Daily Snacking Occasions, Snack Size, and Snack Energy Density as Predictors of Diet Quality among US Children Aged 2 to 5 Years.

Alexandria Kachurak,Adam Davey,Jennifer Orlet Fisher,Regan L Bailey,Lauren Dabritz

doi:10.3390/nu11071440

Alexandria Kachurak, Adam Davey + Show 3 more

Open Access

https://doi.org/10.3390/nu11071440

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Abstract

Whether snacks help young children meet nutritional needs or merely contribute to excessive intakes is debated. This research evaluated associations of snacking with dietary quality among US preschoolers (two to five years, n = 4217) in the 2005–2016 National Health Examination Survey (NHANES). Snacking occasions, size, and energy density (ED) were estimated from two 24-hr dietary recalls. Diet quality indices included the 2015 Healthy Eating Index (HEI-2015, 0–100), the mean adequacy ratio (MAR, 0–100) for five shortfall nutrients (vitamin D, calcium, fiber, potassium, and iron), and the mean % of recommended limits for added sugars, saturated fat, and sodium. Linear regressions included snacking parameters, demographics, and dietary reporting accuracy. Children had a mean HEI-2015 of 53.0, a MAR of 67.7, and intake of 121.4% of nutrients to limit. Daily snacking occasions were positively associated with HEI-2015 scores, whereas mean snack size and ED were negatively associated with HEI-2015 and MAR scores (all p < 0.05). Snack ED was positively associated with daily intakes of added sugar, saturated fat, and sodium (p < 0.001). These nationally representative findings reveal that more frequent, smaller, and less energy-dense snacks are associated with higher diet quality among US preschoolers.

Highlights

Snacking, broadly defined as eating in between meals, is not normative for children in some countries [1], but is nearly universal among US children
Was positively associated with daily intakes of added sugar, saturated fat, and sodium (p < 0.001). These nationally representative findings reveal that more frequent, smaller, and less energy-dense snacks are associated with higher diet quality among US preschoolers
Multiple linear regression evaluated the associations of snacking parameters with the three diet quality outcomes (HEI-2015, mean adequacy ratio (MAR) for shortfall nutrients, and % of recommended limits consumed for added sugar, saturated fat, and sodium)

Summary

Introduction

Broadly defined as eating in between meals, is not normative for children in some countries [1], but is nearly universal among US children. The view of snacks as “essential” holds that young children have small stomachs and need snacks to meet nutrient requirements for growth This view is reflected in the American Academy of Pediatrics (AAP) Healthy Active Living for Families obesity prevention-oriented guidance that includes provisions of two daily snacks for preschool aged children [5]. The view of snacks as “excessive” holds that snacking may contribute to obesity by providing “extra” calories to young children’s diets This position is supported by secular increases in the frequency of and energy consumed from snacking occasions among US children since the 19700 s [6], along with observations that the top foods consumed by US children at snacking occasions are desserts, sweetened beverages, and salty snacks [7,8,9]. This research is the first nationally representative study to comprehensively characterize snacking contributions to diet quality in young children

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Dietary Outcomes

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