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Research Project: Childhood Obesity Prevention

Location: Children's Nutrition Research Center

Title: Snacking patterns, diet quality, and cardiovascular risk factors in adults

item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item O'NEIL, CAROL - LSU Agcenter
item FULGONI III, VICTOR - Nutrition Impact, Llc

Submitted to: BioMed Central(BMC) Public Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/7/2014
Publication Date: 4/23/2014
Citation: Nicklas, T.A., O'Neil, C.E., Fulgoni III, V.L. 2014. Snacking patterns, diet quality, and cardiovascular risk factors in adults. BioMed Central(BMC) Public Health. 14:388.

Interpretive Summary: Nutrition research has traditionally focused on single nutrients in relation to health. Recently however, scientists have acknowledged the complex synergistic interactions among foods in relation to health. This has led to a growing interest in looking at dietary patterns which makes intuitive sense, given that foods are generally not eaten in isolation. Thus, eating patterns may have a greater impact on metabolic risk factors than any single food, food group, or nutrient. This study showed that 12 specific snacking patterns, including no snacks, could be identified in a nationally representative sample of US adults. The snacking patterns varied widely by foods consumed, nutrient contribution, and overall diet quality. To our knowledge this is the first study to examine the various snacking patterns among adults and their impact on nutrient intake, diet quality, and a selection of cardiovascular risk factors (including overweight/obesity). Data analyses show that none of the snacking patterns were associated with cardiovascular risk factors. The patterns varied in food and beverage selections and their contribution to daily intake of nutrients and diet quality. More studies are needed to confirm these findings to better understand how specific snacking patterns fit within an overall healthier eating lifestyle. Some snacking patterns may also be inversely associated with weight and abdominal obesity. Because of inconsistent evidence in the literature, there are several noteworthy findings from this study that should generate future hypotheses for further testing. Moreover, longitudinal studies are needed to further evaluate whether snacking prevents weight gain in adults.

Technical Abstract: The relationship of snacking patterns on nutrient intake and cardiovascular risk factors in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of cardiovascular risk factors in adults participating in the 2001-2008 National Health and Nutrition Examination Survey. 24-hour dietary recalls were used to determine intake and cluster analysis was used to identify the snacking patterns. Height and weight were obtained and the health indices that were evaluated included diastolic and systolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein cholesterol, triacylglycerides, blood glucose, and insulin. The sample was participants (n=18,988) 19+ years (50% males; 11% African-Americans; 72% white, 12% Hispanic-Americans, and 5% other). Cluster analyses generated 12 distinct snacking patterns, explaining 61% of the variance in snacking. Comparisons of snacking patterns were made to the no snack pattern. It was found that miscellaneous snacks constituted the most common snacking pattern (17%) followed by cakes/cookies/pastries (12% and sweets (9%). Most snacking patterns were associated with higher energy intakes. Snacking patterns cakes/cookies/pastries, vegetables/legumes, crackers/salty snacks, other grains and whole fruit were associated with lower intakes of saturated fatty acids. Added sugars intakes were higher in the cakes/cookies/pastries, sweets, milk desserts, and soft drinks patterns. Five snack patterns (cakes/cookies/pastries, sweets, vegetable/legumes, milk desserts, soft drinks) were associated with lower sodium intakes. Several snack patterns were associated with higher intakes of potassium, calcium, fiber, vitamin A, and magnesium. Five snacking patterns (miscellaneous snacks; vegetables/legumes; crackers/salty snacks; other grains; and whole fruit) were associated with better diet quality scores. Alcohol was associated with a lower body mass index and milk desserts were associated with a lower waist circumference. No snack patterns were associated with other cardiovascular risk factors studied. Overall, several snacking patterns were associated with better diet quality than those consuming no snacks. Yet, the majority of the snacking patterns were not associated with cardiovascular risk factors. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet along with more nutrient-dense foods to be included in snacks.