Children who skipped breakfast presented poorer overall diet quality and lower total intakes commonly obtained at breakfast. To address missed opportunities, nutrition professionals should encourage children's consumption of a nutritious breakfast to support overall diet quality.

Nutritional quality of children's diets is a public health priority in the fight against childhood obesity and chronic diseases. The main purpose of this study was to determine contribution of snacks to energy and nutrient intakes and to identify leading snack food sources of energy, total fat, and added sugars amongst young children in the United States. Using the 2005-2012 NHANES data, dietary intakes of 2- to 5-year-old children were analysed from a parent-reported 24-hour dietary recall (n = 3,429). Snacking occasions were aggregated to determine the proportion of total food/beverage intake obtained from snacks, estimate energy, and nutrient intakes, and identify the leading snack food sources of energy, added sugars, and total fat. Nearly all children consumed a snack on the reported day (62% morning, 84% afternoon, and 72% evening). Snacks accounted for 28% of total energy intake, 32% of carbohydrates, 39% of added sugars, and 26% of total fat and dietary fiber intakes for the day. Snacking occasions accounted for 46.6% of all beverages consumed on the reported day. Snacks and sweets food category (i.e., cookies and pastries) were the leading sources of energy (44%), total fat (52%), and added sugars (53%) consumed during snacking occasions. Sweetened beverages (e.g., fruit and sport drinks) contributed 1-quarter of all added sugars obtained from snacks. Snacks contribute considerable amount of energy and nutrients to young children's diets, with a heavy reliance on energy-dense foods and beverages. Targeted interventions are needed to improve the nutritional quality of snacks consumed by young children.

Patients who are malnourished or at-risk for malnutrition often benefit from the consumption of oral nutritional supplements (ONS). ONS supply a range of micro- and macro-nutrients, and they can be used to supplement a diet or provide total nutrition. Since ONS are specially formulated products, all ONS ingredients—including carbohydrates—are added ingredients. This may seem to be at odds with the growing public health discourse on the need to reduce “added sugars” in the diet. However, carbohydrate is an essential nutrient for human health and is a critical ingredient in ONS. Helping to educate patients on the value of “added sugars” in ONS may be useful to improve compliance with nutritional recommendations when ONS are indicated. This perspective paper reviews the important roles of “added sugars” in ONS, in terms of flavor, function, and product formulation.

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