Meal and snack frequency in relation to diet quality in US children and adolescents: the National Health and Nutrition Examination Survey 2003–2012

Abstract

Objective: To examine the associations of meal frequency (MF) and snack frequency (SF) with diet quality. Design: Dietary intake was assessed using two 24 h dietary recalls. All eating occasions providing ≥210 kJ of energy were divided into meals or snacks on the basis of contribution to energy intake (≥15 % or <15 %), self-report and time (06.00-09.00, 12.00-14.00 and 17.00-20.00 hours, or others). Diet quality was assessed using the Healthy Eating Index (HEI)-2010. Setting: Nationally representative sample of the US population. Subjects: Children aged 6-11 years (n 4269) and adolescents aged 12-19 years (n 6193) in the National Health and Nutrition Examination Survey 2003-2012. Results: Irrespective of the definition of meals, higher MF was associated with higher HEI-2010 in both children and adolescents. One additional meal per day increased HEI-2010 by 1·45-3·59 points (all P < 0·005). Conversely, the associations for SF were inconsistent. While SF based on energy contribution was positively associated with HEI-2010 in both children and adolescents (0·70 (P = 0·001) and 1·00 (P < 0·0001) point increase by one additional snack, respectively), there were no associations for SF based on self-report or time. In analyses in which only plausible energy reporters (3425 children and 3753 adolescents) were included, similar results were obtained. Conclusions: In a representative sample of US children and adolescents, MF was associated with better diet quality, while the associations for SF varied depending on the definition of snacks. The findings highlight the importance of applying different definitions of meals and snacks when assessing the impact of dietary patterns on health.

Number of Eating Occasions and Source of Foods and Drinks Among Young Children in the United States: NHANES, 2009–2014

“…All foods and drinks recorded at the same clock time and reported eating occasion (e.g., breakfast) were considered one eating occasion. In line with previous studies, food or drink items recorded with start times longer than 15 min apart were considered different eating occasions [17]. Therefore, if a respondent reported an eating occasion of breakfast at 8:15 am, as well as 9:30 am, the respondent was considered to have had two breakfasts.…”

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

“…We further found that snack occasion frequency was positively associated with HEI-2010 score in the NET-Works and GROW studies, which, to our knowledge, is a relationship that has not previously been examined in this age group. In a sample of 6–11 year-olds from NHANES 2003–12, Murakami and Livingstone (11) observed a null association between each additional self-identified snack occasion and diet quality. However, Evans et al (12) reported that each additional self-identified snack occasion was associated with a 2.3 point increase (p<0.02) in HEI-2005 score in 9–11 year-olds and a 2.7 point decrease (p<0.01) in HEI-2005 score in 12–15-year-olds.…”

“…Although this approach promotes inter-individual differences in the definition of snack occasions by relying on participants’ own perceptions of what a snack occasion is, it offers advantages over other definitions. Specifically, this approach accounts for cultural and lifestyle differences in meal times and meal compositions that other definitions of snack occasions may not take into consideration (10,11) . Thus, for the purpose of the present paper, ‘snack occasion’ refers to an eating occasion specifically designated as such by an individual.…”

Associations between Snacking and Weight Status among Adolescents 12–19 Years in the United States

“…Current Dietary Guidelines for Americans recommend that adolescents consume nutrient-dense snacks to help them meet their nutritional needs [5]. However, whether snacking currently benefits dietary intake and growth among adolescents or promotes obesity is unknown [6,7].…”