Weekday snacking prevalence, frequency, and energy contribution have increased while foods consumed during snacking have shifted among Australian children and adolescents: 1995, 2007 and 2011-12 National Nutrition Surveys

Development and application of the Meal and Snack Assessment (MESA) quality scale for children and adolescents using item response theory

BACKGROUND

Meals differ in terms of food items and nutritional quality. The aim of the present study was to propose a scale to measure the meals quality of schoolchildren according to food processing degree, perform a preliminary evaluation of the scale's validity and reliability and apply the scale to a representative sample of schoolchildren in a city in southern Brazil.

METHODS

A methodological study based on the generalized graded unfolding model (GGUM) of item response theory (IRT) with analysis of secondary data was carried out in 6,399 schoolchildren of 6-15y-old attending 2nd to 5th grades of public elementary schools in Florianópolis, Brazil, in 2013-2015 who answered the validated Food Intake and Physical Activities of Schoolchildren (WebCAAFE) questionnaire. Meal quality was the latent trait. The steps for the development of the scale included: latent trait definition; item generation; dimensionality analysis; estimation of item parameters; scale levels definition; assessment of validity and reliability; and assessment of the meal quality of a subsample of schoolchildren aged 7 to 12 years (n = 6,372).

RESULTS

Eleven out of eighteen items had adequate parameters, without differential item functioning for sex or age. Meal quality was categorized into three levels: healthy, mixed, and unhealthy. Higher scores indicate a greater prevalence of ultra-processed foods in daily meals. Most schoolchildren had mixed (40.6%) and unhealthy (41%) meal patterns.

CONCLUSIONS

IRT analysis allowed the development of the scale, which measures the quality of meals and snacks based on the degree of food processing. At all snack times, there was a higher frequency of ultra-processed foods consumption, therefore foods consumed as snacks are a potential focus for nutritional interventions.

Metabolisable energy from nuts and patterns of nut consumption in the Australian population: a secondary analysis of the 2011-12 National Nutrition and Physical Activity Survey

BACKGROUND

Nut intake is not associated with increased body weight, which may be explained by their metabolisable energy, among other factors. Therefore, total energy intake may be overestimated among nut consumers. This study aimed to describe the metabolisable energy from nuts and nut consumption patterns in the Australian population.

METHODS

A nut-specific database was expanded to include metabolisable energy of nuts (based on nut type and form) and applied to the 2011-12 National Nutrition and Physical Activity Survey (NNPAS). Participants were Australians aged 2 years and older from the 2011-12 NNPAS (n = 12,153, with n = 4,765 nut consumers). Mean metabolisable energy intake was compared with mean energy intake using Atwater factors in nut consumers. Additionally, nut consumption patterns were explored, including the proportion of nuts consumed at meals and snacks.

RESULTS

Among nut consumers, mean metabolisable energy from nuts based only on nut type was 241.2 (95% confidence interval [CI]: 232.0, 250.5) kJ/day and mean metabolisable energy considering both nut type and form was 260.7 (95% CI: 250.2, 271.2) kJ/day. Energy intake from nuts using Atwater factors was 317.6 (95% CI: 304.8, 330.3) kJ/day. Nuts were more likely to be consumed at snack occasions, with approximately 63% of nut intake occurring as a snack.

CONCLUSION

Application of metabolisable energy to the 2011-12 NNPAS has a significant impact on calculation of energy intake from nuts. Nut consumption patterns identified a majority of nut consumption occurring as snacks. These findings may inform strategies to support nut consumption in Australia.

Snacking behavior is associated with snack quality, overall diet quality, and body weight among US college students

Snacking behavior may affect snack quality, overall diet quality, and body weight; however, the associations between these variables have not been studied among college students. The objective of this study was to associate snacking behaviors with snack quality, diet quality, and weight status among college students with overweight and obesity. We hypothesized that a higher snacking frequency, accessibility and availability of unhealthy snacks, and lack of knowledge would be associated with lower snack and diet quality, and higher weight. Participants (n = 140) completed a snack behavior questionnaire, three 24-hour dietary recalls to assess diet quality using Healthy Eating Index 2015 (HEI-2015), and snack score using an algorithm based on the US DA Smart Snack guidelines and reported weight and height to calculate body mass index (BMI). Analysis of variance and Pearson correlation was used in the analyses. After adjusting for confounders, snack frequency was not associated with snack score, HEI-2015 score, or BMI, but evening snacks had a significantly lower snack score compared with late afternoon snacks (P = .017). Also, those with more accessibility and availability of unhealthy snacks had a lower snack score (P = .001), lower HEI-2015 score (P = .006), and higher BMI (P = .019). Snacking for pleasure was significantly associated with a lower snack score (P = .037). Snack score was positively correlated with HEI-2015 score but not with BMI. In conclusion, late snacking, unhealthy snack environment, and snacking for pleasure were associated with lower snack and diet quality. These findings could be used in future intervention strategies to improve snacking behaviors and the food environment.

Eating Frequency in European Children from 1 to 96 Months of Age: Results of the Childhood Obesity Project Study

We aimed to investigate the eating frequency (EF) in children over age, and examined the influence of country, sex, feeding mode and weight status on EF. We used the dietary data of the Childhood Obesity Project, which comprised European children from five countries. Dietary data of 3-days weighed and estimated records were available monthly from 1 to 9 and at 12-, 24-, 36-, 48-, 60-, 72- and 96-months old. Generalized additive mixed effects models were used to estimate EF trajectories with EF as outcome and applying age splines. Additionally, the models were further adjusted for country, feeding mode, sex or weight status. Data from 1244 children were analysed. EF was highest at 1 month with on average 7.3 ± 1.9 feeds per day, and fell to 5.1 ± 1.1 eating occasions at the age 96 months. Night feeding was similarly often than day feeding at 1 month but declined thereafter. Significant differences in EF were observed between countries (p < 0.05), with the highest EF in Poland, and between infant feeding modes, with a higher EF in breastfed than non-breastfed infants (p < 0.05). Sex and body weight were not associated with EF. Despite the importance of EF towards total energy intake, no association with weight status was found.

Fruit and vegetable consumption as a preventative strategy for non-communicable diseases

A high intake of fruit and vegetables (FV) has consistently been associated with a reduced risk of a number of non-communicable diseases. This evidence base is largely from prospective cohort studies, with meta-analyses demonstrating an association between increased FV intake and reduced risk of both CHD and stroke, although the evidence is less certain for cancer and diabetes. Controlled intervention trials examining either clinical or intermediate risk factor endpoints are more scarce. Therefore, evidence that FV consumption reduces the risk of disease is so far largely confined to observational epidemiology, which is hampered by some methodological uncertainties. Although increased FV intake is promoted across all dietary guidelines, national surveys confirm that dietary intakes are suboptimal and are not increasing over time. A range of barriers to increasing FV intake exist, including economic, physical and behavioural barriers that must be considered when exploring potential opportunities to change this, considering the feasibility of different approaches to encourage increased FV consumption. Such interventions must include consideration of context, for example, challenges and uncertainties which exist with the whole food system.

Changes in Student's Breakfast and Snack Consumption during the Second COVID-19 Lockdown in Portugal: A Five-Wave Study

The circumstances of the COVID-19 lockdown affected many students' life spheres, including their feeding patterns and snack intake. The main goals of the present study were to: (a) analyze the changes in students' breakfast and snacking consumption during lockdown, and (b) analyze changes in the content of the students' snacks using the Healthy Eating Index. This study analyzed data from a sample of 726 students from 36 classes from the late elementary (i.e., fifth grade) through high school (i.e., twelfth grade) from two public schools in the north of Portugal. Data were collected in five moments during the 2020/2021 school year, pre-, during, and post-second lockdown moments. Throughout the five moments, almost 90% of the students ate breakfast, and the majority brought snacks from home to eat in school. Surprisingly, there was an increase in the quality of the snacks consumed during lockdown compared to the pre-lockdown moments (e.g., consumption of more whole and total fruits and less consumption of food with added sugar, saturated fats, refined grains, and fatty acids). Suggestions for healthy behavior promotion will be discussed, such as improving the school food environment and teaching children to prepare healthy lunch boxes.

Distribution of energy and macronutrient intakes across eating occasions in European children from 3 to 8 years of age: The EU Childhood Obesity Project Study

PURPOSE

We aimed to characterize the distribution of energy and macronutrient intakes across eating occasions (EO) in European children from preschool to school age.

METHODS

Data from 3-day weighed food records were collected from children at ages 3, 4, 5, 6 and 8 years from Belgium, Germany, Italy, Poland and Spain. Food intakes were assigned to EO based on country-specific daytimes for breakfast, lunch, supper and snacks (morning, afternoon). The average energy and nutrient intakes were expressed as percentage of total energy intake (%E). Nutrients were additionally expressed as percentage per EO (%E_EO). Foods were assigned to food groups; variation in intake was calculated via coefficient of variation (CV). We analyzed age trends in diurnal intake using mixed-effects beta regression.

RESULTS

The 740 healthy children included in the analysis consumed the largest proportion of daily energy at lunch (31%E ± 8, M ± SD) and supper (26%E ± 8), followed by breakfast (19%E ± 7) and snacks [afternoon (16%E ± 8); morning (8%E ± 7)], with the most variable intake at morning snack (CV = 0.9). The nutrient composition at lunch and supper was highest for fat (36 ± 9%E_Lunch; 39 ± 11%E_Supper) and protein (18 ± 5%E_Lunch; 18 ± 6%E_Supper) and at breakfast and snacks for carbohydrates (54 ± 12%E_Breakfast; 62 ± 12%E_Snacks). High-sugar content foods were consumed in relatively large proportions at breakfast and snacks. Food intakes varied significantly with age, with lower snack intakes at later ages (p < 0.001).

CONCLUSION

Possibly unhealthy EOs with high-fat intakes and high-sugar-content foods were observed. Changes in nutrient composition of EOs may be beneficial for health.

TRIAL REGISTRY

ClinicalTrials.gov: NCT00338689; 19/June/2006.

Snacking habits of Brazilian adolescents: Brazilian National Dietary Survey, 2017-2018

This study was aimed at describing the snack consumption among Brazilian adolescents. The Brazilian National Dietary Survey (2017-2018) is a nationwide representative cross-sectional study that collected food consumption data from 8264 adolescents (10 to 19 years old); data from one 24-h recall were used, in which all foods and beverages consumed throughout the day prior to the interview were described along with the amount, unit of measurement, time, place and occasion of consumption (breakfast, lunch, dinner or snack). Snacks were classified as follows: (a) Morning snack: "Snacks" consumed between 6 AM and 12 PM; (b) Afternoon snack: "Snacks" consumed between 1 PM and 5 PM; (c) Evening snack: "Snacks" consumed between 6 PM and 5 AM. Individuals were categorised according to the number of "Snacks" per day (zero, one, two or three or more). Among the evaluated adolescents, 52.8% were female and 23.0% were overweight. The consumption of at least one snack per day was mentioned by 88.2% of the adolescents, with an average of 2.33 snacks per day. An afternoon snack was consumed by 70.0% of the adolescents. Snack consumption was related to higher mean daily energy intake and a greater contribution of carbohydrates, added sugar and trans fat to the total daily energy intake. 'Cookies & Crackers' and 'Fast Foods' were the groups that contributed the most to the energy intake provided by snacks, showing, therefore, that less healthy foods were relevant components of the snacks consumed. For their important contribution to food intake, snacking habits deserve attention among the topics covered in dietary guidelines.

Changes in Package Sizes of Savoury Snacks through Exploration of Euromonitor and Industry Perspectives

Portion sizes of many energy-dense and nutrient-poor foods and drinks have increased in the past decade, whereas our understanding of the pattern of changes in package sizes remains limited. This study aimed to determine changing trends in sales and package sizes of savoury snacks in Australia, the USA, Japan and Hong Kong, and to investigate industry perspectives for these changes. Sales data (units per capita) between 2006−2020 on savoury snacks were extracted from the Euromonitor International database. Industry perspectives on package size changes were extracted systematically from selected databases, company reports and related websites following the PRISMA-ScR guidelines. The findings showed that sales per capita of savoury snacks of all package sizes increased across all four countries/regions between 2006−2020. Although changes in the proportion of smaller (<100 g) versus larger (>100 g) package size sales in each country/region over time were modest, Japan and Hong Kong exhibited a consistently higher proportion of smaller package sales compared with Australia and the USA (83.3%, 64.4%, 44.3%, 20.2%, respectively). Industry perspectives showed that increasing consumer health consciousness, demands for convenience and portion control were the main contributors to decreasing package sizes of savoury snacks. Industry reports from 2020 showed an increase in larger package size sales due to consumer purchasing behaviour amidst the COVID-19 pandemic.

Mealtime TV Use Is Associated with Higher Discretionary Food Intakes in Young Australian Children: A Two-Year Prospective Study

Background: Mealtime television use has been cross-sectionally associated with suboptimal diets in children. This study aimed to assess the two-year prospective association between baseline mealtime television use and subsequent diets in young children, and identify socioeconomic differences. Methods: Parents reported their child’s television use at meals, and fruit, vegetable, and discretionary food intakes. Multivariable linear and logistic regression analyses assessed the association between baseline mealtime television use and follow-up diet outcomes. Differences were assessed by socioeconomic position. Results: Participants were 352 Australian parents of children aged six months to six years. Daily mealtime television use (average frequency/day) was associated with higher daily frequency of discretionary food intakes (β 0.2, 95% confidence interval (CI) 0.07–0.67) at the 2-year follow-up. Individually, television use during breakfast and dinner (1–2 days/week compared to never) predicted higher daily intake frequency of discretionary food, β 0.36 (95% CI 0.12–0.60) and β 0.19 (95% CI 0.00–0.39), respectively. Similarly, 3–7 days/week of television use during breakfast and lunch predicted higher frequency of discretionary food intake, β 0.18 (95% CI 0.02–0.37) and β 0.31 (95% CI 0.07–0.55), respectively. Associations were not socioeconomically patterned. Conclusions: Investigating mealtime television use motivators across the socioeconomic spectrum could inform interventions targeting the high consumption of discretionary foods in children.

Parental work hours and household income as determinants of unhealthy food and beverage intake in young Australian children

OBJECTIVE

This study examined parental work hours and household income as determinants of discretionary (energy dense, nutrient poor) food and beverage intake in young children, including differences by eating occasion.

DESIGN

Secondary analysis of cross-sectional data. Three hierarchical regression models were conducted with percent energy from discretionary food and beverages across the day, at main meals, and at snack times being the outcomes. Dietary intake was assessed by 1x24-hour recall and 1-2x24-hour food record(s). Both maternal/paternal work hours were included, and total household income. Covariates included household, parent and child factors.

SETTING

Data from the NOURISH/SAIDI studies were collected between 2008-13.

PARTICIPANTS

Participants included 526 mother-child dyads (median(IQR) child age 1.99(1.96,2.03) years). Forty-one percent of mothers did not work while 57% of fathers worked 35-40 hours/week. Most (85%) households had an income of ≥$50k AUD/year.

RESULTS

Household income was consistently inversely associated with discretionary energy intake (β= -0.12 to -0.15). Maternal part-time employment (21-35 hours/week) predicted child consumption of discretionary energy at main meals (β=0.10, p=0.04). Paternal unemployment predicted a lower proportion of discretionary energy at snacks (β= -0.09, p=0.047).

CONCLUSIONS

This work suggests that household income should be addressed as a key opportunity-related barrier to healthy food provision in families of young children. Strategies to reduce the time burden of healthy main meal provision may be required in families where mothers juggle longer part-time working hours with caregiving and domestic duties. The need to consider the role of fathers and other parents/caregivers in shaping children's intake was also highlighted.

Where and when are portion sizes larger in young children? An analysis of eating occasion size among 1·5-5-year-olds in the UK National Diet and Nutrition Survey (2008-2017)

OBJECTIVE

To identify eating occasion-level and individual-level factors associated with the consumption of larger portions in young children and estimate their relative importance.

DESIGN

Cross-sectional.

SETTING

Data from parent-reported 4-d food diaries in the UK National Diet and Nutrition Survey (2008-2017) were analysed. Multilevel models explored variation in eating occasion size (kJ) within (n 48 419 occasions) and between children (n 1962) for all eating occasions. Eating contexts: location, eating companion, watching TV, and sitting at a table and individual characteristics: age, gender, ethnicity and parental socio-economic status were explored as potential correlates of eating occasion size.

PARTICIPANTS

Children aged 1·5-5 years.

RESULTS

Median eating occasion size was 657 kJ (IQR 356, 1117). Eating occasion size variation was primarily attributed (90 %) to differences between eating occasions. Most (73 %) eating occasions were consumed at home. In adjusted models, eating occasions in eateries were 377 kJ larger than at home. Eating occasions sitting at a table, v. not, were 197 kJ larger. Eating in childcare, with additional family members and friends, and whilst watching TV were other eating contexts associated with slightly larger eating occasion sizes.

CONCLUSIONS

Eating contexts that vary from one eating occasion to another are more important than demographic characteristics that vary between children in explaining variation in consumed portion sizes in young children. Strategies to promote consumption of age-appropriate portion sizes in young children should be developed, especially in the home environment, in eating contexts such as sitting at the table, eating with others and watching TV.

Characterizing children's eating patterns: does the choice of eating occasion definition matter?

BACKGROUND

Recommendations to define eating occasions (EO) currently exist for research in adults, but not for children or adolescents. We examined how varying EO definitions affect the characterization of eating patterns in children and adolescents.

METHODS

Cross-sectional dietary data collected using a 24-h recall data during the 2011-12 Australian National Nutrition and Physical Activity Survey (1364 boys and 1337 girls aged 2-18 years) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (EO separated by 15- or 60-min and/or an additional energy criterion of 21 or 210 kJ). Frequency of and total energy intake from meals, snacks, and all EO were estimated. F tests stratified by gender and age-group, were used to assess differences between definitions. Agreement between definitions of meal and snack frequencies was assessed using intraclass correlation coefficients (ICC). Linear regression was used to estimate the proportion of variance in total energy intake (kJ) and BMI z-score predicted by each definition.

RESULTS

Mean frequencies of meals and snacks differed between the participant-identified and time-of-day definitions, in boys and girls and for all age groups (P < 0.01). Across the six neutral definitions, there were differences between mean frequencies of EO with the largest mean difference observed for children aged 2-3 y (boys: 2.3, girls: 2.5; P < 0.003). Between the participant-identified and time-of-day definitions, there was good agreement for frequencies of snacks (ICC for both genders: 0.93) but not meals (boys: 0.36; girls: 0.38). The 15-min time interval plus 210 kJ definition of an EO consistently predicted the most variance in total energy intake (R2 range = 8.1-34.8). Definitions that delineated meals and snacks better predicted variance in BMI z-score, when compared to the neutral definitions.

CONCLUSIONS

How eating patterns are characterized vary depending on the EO definitions employed, particularly in young children. Variance in total energy intake was best predicted by a variation of the neutral definition whereas definitions that delineated meals and snacks performed better in relation to predicting BMI variance. Further international research that compares EO definitions in children will help inform a standard approach.

Snack Food Consumption across the Pune Transect in India: A Comparison of Dietary Behaviors Based on Consumer Characteristics and Locations

This study examines patterns of snack food consumption (SFC) in the rural-urban-slum transect (RUST) of a large city Pune and its precincts (population 10 million) in India. The transect structure aims to mimic a representative survey for the location capturing differences by age, gender, urbanicity, and socio-economic levels. Dietary data from 1405 individuals were used to describe snacking patterns and other food consumed at different frequencies; extent of physical activity; and Body Mass Index (BMI) and waist circumference of children, adolescents, and adults. Our results indicate high incidence of SFC across all population age groups, gender, socio-economic levels, and locations. A distinctive finding in relation to studies in high income countries is the prevalence of hunger snacking with 70% identifying hunger as the primary reason for SFC. Apart from hunger, particularly for adolescents, peer influence and social interactions played a significant role in SFC. Dietary behaviors of slum dwellers were characterized by three-quarters of them having SFC together with family members at home. SFC supplemented calories for low-income consumers and complemented calorie intake for high income ones. No significant association with BMI is possibly due to obesogenic SFC being likely offset by lower consumption of non-snack food and higher physical activity among poor and slum dwellers. Promoting awareness about diets and lifestyles, improving physical and economic access to healthier snacks and nutrient dense foods can improve diet quality in a large and heterogeneous population such as Pune.

Snacking patterns throughout the life span: potential implications on health

Eating outside the three main meals - in other words, snacking - is a part of the dietary pattern of individuals in all stages of life. The quality and pattern of snacking have an impact on health during the life span. Thus, the aim of this review was to evaluate various patterns and health outcomes of the snacking habits of different demographical groups, from children to the elderly, throughout their life span. We discuss the snacking pattern among children and adolescents, which is characterized by consuming high energy foods with low nutrient value, and which is associated with increased risk of obesity. During university years, study stress and lack of time were obstacles to a healthy dietary pattern involving nutritious snacks, although awareness of the importance of healthy snacks was higher in this group than among younger age groups. Employment status and skipping regular meals were important factors affecting snacking quality and patterns in adulthood. Unhealthy snacks, high in energy, sugar, and salt and low in nutrients, were demonstrated to have a negative impact on individuals' health, such as oral health, blood pressure, obesity, and diabetes. In conclusion, encouraging individuals to consume healthy snacks that are high in nutrients through education to help them plan for their snacks is important to enhance health and reduce disease risk.

The Role of Snack Choices, Body Weight Stereotypes and Smoking Behavior in Assessing Risk Factors for Adolescent Overweight and Obesity

This study investigated the relationship of behavioral factors, such as snack choices, obesity stereotypes and smoking with adolescents’ body weight. Individual-level data for 1254 Greek youths were selected via a formal questionnaire. Snack choices seem to be gender specific with girls showing a stronger preference for healthier snacks. Frequent consumption of high-calorie and more filling snacks was found to increase Body Mass Index (BMI) in both genders. Fruit/vegetable snacks were associated with lower body weight in females, whereas cereal/nut snacks had a negative influence in males’ BMI. The majority of participants expressed anti-fat attitudes and more boys than girls assigned positive attributes to lean peers. The endorsement of the thin-ideal was positively associated with the BMI of both adolescent boys and girls. This study also revealed that neglecting potential endogeneity issues can lead to biased estimates of smoking. Gender may be a crucial moderator of smoking–BMI relationships. Male smokers presented a higher obesity risk, whereas female smokers were more likely to be underweight. Nutrition professionals should pay attention to increase the acceptance of healthy snack options. Gender differences in the influence of weight stereotypes and smoking on BMI should be considered in order to enhance the efficacy of obesity prevention interventions.

Understanding the influence of physical resources and social supports on primary food providers' snack food provision: a discrete choice experiment

BACKGROUND

Snack eating occasions contribute approximately a third of children's energy intake, with approximately half of all unhealthy foods consumed during snack times. Therefore, it is critical to understand the drivers of primary food providers' snack provision. The study aims were to determine the relative importance of physical resources and social supports when primary food providers are choosing snacks to provide to their child, and to investigate how these attributes differ in social versus non-social occasions, and between subgroups of primary food providers based on socio-economic position.

METHODS

Primary food providers of three to seven-year olds completed an online discrete choice experiment, by making trade-offs when completing repeated, hypothetical choice tasks on the choice of snacks to provide to their child in: 1) non-social and 2) social condition. Choice tasks included two alternatives consisting of varying attribute (i.e. factor) levels, and an opt-out option. The order of conditions shown were randomized across participants. Multinomial logit model analyses were used to determine utility weights for each attribute.

RESULTS

Two-hundred and twenty-five primary food providers completed the study, providing 1125 choice decisions per condition. In the non-social condition, the top three ranked attributes were type of food (utility weight 1.94, p < 0.001), child resistance (- 1.62, p < 0.001) and co-parent support (0.99, p < 0.001). In the social condition, top ranking attributes were child resistance (utility weight - 1.50, p < 0.001), type of food (1.38, p < 0.001) and co-parent support (1.07, p < 0.001). In both conditions, time was not a significant influence and cost was of lowest relative importance. Subgroup analyses revealed cost was not a significant influence for families from higher socio-economic backgrounds.

CONCLUSIONS

Type of food, child resistance and co-parent support were of greatest relative importance in primary food providers' snack provision decision-making, regardless of social condition or socio-economic position. In designing future interventions to reduce unhealthy snacks, researchers should prioritize these influences, to better support primary food providers in changing their physical and social opportunity.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry no. ACTR N12618001173280.

Time, location and frequency of snack consumption in different age groups of Canadians

Background

The location and time of snack consumption may influence the composition, nutrient content and portion sizes of snacks. In this study, we aimed to determine and compare the time, location and frequency of snack consumption among different age groups of Canadians.

Methods

Nationally representative dietary data from the 2015 Canadian Community Health Survey (CCHS) were used (19,677 participants aged ≥2 years). Dietary data were obtained using 24-h dietary recalls. Participants were categorized according to the frequency of snack consumption (1 time, 2–3 times, ≥4 times). The snack consumption over 24 h was divided into four time periods: before 10 am, 10 am to 3 pm, 3 pm to 8 pm and 8 pm to 12 am. Meal and snack location was categorized as at home; someone else’s home; restaurants; and other.

Results

Snacking 2–3 times per day was the most common reported frequency (53.0%). Snacking at home (73.0%) was more prevalent than snacking away from home (27.0%). The most frequently reported time for snacking among Canadians was 3 pm to 8 pm (36.3%), and the least frequently reported time was before 10 am (8.1%). Snacking contributed to a high proportion of Milk and Alternatives (23.7%) and Vegetables and Fruit (23.4%) food groups and lesser proportions of Grain Products (15.4%) and Meat & Alternatives (9.4%) food groups among Canadians.

Conclusions

Home is the main location, 3 pm to 8 pm is the main time, and 2–3 times per day is the most common reported frequency for snacking. A full understanding of snacking behaviors is needed in order to develop targeted strategies to improve the quality of snack food choices.

Snacking in Japanese nursery school children aged 3-6 years: its characteristics and contribution to overall dietary intake

OBJECTIVE

This cross-sectional study evaluated the dietary characteristics of snacks, the contribution of snacks to daily nutrient intake and the association of energy intake (EI) from snacks with the prevalence of nutritional inadequacy in Japanese nursery school children.

DESIGN

Foods and nutrients consumed in each eating occasion were assessed by 3-d dietary records. The prevalence of inadequate intake of twenty nutrients assessed by the age- and sex-specific reference values in the Japanese Dietary Reference Intakes was compared according to tertile categories of EI from snacks.

SETTING

A multi-regional dietary survey based on nursery schools in Japan.

PARTICIPANTS

A total of 187 boys and 191 girls aged 3-6 years.

RESULTS

EI from snacks accounted for 19·5 % (sd 6·9) of total daily EI. Confectionaries accounted for the largest part of EI from snacks (35·3 %), followed by milk (19·5 %). Relative to their energy contribution, snacks accounted for a small proportion for all nutrients examined, except for free sugar, calcium, SFA and riboflavin. Although a higher EI from snacks was associated with favourable profiles for intakes of calcium, iron, thiamine and riboflavin, excessive intakes of free sugar and Na were more prevalent among children with a higher EI from snacks.

CONCLUSIONS

Although snacks are effective in meeting the requirement of some nutrients among Japanese nursery school children, snacks are generally not nutrient-dense and have an impact on excessive intake of some nutrients. There is hence room for improvement in food choices at snack time.

Comprehensive Nutrition Review of Grain-Based Muesli Bars in Australia: An Audit of Supermarket Products

Muesli bars are consumed by 16% of children, and 7.5% of adults, and are classified as discretionary in Australian Dietary Guidelines, containing “higher fat and added sugars” compared with core food choices. This study aimed to provide a nutritional overview of grain-based muesli bars, comparing data from 2019 with 2015. An audit of muesli bars, grain-based bars, and oat slices was undertaken in January 2019 (excluding fruit, nut, nutritional supplement, and breakfast bars) from the four major supermarkets in metropolitan Sydney. Mean and standard deviation was calculated for all nutrients on-pack, including whole grain per serve and per 100g. Health Star Rating (HSR) was calculated if not included on-pack. Of all bars (n = 165), 63% were ≤ 600 kJ (268–1958 kJ), 12% were low in saturated fat, 56% were a source of dietary fibre, and none were low in sugar. Two-thirds (66%) were whole grain (≥8 g/serve), with an average of 10 g/serve, 16% of the 48 g Daily Target Intake. HSR featured on 63% of bars (average 3.2), with an overall HSR of 2.7. Compared to 2015, mean sugars declined (26.6 g to 23.7 g/100 g; p < 0.001), and 31% more bars were whole grain (109 up from 60 bars). Although categorised as discretionary, there were significant nutrient differences across grain-based muesli bars. Clearer classification within policy initiatives, including HSR, may assist consumers in choosing products high in whole grain and fibre at the supermarket shelf.

Snack Consumption Patterns among Canadians

The snacking prevalence, frequency of daily snack consumption, and the contribution of snacks to daily energy intake have substantially increased globally. The aim of this study was to examine the patterns of snack consumption among a representative sample of Canadians aged 2 and older. Nationally representative dietary data from the Canadian Community Health Survey (CCHS) conducted in 2015 (n = 19,677 participants aged ≥2 years) were used to describe snacking patterns. In all, 80.4% of Canadians reported consuming at least one snack per day, which varied between different age groups from 77.0% (≥55 years) to 96.4% (2–5 years). About 37% of snack consumers reported only one snack episode per day but nearly 10% reported four or more episodes of snacking. Snacking contributed to nearly 23% of total daily energy intake in Canadians, which was highest among younger children (27%) and lowest among older adults (20.8%). There were no significant differences in obesity measures comparing snack consumers and non-consumers in children and adults. Snacking considerably contributes to total nutrient and energy intake of Canadians. Promoting nutrient-dense snacks provides an opportunity to improve overall diet quality.

Snacking in nutrition and health

Many studies suggest that distributing energy and nutrient intake across 4-5 eating occasions/day (rather than across three standard meals) could favourably affect human health. The inclusion of 1-2 snacks in the daily pattern alleviates the potential digestive and metabolic overload caused by fewer heavier meals and might contribute to meet recommendations for food groups (e.g. fruits, dairy) and nutrients like fibre and vitamins. The snack composition should be evaluated taking into account the whole day's diet. In early and late ages, and for specific population groups, snacking may need to follow particular characteristics in order to be optimal, both in terms of composition and timing. This document, which is the result of a collaboration of experts across several fields of research, intends to provide a review of the current scientific literature on meal frequency and health, highlighting the beneficial effects of correct snack consumption across the human lifespan.

Breaking habits with mindful snacking? An email-based intervention targeting unwanted snacking habits in an Australian sample

OBJECTIVE

To investigate the potential for an email-based, mindful eating exercise to improve unwanted snacking habits.

METHOD

Australian participants (N = 78, 86% female) with unwanted snacking habits engaged in a mindful eating email-based intervention, over a practice period of two weeks. All measures were completed using an online survey. Habit strength was measured using the Self-Report Habit Index (SHRI). Mindful eating was measured using the Mindful Eating Questionnaire (MEQ) and self-compassion was measured using the Self-Compassion Scale (SCS). Participants were emailed a mindful eating exercise and asked to make action plans to practice it. Reminders to perform the task were sent via email after one week. After two weeks, the MEQ, SCS and SHRI were readministered.

RESULTS

Habit strength significantly increased over the two-week period and self-compassion significantly decreased. The amount of practice reported was not associated with these changes, but self-reported effort expended during practice sessions was partially associated.

DISCUSSION

The intervention resulted in increased habit strength; potential mechanisms underlying these changes are discussed. Decreased self-compassion may be linked to both the electronic delivery of the intervention and the nature of the mindful eating task.

Snacking Patterns in Children: A Comparison between Australia, China, Mexico, and the US

Snacking is common in children and influenced by many factors. The aim of this study is to provide insight of both common and country-specific characteristics of snacking among 4–13 year old children. We analyzed snacking prevalence, energy and nutrient contributions from snacking across diverse cultures and regions, represented by Australia, China, Mexico, and the US using data from respective national surveys. We found that the highest prevalence of snacking was in Australia and the US (over 95%) where snacking provided one-third and one-quarter of total energy intake (TEI), respectively, followed by Mexico (76%, provided 15% TEI) and China (65%, provided 10% TEI). Compared to 4–8 year-olds, the consumption of fruits and milk was lower in 9–13 year-old children, with a trend of increasing savory snacks consumption in China, Mexico, and the US. The nutrient density index of added sugars and saturated fat was higher, especially in Australia, Mexico, and the US. Results suggested that snacking could be an occasion to promote fruit and vegetable consumption in all countries, especially for older children. Snacking guidelines should focus on reducing consumption of snacks high in saturated fat and added sugars for Australia, Mexico, and the US, whereas improving dairy consumption is important in China.