Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: National Health and Nutrition Examination Survey (NHANES) 1999-2004

Background: 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. Objective: This study examined the associations of snacking with weight status and abdominal obesity in adolescents 12-18 y of age (n = 5811). Design: 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 >= 4 snacks/d) and by the percentage of energy intake from snacks (0%, <10%, 10-19%, 20-29%, 30-39%, and >= 40%). We classified adolescents who had a body mass index (BMI) >= 85th percentile of BMI-for-age as overweight or obese. We defined abdominal obesity as a waist circumference >= 90th percentile. We determined covariate-adjusted prevalences of overweight or obesity and abdominal obesity and odds ratios with SUDAAN software (release 9.0.1; Research Triangle Institute, Research Triangle Park, NC). Results: 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 >= 4 snacks/d, respectively. Reduced risks of overweight or obesity and abdominal obesity were associated with snacking. Conclusion: Snackers, compared with nonsnackers, were less likely to be overweight or obese and less likely to have abdominal obesity. Am J Clin Nutr 2010; 92: 428-35.