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Association of Snacking Frequency, Size, and Energy Density with Weight Status among Preschool-Aged Children in the United States

      Abstract

      Background

      Snacking (ie, eating between meals) is common among US preschool-aged children, but associations with weight status are unclear.

      Objective

      This research evaluated associations of snack frequency, size, and energy density as well as the percent of daily energy from snacking with weight status and sociodemographic characteristics among US children aged 2 to 5 years.

      Design

      Cross-sectional analysis of 2007-2018 National Health and Nutrition Examination Survey data using two, caregiver proxy, 24-hour dietary recalls.

      Participants/setting

      US children aged 2 to 5 years (n = 3,313) with at least one snack occasion over 2 days of intake.

      Main outcome measures

      Snacking parameters included frequency (number of occasions per day), size (kilocalories per occasion), and energy density (kilocalories per gram per occasion) as well as percent of daily energy from snacking.

      Statistical analyses

      Generalized linear regression models evaluated associations of snacking with child weight status (ie, normal weight and overweight/obesity), adjusting for survey weights, energy misreporting, mean meal size, and sociodemographic covariates.

      Results

      Children with overweight/obesity consumed more frequent snacks (2.8 [0.06] vs 2.5 [0.03] snacks/day, respectively; P < 0.001), larger snacks (188 [4] vs 162 [23] kcal/occasion, respectively; P < 0.001), and a greater percent of daily energy from snacking (29.80% [1.00%] vs 26.09% [0.40%], respectively; P < 0.001) than children with normal weight. Mean snack frequency and size as well as percentage of daily energy from snacking varied with child age, gender, and head of household education. Associations of snacking with child race and ethnicity were less consistent.

      Conclusions

      These nationally representative findings provide evidence that the consumption of larger, more frequent snacks is associated with overweight/obesity among US children aged 2 to 5 years and snacking varies by sociodemographic characteristics.

      Keywords

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      Biography

      C. M. Croce is a senior research associate, Center for Obesity Research and Education, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA.

      Biography

      G. L. Tripicchio is an assistant professor, Center for Obesity Research and Education, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA.

      Biography

      J. O. Fisher is a professor and associate director, Center for Obesity Research and Education, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA.

      Biography

      D. L. Coffman is an associate professor, Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA.