Snacking characteristics and patterns and their associations with diet quality and BMI in the Childhood Obesity Prevention and Treatment Research Consortium

Abstract

Objective To describe snacking characteristics and patterns in children and examine associations with diet quality and BMI. Design Children’s weight and height were measured. Participants/adult proxies completed multiple 24-hour dietary recalls. Snack occasions were self-identified. Snack patterns were derived for each sample using exploratory factor analysis. Associations of snacking characteristics and patterns with Health Eating Index-2010 (HEI-2010) score and body mass index (BMI) were examined using multivariable linear regression models. Setting Childhood Obesity Prevention and Treatment Research (COPTR) Consortium, United States: NET-Works, GROW, GOALS, and IMPACT studies. Subjects Predominantly low-income, racial/ethnic minorities: NET-Works (n 534 2–4-year-olds); GROW (n 610 3–5-year-olds); GOALS (n 241 7–11-year-olds); and IMPACT (n 360 10–13-year-olds). Results Two snack patterns were derived for three studies, a meal-like pattern and beverage pattern. The IMPACT study had a similar meal-like pattern and a dairy/grains pattern. A positive association was observed between meal-like pattern adherence and HEI-2010 score (p-for-trend<0.01) and snack occasion frequency and HEI-2010 score (β-coefficient [95% CI]: NET-Works: 0.14 [0.04, 0.23], GROW: 0.12 [0.02, 0.21]) among younger children. A preference for snacking while using a screen was inversely associated with HEI-2010 score in all studies except IMPACT (β-coefficient [95% CI]: NET-Works: −3.15 [−5.37, −0.92], GROW: −2.44 [−4.27, −0.61], GOALS: −5.80 [−8.74, −2.86]). Associations with BMI were almost all null. Conclusions Meal-like and beverage patterns described most children’s snack intake, though patterns for non-Hispanic Blacks or adolescents may differ. Diets of 2–5-year-olds may benefit from frequent meal-like pattern snack consumption, and diets of all children may benefit from decreasing screen use during eating occasions.

Dietary patterns and associations with BMI in low-income, ethnic minority youth in the USA according to baseline data from four randomised controlled trials

“…The second pattern identified in the IMPACT study was the Sandwich pattern. The observation that both dietary patterns for IMPACT were distinct from those derived in other COPTR studies is similar to previous research in COPTR which identified distinct snack-occasion-specific dietary patterns for IMPACT compared with the other COPTR studies (44) . Interestingly, the Sandwich pattern in IMPACT was similar to another pattern called 'Packed Lunch' that was previously observed at 7, 10 and 13 years of age in the Avon Longitudinal Study of Parents and Children in England (45) .…”

Meal and snack patterns of 7–13-year-old schoolchildren in southern Brazil

“…The current study presents an original assessment of mealspecific DP in Brazilian schoolchildren. Previous data in the literature had mostly focused on eating patterns at isolated time periods of the day, disregarding other eating occasions (20)(21)(22)(23) . Almost all children ate the traditional three main meals (breakfast, lunch and dinner), while more than twothirds of them reported eating the mid-afternoon snack, and about half of the children reported the mid-morning and evening snacks.…”

“…In a study conducted with 2-11-year-old American children, two snack patterns were identified using factor analysis: a meal-like pattern (higher factor loadings for non-starchy vegetables, meats and grains) and a beverage pattern (higher loadings for unsweetened milk and sugar-sweetened beverage). The authors observed a positive association between the meal-like pattern and the diet quality (23) .…”

“…Only few studies on children and adolescents (18,19) have examined meal-specific DP with some research focusing on breakfast (20,21) or snacking (22,23) patterns. Other Brazilian studies based on adult populations examined DP for main meals (breakfast, lunch and dinner) (9)(10)(11) .…”

Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity

“…Based in Family Systems Theory (FST), prior research has shown supportive and nurturing family interactions and parenting practices promote healthy behavioral outcomes, including healthier weight management practices and improved dietary habits among adolescents [5,[21][22][23][24]. Further, parental support for healthy eating has been associated with healthier dietary intake (e.g., increased fruit and vegetable intake, reduced sweetened beverages), as well as sustained weight loss among adolescents [21,25] In contrast, more restrictive family feeding practices (restricting child's access to foods), are associated with poorer dietary outcomes [26][27][28].…”