BackgroundWhile the role of parenting in children’s eating behaviors has been studied extensively, less attention has been given to its potential association with children’s snacking habits. To address this gap, we conducted a systematic review to describe associations between food parenting and child snacking, or consuming energy dense foods/foods in between meals.MethodsSix electronic databases were searched using standardized language to identify quantitative studies describing associations of general and feeding-specific parenting styles as well as food parenting practices with snacking behaviors of children aged 2–18 years. Eligible peer-reviewed journal articles published between 1980 and 2017 were included. Data were extracted using a standard protocol by three coders; all items were double coded to ensure consistency.ResultsForty-seven studies met inclusion criteria. Few studies focused on general feeding (n = 3) or parenting styles (n = 10). Most studies focused on controlling food parenting practices (n = 39) that were not specific to snacking. Parental restriction of food was positively associated with child snack intake in 13/23 studies, while pressure to eat and monitoring yielded inconsistent results. Home availability of unhealthy foods was positively associated with snack intake in 10/11 studies. Findings related to positive parent behaviors (e.g. role modeling) were limited and yielded mixed results (n = 9). Snacking was often assessed using food frequency items and defined post-hoc based on nutritional characteristics (e.g. energy-dense, sugary foods, unhealthy, etc.). Timing was rarely included in the definition of a snack (i.e. chips eaten between meals vs. with lunch).ConclusionsRestrictive feeding and home access to unhealthy foods were most consistently associated with snacking among young children. Research is needed to identify positive parenting behaviors around child snacking that may be used as targets for health promotion. Detailed definitions of snacking that address food type, context, and purpose are needed to advance findings within the field. We provide suggested standardized terminology for future research.Electronic supplementary materialThe online version of this article (10.1186/s12966-017-0593-9) contains supplementary material, which is available to authorized users.

BackgroundFew interventions have shown efficacy to influence key energy balance behaviors during the preschool years.ObjectiveA randomized controlled trial (RCT) was used to evaluate the efficacy of Food, Fun, and Families (FFF), a 12 week authoritative food parenting intervention for mothers with low-income levels, to reduce preschool-aged children’s intake of calories from solid fat and added sugar (SoFAS).MethodsMothers were randomly assigned to receive FFF (n = 59) or to a delayed treatment control (n = 60). The primary outcome was children’s daily energy intake from SoFAS at the end of the 12 week intervention, controlling for baseline levels, assessed by 24-h dietary recalls. Secondary outcomes included children’s daily energy intake, children’s BMI z-scores, and meal observations of maternal food parenting practices targeted in FFF (e.g. providing guided choices).ResultsParticipating mothers were predominantly African American (91%), with 39% educated beyond high school and 66% unemployed. Baseline demographics and child SoFAS intakes did not differ by group. Lost to follow-up was 13% and did not differ between groups. At post-intervention, FFF children consumed ~ 94 kcal or 23% less daily energy from SoFAS than children in the control group, adjusting for baseline levels (307.8 (95%CI = 274.1, 341.5) kcal vs. 401.9 (95%CI = 369.8, 433.9) kcal, FFF vs. control; p < 0.001). FFF mothers also displayed a greater number of authoritative parenting practices when observed post-intervention with their child at a buffet-style meal (Wilcoxon z = − 2.54, p = 0.012). Neither child total daily energy intake nor BMI z-scores differed between groups post-intervention.ConclusionsFindings demonstrate the initial efficacy of an authoritative food parenting intervention for families with low-income to reduce SoFAS intake in early childhood. Additional research is needed to evaluate longer-term effects on diet and growth.Trial registrationRetrospectively registered at ClinicalTrials.gov: #NCT03646201.

Snacking is a significant contributor to energy intake among adolescents, but its association with weight status is unclear. To elucidate this association, data from 6545 adolescents (12–19 years) in the 2005–2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. The mean number of daily snack occasions, mean snack size, and mean snack energy density were examined by weight classification (body mass index (BMI)-for-age percentiles: normal weight (NW) <85th; overweight (OW) ≥85th to <95th; obese (OB) ≥95th). Models included all snacking parameters, mean meal size, demographic characteristics, survey cycle year, and dietary reporting accuracy. Adolescents with NW consumed fewer snacks daily (1.69 (0.02) snacks/day) and smaller snacks per occasion (262.32 (4.41) calories (kcal)/snack) compared to adolescents with OW (1.85 (0.05) snacks/day, p = 0.005; 305.41 (8.84) kcal/snack, p < 0.001), and OB (1.97 (0.05) snacks/day; 339.60 (10.12) kcal/snack, both p < 0.001). Adolescents with OW and OB also consumed more added sugar, saturated fat and sodium from snacks, but had lower mean energy density per snack compared to snacks consumed by NW adolescents. US adolescents with OW and OB consume more snacks daily and more calories at each snacking occasion compared to adolescents with NW. Future studies should examine the prospective associations between snacking and weight status and impact on overall diet quality.

ObjectiveTo characterize associations of snacking frequency with weight status among US children aged 1 to 5 years.MethodsParticipants were children (n = 4,669) aged 1 to 5 years in the 2005 to 2014 National Health and Nutrition Examination Survey (NHANES). Snacking was assessed by two 24‐hour dietary recalls using definitions that considered “snack” occasions as well as other foods/beverages consumed between meals. Overweight/obesity (OW/OB) was defined using percentile cutoffs: ≥ 97.7th weight‐for‐length (< 2 years) cutoff and the ≥ 85th BMI‐for‐age (≥ 2 years) cutoff. Linear/logistic regressions evaluated snacking based on daily occasions and relative to current recommendations (two to three snacks per day).ResultsDuring 2005 to 2014, US children aged 1 to 5 years consumed, on average, two to three snacks daily. Children with normal weight in both age groups tended to snack less frequently than children with OW/OB when considering all foods/beverages eaten between meals (P < 0.01‐0.12). Across most snacking definitions, children < 2 years who snacked more frequently than recommended had greater odds of having OW/OB (P < 0.01‐0.12) and consumed greater daily snack energy than those who snacked within recommendations (all P < 0.01). Recommendations did not clearly delineate weight status among children aged 2 to 5 years.ConclusionsSnacking frequency and weight are positively associated among US children 1 to 5 years old, with most consistent associations seen among children < 2 years old and when considering all foods/beverages consumed between meals.

Whether snacks help young children meet nutritional needs or merely contribute to excessive intakes is debated. This research evaluated associations of snacking with dietary quality among US preschoolers (two to five years, n = 4217) in the 2005–2016 National Health Examination Survey (NHANES). Snacking occasions, size, and energy density (ED) were estimated from two 24-hr dietary recalls. Diet quality indices included the 2015 Healthy Eating Index (HEI-2015, 0–100), the mean adequacy ratio (MAR, 0–100) for five shortfall nutrients (vitamin D, calcium, fiber, potassium, and iron), and the mean % of recommended limits for added sugars, saturated fat, and sodium. Linear regressions included snacking parameters, demographics, and dietary reporting accuracy. Children had a mean HEI-2015 of 53.0, a MAR of 67.7, and intake of 121.4% of nutrients to limit. Daily snacking occasions were positively associated with HEI-2015 scores, whereas mean snack size and ED were negatively associated with HEI-2015 and MAR scores (all p < 0.05). Snack ED was positively associated with daily intakes of added sugar, saturated fat, and sodium (p < 0.001). These nationally representative findings reveal that more frequent, smaller, and less energy-dense snacks are associated with higher diet quality among US preschoolers.

Snacking makes significant contributions to children's dietary intake but is poorly understood from a parenting perspective. This research was designed to develop and evaluate the psychometrics of a theoretically grounded, empirically-informed measure of snack parenting. The Parenting around SNAcking Questionnaire (P-SNAQ) was developed using a conceptual model derived from current theory and mixed-methods research to include 20 hypothesized snack parenting practices along 4 parenting dimensions (autonomy support, structure, coercive control and permissiveness). Expert panel evaluation and cognitive interviews were used to refine items and construct definitions. The initial instrument of 105 items was administered to an ethnically diverse, low-income sample of 305 parents (92% mothers) of children aged 1-6 y participating in three existing cohort studies. The sample was randomly split into two equal samples. Exploratory factor analysis was conducted with the first sample to identify snack parenting practices within each parenting dimension, followed by confirmatory factor analysis with the second sample to test the hypothesized factor structure. Internal consistency of sub-scales and associations with existing measures of food parenting practices and styles and child weight status were evaluated. The final P-SNAQ scale included 51 items reflecting 14 snack parenting practices across four parenting dimensions. The factor structure of the P-SNAQ was consistent with prior theoretical frameworks. Internal consistency coefficients were good to very good for 12 out of 14 scales and subscale scores were moderately correlated with previously validated measures. In conclusion, initial evidence suggests that P-SNAQ is a psychometrically sound measure for evaluating a wide range of snack parenting practices in young children.

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