BACKGROUND

SNACKING LITTERATURE

AIM

METHODS MEASURES

RESULTS

OBJECTIVE MEASURE OF SNACKING BEHAVIOUR IN AUSTRALIAN CHILDREN

F Fayet-Moore1, L Ridges2, T Keighley, 3P Petocz3

1Nutrition Research Australia, Sydney, NSW; 2Nestle Australia Ltd, Rho-des, NSW; 3Macquarie University, Epping, NSW Australia

PRESENTING AUTHOR: F Fayet-Moore

• The Australian National Children’s Nutrition and Physical Activity Survey (ANCNPAS) did not measure snacking behaviour subjectively or objectively.

• THERE IS NO UNIVERSAL DEFINITION OF SNACKING IN THE SCIENTIFIC LITERATURE.

h This objective method for assessing snacking behaviour showed SO significantly contributed to total energy and nutrient intake without being associated with BMI z score, waist circumference or physical activity level.

h Children consumed on average 7 EO/d and on average each EO contributed 14% of total energy.

h Both total number of EO and SO decreased with age and no gender differences were found.

h We hope nutrition researchers will adopt this new methodology to objectively measure snacking behaviour so comparisons can be made between studies to assist evidence based recommendations on healthy snacking.

• 3 main meal peaks and between-meal time periods were identified

• Snacking was defined as any food or beverage consumed between main meals.

There is a need for an objective measure of snacking to be developed and adopted for nutrition research.

EXAMPLES OF SNACKING DEFINITIONS:

DEFINITIONS:

TIME PERIODS:

EXAMPLE:

EXAMPLES OF ‘SNACKING’ BEING DEFINED BY TYPES OF FOOD AS:

CONCLUSIONS

“Leaving such a key concept [such as snacking] undefined and merely understood by a common, a priori idea seems to be inappropriate in epidemiological and nutrition research and may affect the accuracy of the information offered as well as the validity of the conclusions proposed”3

TO DEVELOP AN OBJECTIVE MEASURE TO ASSESS SNACKING BEHAVIOUR AND PROFILE SNACKING AMONG AUSTRALIAN CHILDREN.

COMBINATIONOF THESE

TIME OF DAY & TIMING OF CONSUMPTION 2-5

TYPE OF FOOD 4, 6 SUBJECTIVELY DEFINED 12, 17

9:00

11:30

EATING OCCASION

EATING OCCASION

MEAL PATTERN (I.E FREQUENCY) 2, 5, 17, 18

There is an inherent bias in how we define ‘snacks’ in the research – usually ‘junk’ or discretionary foods and beverages.

• Salty snacks, cookies, candy bars, candy, pastries and cakes, beef jerky, fruit leather, granola bars, cereal 13

• Filled cakes/sweet snacks, plain cakes, chocolate snacks, sodas 19

• Sweets (chocolates, licorice, candy), cakes and pastry, savoury snacks (fast foods, spring rolls, cheese cubes, party sausages, nuts, crisps) 14

• Ice cream, pies, candy, french fries 20

• Energy-dense nutrient poor foods by failure to belong to major food groups 21

TIME OF DAY UTILISED TO DEVELOP A SNACKING DEFINITION

24hWEEKDAYDATA

recall

FROM 2007 ANCNPAS

CHILDREN 2-16yo (N=3637)

% &energyfrequency ofFOODSwere plotted by time of day (Fayet)

consumed on weekdays

Were defined as the time periods where large peaks appeared in percentage energy intake and grams of food consumed across the day. As expected there were three main peaks: breakfast (5:30-09:00am), the midday (11:30am-2:00pm) and evening meals (5:00pm-9:00pm).

MAIN MEAL TIME PERIODS

Defined as the time periods between main meal time periods: morning (9:00-11:30am), afternoon (2:00-5:00pm) and late night (9:00pm-5:30am).

BETWEEN MEAL TIME PERIODS

Were defined as all foods and beverages consumed at the same point in time.

EATING OCCASIONS (EO)

Were defined as all EO that occurred during a ‘between meal’ time period.SNACKING OCCASIONS (SO)

Were defined as all eating occasions (EO) that occurred during a main meal time period. MAIN MEALS

MAIN MEAL

BRE A K FA ST M I D DAY EV E N I N G

MAIN MEAL MAIN MEAL

5.30 - 9.00AM

11.30 - 2.30PM

5.00 - 9.00PM

9.00 - 11.30AM

morning afternoon late night

2.30 - 5.00PM 9.00PM - 5.30AM

BETWEEN MEAL BETWEEN MEAL BETWEEN MEAL

Per c

ent o

f all

ener

gy c

onsu

med

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

12:0

0AM

12:3

0AM

1:00

AM

1:30

AM

2:00

AM

2:30

AM

3:00

AM

3:30

AM

4:00

AM

4:30

AM

5:00

AM

5:30

AM

6:00

AM

6:30

AM

7:00

AM

7:30

AM

8:00

AM

8:30

AM

9:00

AM

9.30

AM

10:0

0AM

10:3

0AM

11:0

0AM

11:3

0AM

12:0

0PM

12:3

0PM

1:00

PM1:

30PM

2:00

PM2:

30PM

3:00

PM3:

30PM

4:00

PM4:

30PM

5:00

PM5:

30PM

6:00

PM6:

30PM

7:00

PM7:

30PM

8:00

PM8:

30PM

9:00

PM9:

30PM

10:0

0PM

10:3

0PM

11:0

0PM

11:3

0PM

BETWEEN MEAL

BETWEEN MEAL

BETWEEN MEAL

BETWEEN MEAL

MAIN MEAL

MAIN MEAL

MAIN MEAL

LATE NIGHT LATE NIGHTBREAKFAST AFTERNOON EVENINGMORNING MIDDAY

• Time periods defined based on peaks.• Weekday data used due to clear differences in main meal peaks between weekday & weekend graphs.

The morning 'between meal' time period

= 5 itemswater, banana, bread, butter, vegemite

= 2 snacking occasions

“...the lack of a universally accepted definition of snacking is an impediment to interpretation of the literature.”3

TOTAL DAILY #OF EO, SO & ITEMS

MULTIPLE LINEAR STATISTICAL SIGNIFICANCE WAS SET AT:

REGRESSION USEDTO ADJUST FOR:

NUTRIENT CONTRIBUTIONOF EO & SO TO DAILY DIET

• AGE & GENDER• BMI Z SCORE• ENERGY INTAKE• PHYSICAL ACTIVITY

ENERGY &CONSUMED

P<0.01.

EATING OCCASIONS (EO)

7 EO/DAY

21 ITEMS/DAY

2.5 ITEMS/EO

19-35 %

6 ITEMS/DAY

HIGHER DAILY ENERGY INTAKE

HIGHER DAILY ENERGY INTAKE

12% ENERGY/SO14% ENERGY/EO

2.6 SO/DAY

SNACKING OCCASIONS (SO)

28% TOTAL ENERGY

OF NUTRIENT INTAKE

NO ASSOCIATION WITH ANTHROPOMETRIC MEASURES

MORE SO = MORE EO =

Decreased with increasing age Boys have slightly less than girls

Highest prevalence 2 or 3/day Decreased with increasing age

No gender differences

For every 3MJ increase in energy = + 1 ITEM from SO

For every 1MJ increase in energy = 25% from SO

Decreased with increasing age Boys have one fewer than girls

For every 1MJ increase = 1 additional item per EO was consumed. Small significant inverse assoc. with BMI

Increases with age Increases with age

90%

3 MAIN MEALS

CHILDREN HADOF

EVENING MEAL

ONLY TIME PERIOD WHERE MORE KIDS HAD 2 EO RATHER THAN 1 EO

98%SNACKERSCHILDREN WERE

OF

(≥ 1 SO/DAY)

90%morning SO

HAVE

82%afternoon SO

HAVE

13%late evening SO

HAVE

REFERENCES1 The 2007 Australian National Children’s Nutrition and Physical Activity Survey.

Department of Health and Ageing CSIRO. Canberra: University of South Australia, 2008.

2 Zizza CA, Xu B. Snacking Is Associated with Overall Diet Quality among Adults. Journal of the Academy of Nutrition and Dietetics. 2012; 112(2):291-296.

3 JohnsonGH,AndersonGH.Snackingdefinitions:impactoninterpretationofthe literature and dietary recommendations. Critical reviews in Food Science and Nutrition. 2010; 50: 848-71.

4 Mercille G, Receveur O, Macaulay AC. Are snacking patterns associated with risk of overweight among Kahnawake schoolchildren? Public Health Nutrition. 2010; 13: 163-71.

5 Ritchie LD. Less frequent eating predicts greater BMI and waist circumference in female adolescents. The American Journal of Clinical Nutrition. 2012; 95: 290-6.

6 Berteus Forslund H, Torgerson JS, Sjostrom L, Lindroos AK. Snacking frequency in relation to energy intake and food choices in obese men and women compared to a reference population. International Journal of Obesity. 2005; 29: 711-9.

7 Nicklas TA, Morales M, Linares A, et al. Children’s meal patterns have changed over a 21-year period: the Bogalusa Heart Study. Journal of the American Dietetic Association. 2004; 104: 753-61.

8 Jimenez-Cruz A, Bacardi-Gascon M, Jones EG. Consumption of fruits, vegetables, soft drinks, and high-fat-containing snacks among Mexican children on the Mexico-U.S. border. Archives of Medical Research. 2002; 33: 74-80.

9 Phillips SM, Bandini LG, Naumova EN, et al. Energy-dense snack food intake in adolescence: longitudinal relationship to weight and fatness. Obesity Research. 2004; 12: 461-72.

10 Bisset S, Gauvin L, Potvin L, Paradis G. Association of body mass index and dietary restraint with changes in eating behaviour throughout late childhood and early adolescence: a 5-year study. Public Health Nutrition. 2007; 10: 780-9.

11 Macdiarmid J, Loe J, Craig LC, Masson LF, Holmes B, McNeill G. Meal and snacking patterns of school-aged children in Scotland. European Journal of Clinical Nutrition. 2009; 63: 1297-304.

12 Wadhera D, Capaldi ED. Categorization of foods as “snack” and “meal” by college students. Appetite. 2012; 58: 882-8.

13 Byrd-Bredbenner C, Johnson M, Quick VM, et al. Sweet and salty. An assessment of the snacks and beverages sold in vending machines on US post-secondary institution campuses. Appetite. 2012; 58: 1143-51.

14 Hendriksen MA, Boer JM, Du H, Feskens EJ, van der AD. No consistent association between consumption of energy-dense snack foods and annual weight and waist circumference changes in Dutch adults. The American Journal of Clinical Nutrition. 2011; 94: 19-25.

15 M affeis C, Grezzani A, Perrone L, Del Giudice EM, Saggese G, Tato L. Could the savory taste of snacks be a further risk factor for overweight in children? Journal of pediatric gastroenterology and nutrition. 2008; 46: 429-37.

16HamplJS,HeatonCL,TaylorCA.Snackingpatternsinfluenceenergyandnutrient intakes but not body mass index. Journal of human nutrition and dietetics:theofficialjournaloftheBritishDieteticAssociation.2003;16:3-11.

17 Mills JP, Perry CD, Reicks M. Eating frequency is associated with energy intake but not obesity in midlife women. Obesity. 2011; 19: 552-9.

18 Drummond S, Crombie N, Kirk T. A critique of the effects of snacking on body weight status. European Journal of Clinical Nutrition. 1996; 50:779-83.

16HamplJS,HeatonCL,TaylorCA.Snackingpatternsinfluenceenergyandnutrient intakes but not body mass index. Journal of human nutrition and dietetics:theofficialjournaloftheBritishDieteticAssociation.2003;16:3-11.

17 Mills JP, Perry CD, Reicks M. Eating frequency is associated with energy intake but not obesity in midlife women. Obesity. 2011; 19: 552-9.

18 Drummond S, Crombie N, Kirk T. A critique of the effects of snacking on body weight status. European Journal of Clinical Nutrition. 1996; 50:779-83.

19 Gregori 2011 Nutr J 10(132):1-10.20 McCrory MA, Fuss PJ, McCallum JE, Yao M, Vinken AG, Hays NP, Roberts SB.

Dietary variety within food groups: association with energy intake and body fatness in men and women. The American Journal of Clinical Nutrition. 1997 69(3):440-447.

21 Kant AK. Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications. The third National Health and Nutrition Examination Survey, 1988-1994. American Journal of Clinical Nutrition. 2000; 72:929-36.

SNACKING OCCASIONS NUTRIENT CONTRIBUTION

MEAN % NUTRIENT CONTRIBUTION FROM ALL SO

<20%LC N-3 PUFA 17.9NIACIN 19.3

>30%

TOTAL CARBOHYDRATES 30.6VITAMIN C 31.5SUGARS 35.5

20-25%ZINC 20.3 | PROTEIN 20.7 THIAMIN 20.9 | IRON 21.8IODINE 22.6 | RIBOFLAVIN 23 | PHOSPHOROUS 23.3VITAMIN A 23.6 | SODIUM 24.1 | CALCIUM 24.6

25-30%

FOLATE 25.1 | STARCH 25.5 | MAGNESIUM 25.9 POTASSIUM 26.3 | PUFA 26.7 | MUFA 27.2 | TOTAL FAT 27.9 | ENERGY 28 FIBRE 28.1 | SATURATED FAT 28.9 | VITAMIN E 28.9

MAIN MEALbreakfast

BETWEEN MEALmorning

MAIN MEALmidday

BETWEEN MEALafternoon

MAIN MEALevening

BETWEEN MEALnight

500Number of observations per eating occasion

1000 1500 2000 25000

1 EO 2 EO

3 EO 4 EO

THE MAJORITY OF CHILDREN HAD ONE EATING OCCASION AT EACH TIME PERIOD, WITH THE EXCEPTION OF THE EVENING MAIN MEAL.

FUNDING SOURCE