Background: Children in low-income and minority populations are at risk for poor dietary quality. At least one-third of the calories consumed by children are eaten between meals (ie, snacks). The contribution of snacking to diet quality among children is poorly understood. Objective: The current study examined associations between snacking and children's diet quality along with differences across ethnicity or race, sex, and weight status. Design: Cross-sectional data came from Phase I of the Family Matters Study, an observational study. Participants/setting: This study included 150 families with children aged 5 to 7 years old from six ethnic or racial groups (n=25 from each: African American, Hispanic, Hmong, Native American, Somali, non-Hispanic white); data were collected in Minneapolis–Saint Paul, MN in 2017-2018. Main outcome measures: Total daily energy (kilocalories), overall diet quality using the Healthy Eating Index (HEI-2010), and food group intakes (eg, fruit, vegetables, refined grains, sugar-sweetened beverages [SSB]) were assessed using three 24-hour dietary recalls. Statistical analyses performed: Conditional fixed effects estimators (within-child variation) were used in regression analyses to characterize the relationship between daily snacking and dietary intake relative to dietary intake at all other daily meal occasions. Mean (±standard deviation) overall dietary intake including all meals and snacks was compared with mean (±standard deviation) intake of meals only. Results: Among boys, snacking was found to contribute positively to HEI-2010 scores (HEI-2010=57.6, HEI-2010 without snacks=55.0; effect size [ES]=0.28, P=0.03). Snacking was an important source of fruit (ES=0.71) and dairy (ES=0.53), but also contributed to children's consumption of refined grains (ES=0.68) and SSB (ES=0.31). Very few vegetables were consumed as snacks. Furthermore, snacks contributed more to the overall diet quality (HEI-2010) of Native American (ES=0.30) and Somali (ES=0.35) youth as compared with youth from other ethnic or racial backgrounds. Conclusions: Findings suggest that snacks have the potential to improve diet quality in children. Future research should examine influences on children's food choices at snack times and barriers to serving more healthful foods as snacks that are faced by ethnically or racially diverse families.
Bibliographical noteFunding Information:
The Family Matters study is a team effort and could not have been accomplished without the dedicated staff who carried out the home visits, including: Awo Ahmed, Nimo Ahmed, Rodolfo Batres, Carlos Chavez, Mia Donley, Michelle Draxton, Carrie Hanson-Bradley, Sulekha Ibrahim, Walter Novillo, Alejandra Ochoa, Luis ?Marty? Ortega, Anna Schulte, Hiba Sharif, Mai See Thao, Rebecca Tran, Bai Vue, and Serena Xiong. K. A. Loth assisted with the development of study concept and design, assisted with interpretation of the data, wrote the initial draft of the manuscript, and coordinated revisions to the manuscript. A. Tate assisted with the development of study concept and design, lead data analysis, and assisted with writing and thorough review of the manuscript. A. Trofholz assisted with the development of study concept and design, led data acquisition, assisted with interpretation of the data, and assisted with writing and thorough review of the manuscript. J. Orlet Fisher assisted with writing and thorough review of the manuscript. D. Neumark-Sztainer assisted with the development of study concept and design and assisted with writing and conducting a thorough review of the manuscript. J. M. Berge, the principal investigator of the study, acted as a guarantor of the integrity of entire study, led the development of study concept and design, assisted with data acquisition, and assisted with writing and thorough review of the manuscript. FUNDING/SUPPORT Research is supported by grant no. R01 HL126171-04 from the National Heart, Lung and Blood Institute (PI: J. M. Berge), and the first author's (K. A. Loth) time is supported by grant no. K23-HD090324-01A1 from the National Institute of Child Health and Human Development (PI: K. A. Loth). Content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute, the National Institute of Child Health and Human Development, or the National Institutes of Health.
- Dietary intake
- Healthy Eating Index
- Quantitative study
- School-aged children
PubMed: MeSH publication types
- Journal Article
- Observational Study
- Research Support, N.I.H., Extramural