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.
Bibliographical noteFunding Information:
Financial support: This research was supported by the National Heart, Lung, and Blood Institute and the Eunice Kennedy Shriver National Institute of Child Health and Development and the Office of Behavioral and Social Sciences Research (grant numbers U01 HL103561, U01 HL103620, U01 HL103622, U01 HL103629, U01 HD068890, UL 1RR024989 and NIH DK56350). The content expressed in this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institutes of Health, or the US Department of Health and Human Services. The National Heart, Lung, and Blood Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institutes of Health, and the US Department of Health and Human Services had no role in the design, analysis or writing of this article. Conflict of interest: None. Authorship : M.N.L., K.P.T., D.M.M., T.N.R., J.M.B. and H.L.N. designed the research question; D.M.M., J.M.B. and A.J.T. collected data hands-on; S.M.M., T.N.R. and J.M.B. provided essential data sets; M.N.L. analysed the data; M.N.L. and K.P.T. wrote the manuscript; D.M.M., S.M.K., S.M.M., T.N.R. and J.M.B. substantially edited and critically reviewed the manuscript; M.N.L. had primary responsibility for final content. All authors have read and approved the final manuscript. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by the Institutional Review Boards at the University of North Carolina at Chapel Hill, University of Minnesota, Vanderbilt University, Stanford University and Case Western Reserve University. Written informed consent was obtained from all subjects.
- Child diet
- Childhood obesity
- Dietary pattern
- Screen use