Association of meal and snack patterns with micronutrient intakes among Greek children and adolescents: data from the Hellenic National Nutrition and Health Survey

Abstract

Background The present study aimed to examine how different meal and snack patterns are associated with micronutrient intakes and diet quality among a nationally representative sample of Greek children and adolescents aged 1–19 years from the cross‐sectional Hellenic National Nutrition and Health Survey (n = 598). Methods Meal and snack patterns were derived using 24‐h dietary recalls. Mean adequacy ratio (MAR) was used as an overall measure of diet quality. Multiple linear regression adjusted for covariates was conducted to examine associations between eating patterns, nutrient intakes and MAR. Results Four most frequently reported eating schemes were identified including breakfast (B), lunch (L), dinner (D) and two snacks (S) (20.9%); B, L, D and 1S (16.2%); B, L, D and 3S (10.8%); and B, L and D (7.9%). Based on these schemes, the daily consumption of all main meals from the majority of the sample was highlighted. In children and adolescents aged 4–19 years, increasing snack frequency was positively associated with intakes of vitamin D, vitamin K, riboflavin, niacin, pantothenic acid, folate, magnesium, copper and selenium. An inverse association was recorded for vitamin E, vitamin B6, calcium and iron. Among children aged 1–3 years, only niacin and copper were significantly associated with number of snacks, with the group of ‘B‐L‐D‐2S’ presenting the highest intake. As for the overall diet quality, among all participants, there was no significant association of MAR with the type of meal and snack pattern, and thus the snack frequency. Conclusions Snacking behaviour is a common practice among children and adolescents. Modifying current snack foods with nutrient‐rich choices could lead to an improvement of their diet's nutritional quality.

Snack frequency, size, and energy density are associated with diet quality among US adolescents

“…Work from younger paediatric populations and adults in the US suggest that snacks can help contribute to higher overall diet quality but snacking also clearly contributes to greater intake of food groups to limit including refined grains, added sugar, and fat (15,16,39,40) . This trend was also observed in an international sample of children and adolescents; greater snacking frequency was associated with higher micronutrient intakes, but the main sources of snack energy were desserts, sweets, and baked products (41) . Our work confirms these findings and further contributes important details about snacking characteristics and diet quality.…”

Association between Serum Lipid Levels in Greek Children with Dyslipidemia and Mediterranean Diet Adherence, Dietary Habits, Lifestyle and Family Socioeconomic Factors

“…The above findings could be related to a possible postprandial hyperglycemia and lipemia [ 36 ]. Data from the cross-sectional Hellenic National Nutrition and Health Survey in 598 children and adolescents aged 4– 19 years, showed that increased snack consumption was positively correlated with vitamin D, vitamin K, riboflavin, niacin, pantothenic acid, folate, magnesium, copper and selenium intake [ 37 ]. A metanalysis of 47 studies who investigated the correlation between breakfast consumption and nutritional adequacy, body weight and academic performance in children and adolescents showed that the consumption of a healthy breakfast consisting of a variety of foods on a daily basis (particularly whole grains, rich with roughage and nutrients, fruit and dairy products) is beneficial for children’s health [ 31 ].…”

Iron Nutrition of Pre-Schoolers in High-Income Countries: A Review

“…Despite the importance of understanding the nutrient intake profiles of dietary patterns [57], only a small number of studies have reported on the associations between the dietary patterns and nutrient intakes of children aged 2-5 years in high-resource countries [4,53,[58][59][60][61][62][63][64][65][66][67][68]. Of the diet quality studies published in English and focused on pre-school nutrient intakes, twelve have reported patterns associated with iron intakes (Table 2) [53,[58][59][60][61][62][63][64][65][66][67][68]. These studies have implemented a variety of approaches, including three that used PCA [53,58,64], they were from a variety of locations (South Korea, the Netherlands, UK, USA, Australia, and Greece), and they reported varied results.…”

“…Iron intake has been positively associated with pre-schooler diets characterised by healthier foods (such as fruit, fish, rice, and vegetables) [58,64], fruit juice [60], 'good' diets [61], and non-haem and non-iron fortified foods (such as cheese and bread) [53]. In addition, it has been inversely associated with patterns dominated by confectionery and convenience foods [58,59] and snack frequency [66]. For South Korean children, where cluster analysis identified two patterns for foods consumed outside of the home, the index of nutritional quality for iron was lower for a mixed pattern than for a rice-centred pattern [67].…”