Abstract
Background
Current dietary guidelines recommend avoiding foods and beverages with added sugars
and higher sodium before age 2 years.
Objective
The aim was to describe daily snack food intake (frequency and total energy) and the
associations with overconsumed nutrients (added sugars, sodium, and saturated fats)
and child weight-for-length z scores.
Design
A cross-sectional, secondary analysis of baseline data from an ongoing longitudinal
intervention was conducted.
Participants and setting
A sample of 141 caregivers with infants (aged 9 to 11 months) and toddlers (aged 12
to 15 months) was recruited in Buffalo, NY, between 2017 and 2019.
Main outcome measures
Three 24-hour dietary recalls were used to categorize 'sweet and salty snack foods'
or 'commercial baby snack foods' based on the US Department of Agriculture What We
Eat in America food group classifications and estimate nutrient intakes. Child recumbent
length and weight were measured by trained researchers.
Statistical analysis
Daily frequency (times/day), energy (kcal/day), and overconsumed nutrients from snack
food intake were calculated. Multivariable regression models examined associations
between the frequency of and energy from snack food intake with overconsumed nutrients
and child weight-for-length z scores.
Results
Infants consumed snack foods on average 1.2 times/day contributing 5.6% of total daily
energy, 19.6% of added sugars, and 6.8% of sodium. Toddlers consumed snack foods on
average 1.4 times/day contributing 8.9% of total daily energy, 40.0% of added sugars,
and 7.2% of sodium. In adjusted models including all children, greater frequency of
sweet and salty snack food intake, but not commercial baby snack foods, was associated
with higher weight-for-length z scores.
Conclusions
Snack foods are frequently consumed by infants and toddlers and contribute to the
intake of overconsumed nutrients such as added sugars and sodium. Given the current
guidelines to avoid added sugars and higher sodium before age 2 years, additional
recommendations related to nutrient-dense snack intake may be beneficial.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Academy of Nutrition and DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Complementary feeding: critical considerations to optimize growth, nutrition, and feeding behavior.Curr Pediatr Rep. 2013; 1: 247-256https://doi.org/10.1007/s40124-013-0030-8
- Pediatric Nutrition.8th ed. American Academy of Pediatrics, Itasca, IL2019
- Dietary Guidelines for Americans, 2020-2025. 9th ed. December 2020.
- Learning to eat: birth to age 2 y.Am J Clin Nutr. 2014; 99: 723S-728Shttps://doi.org/10.3945/ajcn.113.069047
- Promoting healthy food preferences from the start: a narrative review of food preference learning from the prenatal period through early childhood.Obes Rev. 2018; 19: 576-604https://doi.org/10.1111/obr.12658
- Parental influences on eating behavior: conception to adolescence.J Law Med Ethics. 2007; 35: 22-34https://doi.org/10.1111/j.1748-720X.2007.00111.x
- Influences on the development of children’s eating behaviours: from infancy to adolescence.Can J Diet Pr Res. 2009; 68: 1-11https://doi.org/10.1097/MD.0000000000000215
- Fruit and vegetable intake during infancy and early childhood.Pediatrics. 2014; 134: S63-S69https://doi.org/10.1542/peds.2014-0646K
- Dietary patterns in infancy are associated with child diet and weight outcomes at 6 years.Int J Obes. 2017; 41: 783-788https://doi.org/10.1038/ijo.2017.27
- Tracking of dietary intakes in early childhood: the Melbourne InFANT Program.Eur J Clin Nutr. 2013; 67: 275-281https://doi.org/10.1038/ejcn.2012.218
- Trends in food and beverage consumption among infants and toddlers: 2005-2012.Pediatrics. 2017; 139e20163290https://doi.org/10.1542/peds.2016-3290
- Cross-sectional analysis of eating patterns and snacking in the US Feeding Infants and Toddlers Study 2008.Public Health Nutr. 2017; 20: 1584-1592https://doi.org/10.1017/S136898001700043X
- Food consumption patterns of infants and toddlers: findings from the Feeding Infants and Toddlers Study (FITS) 2016.J Nutr. 2018; 148: 1525S-1535Shttps://doi.org/10.1093/jn/nxy171
- Nutritional aspects of commercially prepared infant foods in developed countries: a narrative review.Nutr Res Rev. 2017; 30: 138-148https://doi.org/10.1017/S0954422417000038
- Sodium, sugar, and fat content of complementary infant and toddler foods sold in the United States, 2015.Am J Clin Nutr. 2017; 105: 1443-1452https://doi.org/10.3945/ajcn.116.142653
- Nutritional content and ingredients of commercial infant and toddler food pouches compared with other packages available in the United States.Nutr Today. 2019; 54: 305-312https://doi.org/10.1097/nt.0000000000000385
- Food consumption patterns and micronutrient density of complementary foods consumed by infants fed commercially prepared baby foods.Nutr Today. 2018; 53: 68-78https://doi.org/10.1097/NT.0000000000000265
- Daily snacking occasions and weight status among US children aged 1 to 5 years.Obesity. 2018; 26: 1034-1042https://doi.org/10.1002/oby.22172
- Relationship between food insecurity, child weight status, and parent-reported child eating and snacking behaviors.J Spec Pediatr Nurs. 2017; 22: 1-11https://doi.org/10.1111/jspn.12177
- Interrelationships of child appetite, weight and snacking among Hispanic preschoolers.Pediatr Obes. 2018; 13: 38-45https://doi.org/10.1111/ijpo.12186
- Associations of less healthy snack food consumption with infant weight-for-length z-score trajectories: findings from the Nurture Cohort study.Nutrients. 2019; 11: 2752https://doi.org/10.3390/nu11112752
- Daily snacking occasions, snack size, and snack energy density as predictors of diet quality among us children aged 2 to 5 years.Nutrients. 2019; 11: 1-12https://doi.org/10.3390/nu11071440
- High intake of added sugars is linked to rapid weight gain in infancy, breastfeeding ≥12 months may protect against this: a preliminary investigation.Pediatr Obes. 2021; 16: 1-9https://doi.org/10.1111/ijpo.12728
- Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids.National Academies Press, 2005https://doi.org/10.17226/10490
- Trends in snacking among U.S. children.Health Aff. 2010; 29: 398-404https://doi.org/10.1377/hlthaff.2009.0666
- A comparison of snack serving sizes to USDA guidelines in healthy weight and overweight minority preschool children enrolled in Head Start.BMC Obes. 2016; 3https://doi.org/10.1186/S40608-016-0116-2
- Infant feeding practices study II: study methods.Pediatrics. 2008; 122: S28-S35https://doi.org/10.1542/peds.2008-1315c
- The Feeding Infants and Toddlers Study 2008: Study design and methods.J Am Diet Assoc. 2010; 110: S16-S26https://doi.org/10.1016/j.jada.2010.09.005
- An overview of USDA’s Dietary Intake Data System.J Food Compos Anal. 2004; 17: 545-555https://doi.org/10.1016/j.jfca.2004.02.013
- Nutrition Data System for Research 2019. Nutrition Coordinating Center, 2019
- Feeding Infants and Toddlers Study (FITS): development of the FITS survey in comparison to other dietary survey methods.J Am Diet Assoc. 2006; 106: S12-S27https://doi.org/10.1016/j.jada.2005.09.033
- Dietary Reference Intakes (DRIs): Estimated Average Requirements.National Academies Press, Washington, DC2011
- Baby Food FACTS: nutrition and marketing of baby and toddler food and drinks; 2017.
- What We Eat in America food categories: 2017-2018.
- The WHO Multicentre Growth Reference Study: planning, study design, and methodology.Food Nutr Bull. 2004; 25: 15-26https://doi.org/10.1177/15648265040251s104
- Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy.Arch Dis Child. 2012; 97: 1019-1026https://doi.org/10.1136/archdischild-2012
- SAS Software. SAS Institute Inc,
2015www.sas.comVersion: Version 9.4 of the SAS System for Windows
- Systat Software. Systat Software, Inc, 2004
- Types and amounts of complementary foods and beverages consumed and growth, size, and body composition: a systematic review.Am J Clin Nutr. 2019; 109: 956S-977Shttps://doi.org/10.1093/ajcn/nqy281
- Development of food pattern recommendations for infants and toddlers 6-24 months of age to support the dietary guidelines for Americans, 2020–2025.J Nutr. 2021; 151: 3113-3124https://doi.org/10.1093/jn/nxab201
- Overestimation of infant and toddler energy intake by 24-h recall compared with weighed food records.Am J Clin Nutr. 2008; 88: 407-415https://doi.org/10.3945/ajcn.2008.27309
Biography
A. M. Moore is a postdoctoral scholar, Center for Childhood Obesity Research, The Pennsylvania State University, University Park.
Biography
J .O. Fisher is a professor, Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA.
Biography
C. M. Croce is a senior research associate, Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA.
Biography
K. S. Morris is a project coordinator, Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY.
Biography
R. A. Paluch is a data manager/statistician, Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY.
Biography
K. L. Kong is an assistant professor, Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, MO. Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center, Kansas City, KS. Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO
Article Info
Publication History
Published online: February 24, 2022
Accepted:
February 21,
2022
Received:
August 6,
2021
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was supported by a grant from the National Institute on Child Health and Human Development of the National Institutes of Health (grant no: R01HD087082-01 ).
Identification
Copyright
© 2022 by the Academy of Nutrition and Dietetics.
