Advertisement

Frequency of Sweet and Salty Snack Food Consumption Is Associated with Higher Intakes of Overconsumed Nutrients and Weight-For-Length z Scores During Infancy and Toddlerhood

  • Amy M. Moore
    Correspondence
    Address correspondence to: Amy M. Moore, PhD, RD, Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA 16802.
    Affiliations
    Center for Childhood Obesity Research, The Pennsylvania State University, University Park, Pennsylvania
    Search for articles by this author
  • Jennifer Orlet Fisher
    Affiliations
    Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania
    Search for articles by this author
  • Katherine S. Morris
    Affiliations
    Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
    Search for articles by this author
  • Christina M. Croce
    Affiliations
    Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania
    Search for articles by this author
  • Rocco A. Paluch
    Affiliations
    Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
    Search for articles by this author
  • Kai Ling Kong
    Affiliations
    Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, Missouri

    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
    Search for articles by this author
Published:February 24, 2022DOI:https://doi.org/10.1016/j.jand.2022.02.013

      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 access
      One-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 Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Young B.E.
        • Krebs N.F.
        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
        • American Academy of Pediatrics
        Pediatric Nutrition.
        8th ed. American Academy of Pediatrics, Itasca, IL2019
        • US Depts of Agriculture and Health and Human Services
        Dietary Guidelines for Americans, 2020-2025. 9th ed. December 2020.
        • Birch L.L.
        • Doub A.E.
        Learning to eat: birth to age 2 y.
        Am J Clin Nutr. 2014; 99: 723S-728Shttps://doi.org/10.3945/ajcn.113.069047
        • Anzman-Frasca S.
        • Ventura A.K.
        • Ehrenberg S.
        • Myers K.P.
        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
        • Savage J.S.
        • Fisher J.O.
        • Birch L.L.
        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
        • Birch L.L.
        • Arbor A.
        • Savage J.S.
        • Ventura A.
        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
        • Grimm K.A.
        • Kim S.A.
        • Yaroch A.L.
        • Scanlon K.S.
        Fruit and vegetable intake during infancy and early childhood.
        Pediatrics. 2014; 134: S63-S69https://doi.org/10.1542/peds.2014-0646K
        • Rose C.M.
        • Birch L.L.
        • Savage J.S.
        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
        • Lioret S.
        • McNaughton S.A.
        • Spence A.C.
        • Crawford D.
        • Campbell K.J.
        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
        • Miles G.
        • Siega-Riz A.M.
        Trends in food and beverage consumption among infants and toddlers: 2005-2012.
        Pediatrics. 2017; 139e20163290https://doi.org/10.1542/peds.2016-3290
        • Deming D.M.
        • Reidy K.C.
        • Fox M.K.
        • Briefel R.R.
        • Jacquier E.
        • Eldridge A.L.
        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
        • Roess A.A.
        • Jacquier E.F.
        • Catellier D.J.
        • et al.
        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
        • Maslin K.
        • Venter C.
        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
        • Maalouf J.
        • Cogswell M.E.
        • Bates M.
        • et al.
        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
        • Moding K.J.
        • Ferrante M.J.
        • Bellows L.L.
        • Bakke A.J.
        • Hayes J.E.
        • Johnson S.L.
        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
        • Reidy K.C.
        • Bailey R.L.
        • Deming D.M.
        • et al.
        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
        • Kachurak A.
        • Davey A.
        • Bailey R.L.
        • Fisher J.O.
        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
        • Kral T.V.E.
        • Chittams J.
        • Moore R.H.
        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
        • Rudy E.
        • Bauer K.W.
        • Hughes S.O.
        • et al.
        Interrelationships of child appetite, weight and snacking among Hispanic preschoolers.
        Pediatr Obes. 2018; 13: 38-45https://doi.org/10.1111/ijpo.12186
        • Moore A.M.
        • Vadiveloo M.
        • Tovar A.
        • McCurdy K.
        • Østbye T.
        • Benjamin-Neelon S.E.
        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
        • Kachurak A.
        • Bailey R.L.
        • Davey A.
        • Dabritz L.
        • Fisher J.O.
        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
        • Kong K.L.
        • Burgess B.
        • Morris K.S.
        • Faith M.S.
        • Paluch R.A.
        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
        • Institutes of Medicine, Food and Nutrition Board
        Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids.
        National Academies Press, 2005https://doi.org/10.17226/10490
        • Piernas C.
        • Popkin B.M.
        Trends in snacking among U.S. children.
        Health Aff. 2010; 29: 398-404https://doi.org/10.1377/hlthaff.2009.0666
        • Charvet A.
        • Hartlieb K.B.
        • Yeh Y.
        • Jen K.L.C.
        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
        • Fein S.B.
        • Labiner-Wolfe J.
        • Shealy K.R.
        • Li R.
        • Chen J.
        • Grummer-Strawn L.M.
        Infant feeding practices study II: study methods.
        Pediatrics. 2008; 122: S28-S35https://doi.org/10.1542/peds.2008-1315c
        • Briefel R.R.
        • Kalb L.M.
        • Condon E.
        • et al.
        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
        • Raper N.
        • Perloff B.
        • Ingwersen L.
        • Steinfeldt L.
        • Anand J.
        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
      1. Nutrition Data System for Research 2019. Nutrition Coordinating Center, 2019
        • Ziegler P.
        • Briefel R.
        • Clusen N.
        • Devaney B.
        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
        • Institute of Medicine, Food and Nutrition Board
        Dietary Reference Intakes (DRIs): Estimated Average Requirements.
        National Academies Press, Washington, DC2011
        • Harris J.L.
        • Fleming-Milici F.
        • Frazier W.
        • et al.
        Baby Food FACTS: nutrition and marketing of baby and toddler food and drinks; 2017.
        • US Dept of Agriculture, Agricultural Research Service
        What We Eat in America food categories: 2017-2018.
        • de Onis M.
        • Garza C.
        • Victora C.G.
        • Onyango A.W.
        • Frongillo E.A.
        • Martines J.
        The WHO Multicentre Growth Reference Study: planning, study design, and methodology.
        Food Nutr Bull. 2004; 25: 15-26https://doi.org/10.1177/15648265040251s104
        • Weng S.F.
        • Redsell S.A.
        • Swift J.A.
        • Yang M.
        • Glazebrook C.P.
        • Glazebrook C.
        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
      2. SAS Software. SAS Institute Inc, 2015
        www.sas.com
        Version: Version 9.4 of the SAS System for Windows
      3. Systat Software. Systat Software, Inc, 2004
        • English L.K.
        • Obbagy J.E.
        • Wong Y.P.
        • et al.
        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
        • Dewey K.G.
        • Pannucci T.R.
        • Casavale K.O.
        • et al.
        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
        • Fisher J.O.
        • Butte N.F.
        • Mendoza P.M.
        • et al.
        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