Dietary Intake Assessment of Snacking among Children in China and U.S.

Snacking between meals is growing in importance as an eating occasion in children across the world, but there are increasing concerns about the types of foods and their nutritional quality as well as the amount of energy snacking provides. Diet, including snacking, is highly influenced by culture; however few studies have explored snacking habits across cultures. Objective To compare snacking prevalence, energy contribution and major food sources of energy from snacks between children in China and the U.S. to understand the impact of culture on snacking habits. Methods Data from the China Health and Nutrition Survey 2011 and the U.S. National Health and Nutrition Examination Survey 2009–12 were used. The USDA What We Eat in America food grouping system was applied to classify food groups. Snacking was self‐defined by study participants in both countries. All foods and drinks reported as snacks by the participants were aggregated into Morning (0:00–12:00), Afternoon (12:00–18:00) and Evening (18:00–24:00) “snacking periods.” Per capita weighted average (U.S.) and 3‐d average (China) intakes of the amounts of foods and beverages consumed during different snacking periods were calculated. In total, 1326 Chinese and 3647 U.S. children ages 4 to 13 years were included. Results Almost all U.S. children reported snacking (95.7%), much higher than that of Chinese children (69.3%, p<0.05). However among the three snacking periods, the afternoon period was the most commonly reported snacking period in both countries, followed by the evening period. The energy contribution of total snacking was 482 kcal in U.S. children, corresponding to 25% of their daily energy intake. In Chinese children, total snacking provided on average 138 kcal, which was only 10% of their daily energy intake. The top 3 food sources of energy during snacking were Snacks and Sweets, Non‐alcoholic Beverages, and Milk and Dairy in U.S. children, and Snacks and Sweets, Fruits, and Milk and Dairy in Chinese children. However, the most frequently reported snacks were Fruits in China (56.1%), and Snacks and Sweets in U.S. (76.5%). Discussion Snacking habits are different between children in U.S. and China, both in terms of frequency and specific foods consumed. Snacking plays an important role in nutrient and energy intakes in both Chinese and U.S. children, though energy contribution and nutritional impact from snacks was very different between the countries. Nutrition education and intervention programs on snacking need to be culturally specific. Support or Funding Information Funded by Nestlé Research Center, Lausanne, Switzerland.