Abstract
We investigated the effect of snacking habits in childhood on changes in body mass index (BMI) and high BMI in adolescence and adulthood. In total, 2141 Japanese children from the Ibaraki Children’s Cohort Study were evaluated at age 6 years (baseline), then at ages 12 and 22 years. We examined associations between snacking (scheduled times, when children wanted, and freely) at age 6 years and changes in BMI over time and the proportion of high BMI at ages 12 and 22 years, using time-dependent mixed-effects and logistic regression models. Compared with children who snacked at scheduled times, those provided snacks when they wanted experienced larger increases in BMI over time between ages 6 and 22 years (multivariable time-dependent effect: 0.03 kg/m2 for boys, p = 0.047; 0.04 kg/m2 for girls, p = 0.019). No differences were observed in children who snacked freely. A higher proportion of high BMI was found in boys who were provided snacks when they wanted compared with those who snacked at scheduled times. The multivariable odds ratio (95% confidence interval) was 1.52 (1.04–2.23) at age 12 years and 2.23 (1.12–4.45) at age 22 years. No differences were observed for girls at either age. Children who were provided snacks when they wanted showed larger increases in BMI over time compared with those who snacked at scheduled times. Boys who were provided snacks when they wanted showed the higher proportion of high BMI at follow-up.
Highlights
Obesity among children and young adults is an emerging health problem worldwide[1]
The mean baseline body mass index (BMI) and proportions of high BMI, inactivity, skipping breakfast, between-meal eating before dinner, and between-meal eating before bedtime were higher in children who were provided snacks when they wanted compared with those who were provided snacks at scheduled times (Table 1)
Boys and girls who were provided snacks when they wanted in early childhood experienced a slightly larger increase in BMI over time compared with those who were provided snacks at scheduled times
Summary
Obesity among children and young adults is an emerging health problem worldwide[1]. In Japan, the proportions of obesity (obesity index ≥ 20%) among boys and girls aged 11 years were 9.7% and 8.7%, respectively[2]. In 2017, the proportions of men and women aged 20–29 years with obesity (defined as a body mass index [BMI] ≥ 25.0 kg/m2) were 26.8% and 5.7%, respectively[3] These proportions were not as high in Eastern countries as in Western countries such as the US, rapid Westernization may result in increased proportions of obesity. The effect of consuming snacks in childhood on subsequent obesity in young adulthood and adolescence is unclear because no previous cohort studies have investigated the long-term effect. This cohort study aimed to examine the associations between snacking habits at age 6 years and changes in BMI and the proportion of high BMI at ages 12 and 22 years. Our a priori hypothesis was that children who are provided snacks when they want or those who snack freely at age 6 years experience a larger increase in BMI and are more likely to have high BMI later in life compared with those who are provided snacks at scheduled times
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