four types of meals and three types of snacks, their energy content and nutrients, and their contribution to total intake were subsequently analysed. Results: Meals were associated with a higher energy, vitamin and mineral content than were snacks. Complete Meals were the major source for beta-carotene and ascorbic acid. Intakes from Low-Quality Snacks were relatively high in energy, fat and sucrose. Conclusion: The qualitative meal-classification tool was found to be simple to use and useful for reflecting meal order and the nutritional roles of different types of meals and snacks in the diet. This method is recommended for dietary monitoring.     

Benefits of snacking in older Americans

OBJECTIVE: Because energy intakes decline with age, the purpose of this study was to evaluate the influence of snacking on energy intakes and energy density in older adults. DESIGN: Twenty-four-hour dietary recall data from the National Health and Nutrition Examination Survey 1999-2002 were used to compare the diets of snackers and nonsnackers. SUBJECTS: This study included 2,002 adults aged 65 years and older. STATISTICAL ANALYSIS PERFORMED: All statistical analyses accounted for the survey design and sample weights. Linear regression was used to estimate energy and energy-yielding nutrient intakes, eating occasions, energy intake per eating occasions, and energy density of eating occasions. RESULTS: The prevalence of snacking was high (84%) among this age group, and snackers had significantly higher daily intakes of energy, protein, carbohydrate, and total fat. Alcohol intakes were not significantly different. For those who snacked, it contributed almost a quarter of their energy and carbohydrate intakes and a fifth of their daily fat intakes. Snacking contributed 14% of their daily protein intakes. Snackers had, on average, two and a half snacking occasions per day, with each snacking occasion contributing 150 kcal. The average energy contribution of meals was not different between snackers and nonsnackers. The energy density of meals is significantly greater for snackers than for nonsnackers. CONCLUSIONS: Results from this study demonstrate that snacking is an important dietary behavior among older adults. Whereas snacking may promote energy imbalance resulting in obesity among other age groups, our results suggest snacking may ensure older adults consume diets adequate in energy.     

Meals, snacks and food choices in Brazilian shift workers with high energy expenditure

Objective To describe the food intake of garbage collectors, who works in three shifts, in terms of meal and snack frequency, content, time distribution and the contribution of various popular foods to the total diet. Methods Sixty‐six Brazilian garbage collectors, who work in morning, afternoon, and night shift, participated in the present study. The quantitative methods used were a combination of one 24‐h recall and two 24‐h records during three nonconsecutive work days. The qualitative method used was the food‐based classification of eating episodes model modified in order to define meals or snacks in three categories of events: meals with three food groups of high nutrient density (three HND meals), meals with two food groups of high nutrient density (two HND meals) and snacks, composed of only one food category of high nutrient density. Results The total number of eating events per day was significantly higher for night shift workers. Over 24‐h, ‘two HND meals’ were the most common events and contributed the most energy, in all three shifts. Night shift workers ate more at dawn and less in the morning than other shifts. In all three shifts, meat was the most important food contributing to energy intake. Conclusion Different work schedules did not affect the relative frequency of meal types and snacks or their contribution to daily energy intake, but affected the daily distribution of eating events, with a redistribution of intake from day to night in night shift workers.     

Daily Energy Intake from Meals and Afternoon Snacks: Findings from the Malaysian Adults Nutrition Survey (MANS)

Meal and snack patterns are associated with energy and nutrient intakes and consequently health and nutritional status. The aim of this paper is to describe the percentage of daily energy intake from meals and afternoon snack among Malaysian adults. The study included a representative sample of adults aged 18-59 years (n=7349) from a nationwide Food Consumption Survey conducted by the Ministry of Health. Information on dietary intake was obtained using a one day 24-hour diet recall (24-HDR). Dietary data on 6886 adults were analysed using Nutritionist ProTM and statistical analysis was carried out using the SPSS 13.0. The median percentage of daily energy intake is reported only for adults consuming meals and afternoon tea and by socio-demographic characteristics as well as body mass index (BMI) status. More than 80% of Malaysian adults consumed morning meals, lunch and dinner and 54% reported having afternoon tea. The median percentage of energy intake from morning meals, lunch, dinner and afternoon tea was 29.9%, 30.5%, 32.4% and 17%, respectively. There were variations in the median percentage of energy from meals and snacks according to the socio-demographic variables and BMI status. It is important to understand the eating patterns of Malaysians as the information can assist in efforts to address obesity and diet-related chronic diseases among adults.     

Influence of stress on snack consumption in middle school girls

Stress has been known to change dietary behaviors and food intakes in individuals. The purpose of this study was to investigate the effect of stress level on the frequency and the amount of snack consumption. The high stress group (HS) showed significantly higher frequency of consumption for bread, chips, cookies, ramyeon, and frozen snacks (p<0.05) compared to low stress group (LS) with higher frequency of snack consumption (p<0.01), and increased intakes of energy, carbohydrates, and sodium from snacks (p<0.01) than LS. As the stress level became higher, the proportions of students with irregular meals, overeating, and night snacking increased (p<0.01). Also, 33.0% of the subjects answered that they consumed an increased amount of snacks when they were feeling stressed. Our results indicated that stress has negative influence on snack consumption in middle school girls.     

Is snacking good or bad for health: An overview

Snacking, or the habit of eating little and often, has been postulated to have a range of health benefits in relation to appetite control, bodyweight management and improved blood glucose control in diabetics and pre‐diabetics. However, there is widespread agreement that our current obesogenic environment is encouraging overeating in response to increased food portion sizes, palatability and/or energy‐density of foods, alongside the many social and psychological cues to eat. In this context, and as findings on the health effects of snacking are conflicting, the question remains as to whether more frequent eating and snacking can be of benefit to health. Snacks, if added to habitual meal intake, with no compensation for snack energy contribution, are likely over time to lead to positive energy balance. Hence, snacking might be a contributing factor to the obesity epidemic, in addition to more established factors, such as food choice and physical activity. This paper explores the existing evidence concerning the impact of snacking on bodyweight and the behavioural and metabolic response to snacking. The impact of snacking on cognitive function is also discussed. The review highlights the need for further research as, despite many years of scientific interest in snacking, the lack of consistency in study design and snacking definitions and the array of potential confounding factors (e.g. physical activity levels) makes interpretation of findings difficult and has led to little consensus about the optimum number and composition of meals and/or snacks for bodyweight control, health and wellbeing on a population‐wide basis.     

Meal and snack patterns are associated with dietary intake of energy and nutrients in US adults

OBJECTIVE: This study was undertaken to test the hypothesis that specific meal and snack patterns are associated with selected nutrient intakes in US adults. DESIGN: Using the 24-hour dietary recall from the Third National Health and Nutrition Examination Survey, meal and snack patterns were described in relation to nutrient intakes. SUBJECTS: The study included US adults aged 20 years or older (n=15,978). STATISTICAL ANALYSES PERFORMED: All statistical analyses accounted for the survey design and sample weights. Linear regression analyses controlled for confounding factors, including energy intakes. Wald F tests were used for determination of significance between means of nutrient intakes by daily eating frequency or meal pattern groups. RESULTS: Daily eating frequency was positively related to carbohydrate, folic acid, vitamin C, calcium, magnesium, iron, potassium, and fiber intakes and inversely related to protein, total fat, cholesterol, and sodium intakes. Meal patterns were further categorized into the five most commonly reported meal and snack combinations by population percentages including breakfast (B), lunch (L), dinner (D), and > or =2 snacks (S) (31.6%); B, L, D and 1 S (15.4%); B, D and > or =2 S (13.1%); B, L, D (8.3%); and L, D and > or =2 S (7.6%). Groups reporting B, L, D and 1 S and B, L, D and > or =2 S had the highest intakes of all micronutrients examined except cholesterol, vitamin B-6, and sodium. Breakfast skippers (L, D and > or =2 S) had the lowest intakes of all micronutrients examined except sodium. CONCLUSIONS: Findings from this cross-sectional survey suggest that meal and snack patterns may be markers for nutrient intakes and therefore diet quality. Complete nutrient intakes should be considered in investigations of meal patterns and health outcomes.     

Contribution of Snacking to Older Adults' Vitamin, Carotenoid, and Mineral Intakes

Decreased food and beverage consumption among older adults can lead to inadequate intakes of energy and numerous micronutrients. Although older adults are prone to having inadequate diets, little research attention has been directed at their dietary behaviors, such as snacking. The purpose of this study was to examine the association between snacking frequency and older adults' daily intakes of vitamins, carotenoids, and minerals. Cross-sectional data for 2,056 older adults (65 years and older) from the 2003-2006 National Health and Nutrition Examination Survey were used for this study. Dietary data were collected through two 24-hour dietary recall interviews. Participants' snacking occasions and daily nutrient intakes were averaged during the two 24-hour recalls. Using linear regression models to adjust for multiple covariates, mean vitamin, carotenoid, and mineral intakes by snacking category were estimated. As snacking frequency increased, daily intakes of vitamins A, C, and E and beta carotene increased. Older adults' daily intakes of magnesium, copper, and potassium also increased as snacking frequency increased. As older adults' snacking frequency increased, their daily intake of selenium decreased, and their snacking frequency was not associated with their daily intakes of the B-complex vitamins, vitamin K, lycopene, phosphorus, iron, and zinc. Providing healthy snacks on a regular basis has practical implications for institutions, centers, or organizations that serve older adults; however, nutritional benefits obtained from snack food and beverages warrant their inclusion in older adults' diet.     

Associations between snacking and weight loss and nutrient intake among postmenopausal overweight to obese women in a dietary weight-loss intervention

Snacking may play a role in weight control. The associations of timing and frequency of snacking with observed weight change and nutrient intake were assessed in an ancillary study to a 12-month randomized controlled trial in Seattle, WA. Overweight-to-obese postmenopausal women (n=123) enrolled in the two dietary weight-loss arms from 2007 to 2008 with complete data at 12 months were included in these analyses. Generalized linear models were used to test the associations between snacking and weight loss (percent) and nutrient intake at the 12-month time point. Participants were, on average, 58 years old and mainly non-Hispanic white (84%). Ninety-seven percent reported one or more snacks per day. Weight loss (percent) was significantly lower among mid-morning (10:30 am to 11:29 am) snackers (7.0%, 95% confidence interval: 4.3 to 9.7) compared to non–mid-morning snackers (11.4%, 95% confidence interval: 10.2 to 12.6; P=0.005). A higher proportion of mid-morning snackers reported more than one snack per day (95.7%), compared to afternoon (82.8%) and evening (80.6%) snackers, although differences were not statistically significant (P>0.05). Women who reported two or more snacks per day vs one or no snacks per day had higher fiber intake (P=0.027). Afternoon snackers had higher fruit and vegetable intake compared to non–afternoon-snackers (P=0.035). These results suggest that snack meals can be a source for additional fruits, vegetables, and fiber-rich foods; however, snacking patterns might also reflect unhealthy eating habits and impede weight-loss progress. Future dietary weight-loss interventions should evaluate the effects of timing, frequency, and quality of snacks on weight loss.     

Comparison of high-fat and high-carbohydrate foods in a meal or snack on short-term fat and energy intakes in obese women

The present study aimed to compare the action of high-fat and high-carbohydrate (CHO) foods on meal size (satiation) and post-meal satiety in obese women. A within-subjects design was used; each participant received all four nutritional challenges. Fifteen healthy obese women (age 21-56 years, BMI 35-48 kg/m2) participated; thirteen completed all four test days. On two test days, participants were exposed to a nutritional challenge comprising an ad libitum high-fat or high-CHO lunch. On the other two test days they were exposed to a challenge comprising an ad libitum sweet high-fat or high-CHO mid-afternoon snack. Energy and macronutrient intakes were measured at each eating episode. Visual analogue rating scales were completed periodically to record subjective feelings of appetite. When offered a high-CHO selection of foods at lunch and mid-afternoon participants consumed less energy than when offered a high-fat selection. However, post-meal satiety was similar. Total test-day energy intake was significantly higher when high-fat foods were consumed at lunch, but not as a snack. Consumption of high-fat foods at a lunch and snack increased the amount of fat consumed over the whole test day. In conclusion, energy intake of an eating episode was influenced by nutrient composition in this group of obese women. Consumption of high-fat foods at lunch or as a snack led to overconsumption relative to high-CHO foods. However, high-fat foods at meals may have greater potential to influence daily intake than at snacks, probably because meals are larger eating episodes and therefore give greater opportunity to overconsume.     

Snacking in nutrition and health

Abstract

Many studies suggest that distributing energy and nutrient intake across 4–5 eating occasions/day (rather than across three standard meals) could favourably affect human health. The inclusion of 1–2 snacks in the daily pattern alleviates the potential digestive and metabolic overload caused by fewer heavier meals and might contribute to meet recommendations for food groups (e.g. fruits, dairy) and nutrients like fibre and vitamins. The snack composition should be evaluated taking into account the whole day’s diet. In early and late ages, and for specific population groups, snacking may need to follow particular characteristics in order to be optimal, both in terms of composition and timing. This document, which is the result of a collaboration of experts across several fields of research, intends to provide a review of the current scientific literature on meal frequency and health, highlighting the beneficial effects of correct snack consumption across the human lifespan.     

Role of dietary carbohydrate and frequent eating in body-weight control

Despite widespread interest in body-weight control, the prevalence of obesity continues to rise worldwide. Current public health advice for obesity prevention is clearly failing. The present paper examines the appropriateness of current public health advice for body-weight control, i.e. to reduce consumption of fatty foods, to reduce consumption of sugar and to avoid snacking between meals. An increase in carbohydrate: fat ratio should improve body-weight control, as high-carbohydrate low-fat diets are less likely to lead to overeating, and if overeating does occur, less of the excess energy is likely to be stored as fat. However, it is suggested that for the long-term prevention of weight gain, advice to increase consumption of carbohydrate-rich foods may be more effective than advice which focuses on reducing consumption of fatty food. Moreover, in view of the inverse relationship between fat and sugar intakes, sugar may have a positive role to play in body-weight control in facilitating an increase in carbohydrate: fat ratio. Snacking for most individuals appears not to adversely affect body-weight control, and for some it may improve control. This situation may exist because frequent eating helps appetite control, thus preventing overeating at meals, and as snacks overall tend to be higher in carbohydrate and lower in fat than meals, frequent eating may be a strategy for increasing carbohydrate: fat ratio. It is also suggested that eating 'little and often' may be a more compatible pattern of eating for a physically-active lifestyle than eating large meals. Perhaps the most appropriate advice on food intake that would work synergistically with concurrent advice to increase physical activity is to eat more carbohydrate, and to eat frequently.     

The Frequency and Context of Snacking among Children: An Objective Analysis Using Wearable Cameras

Snacking is a common eating behaviour, but there is little objective data about children’s snacking. We aimed to determine the frequency and context of children’s snacking (n = 158; mean age = 12.6 years) by ethnicity, gender, socioeconomic deprivation and body mass index (BMI) children. Participants wore wearable cameras that passively captured images of their surroundings every seven seconds. Images (n = 739,162) were coded for snacking episodes, defined as eating occasions in between main meals. Contextual factors analysed included: snacking location, food source, timing, social contact and screen use. Rates of total, discretionary (not recommended for consumption) and healthful (recommended for consumption) snacking were calculated using negative binomial regression. On average, children consumed 8.2 (95%CI 7.4, 9.1) snacks per day, of which 5.2 (95%CI 4.6, 5.9) were discretionary foods/beverages. Children consumed more discretionary snacks than healthful snacks in each setting and at all times, including 15.0× more discretionary snacks in public spaces and 2.4× more discretionary snacks in schools. Most snacks (68.9%) were sourced from home. Girls consumed more total, discretionary and healthful snacks than boys, and Māori and Pacific consumed fewer healthful snacks than New Zealand (NZ) Europeans. Results show that children snack frequently, and that most snacking involves discretionary food items. Our findings suggest targeting home buying behaviour and environmental changes to support healthy snacking choices.     

Snacking for a Cause: Nutritional Insufficiencies and Excesses of U.S. Children,a Critical Review of Food Consumption Patterns and Macronutrient and Micronutrient Intake of U.S. Children

The objective of this review was to identify dietary insufficiencies and excesses in children aged two to 11 in the United States (U.S.) and eating habits that merit concern in terms of nutrient and energy density to improve overall diet quality. Data from the What We Eat in America (WWEIA) tables from the National Health and Nutrition Examination Survey (NHANES) were examined as well as survey data from the School Nutrition Dietary Assessment Study (SNDA). Analysis of survey data revealed that children consume insufficient Vitamin D, calcium, and potassium and excess energy, carbohydrates, and sodium. Dietary modifications are necessary to prevent serious deficiencies and the development of chronic illness. Snacking has steadily increased in this population since the 1970s, and snacks provide necessary nutrients. However, carbohydrates and added sugars tend to be over-consumed at snacking occasions. Replacement of current snack choices with nutrient-dense foods could lower the risks of nutrient deficiencies and help lower excess nutrient consumption. Increased consumption of low sugar dairy foods, especially yogurt, at snack times could increase intake of important micronutrients without contributing to dietary excesses.