|Keast, Debra -|
|Nicklas, Theresa -|
|O'Neil, Carol -|
Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 25, 2010
Publication Date: June 16, 2010
Citation: Keast, D.R., Nicklas, T.A., O'Neil, C.E. 2010. Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: National Health and Nutrition Examination Survey (NHANES) 1999–2004. American Journal of Clinical Nutrition. 92: 428-435. Interpretive Summary: Snacking is common in adolescents; however, it is unclear if there is an association between snacking and overweight or obesity within the context of the overall diet. This study examined the associations of snacking with weight status and abdominal obesity in adolescents. Our study showed that adolescents who consumed greater or equal 2 snacks per day were less likely than non-snack consumers to be overweight, and eating greater or equal to 2 snacks per day was associated with reduced risks for abdominal obesity. Because of inconsistent evidence in the literature, longitudinal studies are needed to further evaluate whether snacking prevents weight gain in adolescents.
Technical Abstract: Snacking is common in adolescents; however, it is unclear if there is an association between snacking and overweight or obesity within the context of the overall diet. This study examined the associations of snacking with weight status and abdominal obesity in adolescents 12–18 y of age (n = 5811). We conducted secondary analyses of 24-h diet recalls and anthropometric data from the National Health and Nutrition Examination Survey (NHANES) 1999–2004. We classified adolescents by frequency of snack consumption (0, 1, 2, 3, and greater or equal to 4 snacks/d) and by the percentage of energy intake from snacks (0%, less than 10%, 10–19%, 20–29%, 30–39%, and greater or equal to 40%). We classified adolescents who had a body mass index (BMI) greater or equal to 85th percentile of BMI-for-age as overweight or obese. We defined abdominal obesity as a waist circumference greater or equal to 90th percentile. We determined covariate-adjusted prevalence of overweight or obesity and abdominal obesity and odds ratios with SUDAAN software (release 9.0.1; Research Triangle Institute, Research Triangle Park, NC). Mean values of all obesity indicators studied were inversely associated with snacking frequency and percentage of energy from snacks. The prevalence of overweight or obesity and of abdominal obesity decreased with increased snacking frequency and with increased percentage of energy from snacks. Odds ratios (95% CIs) for overweight or obesity and for abdominal obesity ranged from 0.63 (0.48, 0.85) to 0.40 (0.29, 0.57) and from 0.61 (0.43, 0.86) to 0.36 (0.21, 0.63) for 2 to greater or equal to 4 snacks/d, respectively. Reduced risks of overweight or obesity and abdominal obesity were associated with snacking. In conclusion, snackers, compared with nonsnackers, were less likely to be overweight or obese and less likely to have abdominal obesity.