ASSOCIATIONS OF SNACK FOOD GROUP CONSUMPTION AND PATTERNS WITH WEIGHT STATUS AND DIET QUALITY AMONG ADOLESCENTS 12-19 YEARS IN THE UNITED STATES

Abstract

Purpose: Snacking is an important component of dietary intake yet remains understudied, particularly among adolescents who consume 25% of their daily calories from snacks. Previous research provides evidence that adolescents with overweight (OW) and obesity (OB) consume larger and more frequent snacks than adolescents with normal weight (NW). The objective of this study was to compare the food group composition of snacks by weight status as well as to identify snacking patterns and predictors among adolescents in the United States (US). Methods: Anthropometric, dietary, and demographic data from adolescents, 12-19 years old, in the 2005-2016 National Health and Nutrition Examination Survey were analyzed. The mean of the two days of dietary recall was used to measure dietary intake, which serves as a proxy for usual intake. Mean equivalents of the 37 food components present in individual snack foods reported by each adolescent across two days of intake were estimated using the Food Patterns Equivalents Database. Latent Class Analysis (LCA) was used to study the effect of mutually exclusive food component consumption groups. Multivariate logistic regression models were used to analyze membership in relation to dietary quality (Healthy Eating Index 2015 [HEI-2015] scores), weight status (BMI & BMI Z-score), selected snacking parameters (e.g., mean snack calories), and socio-demographic (e.g., race, gender) covariates. Results: Adolescents with two days of reliable dietary recall data and complete anthropometrics were included in the descriptive analysis (n = 6423). Adolescents with NW consumed greater energy, vegetable, whole grains, refined grains, dairy, and solid fat from snacks than adolescents with OW and OB (p < 0.05). LCA identified two main snacking patterns. The “Heavy Snackers” pattern was associated with higher consumption of each food component, total energy and snacking energy while the “Light Snackers” pattern was associated with lower consumption each food component, total energy and snacking energy. After adjustment for energy misreporting, OW or OB classification did not significantly increase the odds of being in either class while being classified with NW decreased the odds of being in the “Heavy Snacker” class. In addition, increasing BMI z-score and HEI-2015 total score increased and decreased the odds of being in the “Heavy Snackers” class respectively. The strongest predictors of a “Heavy Snacker” pattern were male gender, non-Hispanic white race, lower dietary quality, and increased snacking parameters, while female gender, all races except non-Hispanic white, better dietary quality, and decreased snacking parameters were strong predictors of a “Light Snacker” pattern. Conclusion: We can conclude that consuming less foods as snacks contributed positively to weight status and overall diet quality among US adolescents. Findings from this cross-sectional study remain consistent with snacking, diet quality, and weight status associations, but add to existing knowledge with the identification of snack consumption patterns. The dietary patterns derived may provide a useful basis for dietary interventions targeted at snacking among adolescents by recommending light snacking and low consumption of energy dense snack foods. Additional studies are needed to further understand what the main food pattern components are across gender and racial backgrounds and to confirm whether associations between snacking and weight status are due to food quality, quantity, or both.