Snacking frequency in relation to energy intake and food choices in obese men and women compared to a reference population

OBJECTIVE: To investigate snacking frequency in relation to energy intake and food choices, taking physical activity into account, in obese vs reference men and women. DESIGN: Cross- sectional, descriptive study. SUBJECTS: In total, 4259 obese, middle- aged subjects ( 1891 men and 2368 women) from the baseline examination of the XENDOS study and 1092 subjects ( 505 men and 587 women) from the SOS reference study were included. MEASUREMENTS: A meal pattern questionnaire describing habitual intake occasions ( main meals, light meals/ breakfast, snacks, drink- only), a dietary questionnaire describing habitual energy and macronutrient intake and a questionnaire assessing physical activity at work and during leisure time were used. RESULTS: The obese group consumed snacks more frequently compared to the reference group ( P < 0.001) and women more frequently than men ( P < 0.001). Energy intake increased with increasing snacking frequency, irrespective of physical activity. Statistically significant differences in trends were found for cakes/ cookies, candies/ chocolate and desserts for the relation between energy intake and snacking frequency, where energy intake increased more by snacking frequency in obese subjects than in reference subjects. CONCLUSION: Obese subjects were more frequent snackers than reference subjects and women were more frequent snackers than men. Snacks were positively related to energy intake, irrespective of physical activity. Sweet, fatty food groups were associated with snacking and contributed considerably to energy intake. Snacking needs to be considered in obesity treatment, prevention and general dietary recommendations.