LAUSR

The purpose of this analysis was to compare the association between adult snacking frequency and weight status and central adiposity across various definitions of a snack. Specifically, we investigated whether the definition of a snack alters the odds ratio (OR) of having overweight or obesity (OW/OB, BMI ≥ 25 kg/m2) by consumption frequency and the contribution to total daily energy intake. In addition, we compared the OR of waist circumference risk (WC ≥ 102 men; 88 cm women) and sagittal abdominal diameter risk (SAD ≥ 25 men and 24 cm women) with snacking frequency and contribution to total daily energy using three common snack definitions. Anthropometric measurements, one 24HR dietary recall, and demographic information (sex, age, race and Hispanic origin, income, and smoking status) from U.S. adults (≥20y; n = 20,146) collected during NHANES 2013–2016 were used in this analysis. Snacking events were defined by one of three definitions: 1) events defined by the reporter as a “snack,” 2) any event outside of a typical meal time (i.e., breakfast, lunch, dinner, super, brunch), or 3) ingestion events that contribute <15% of total daily energy intake. PROC SURVEYLOGISTIC was used to calculate OR of elevated OW/OB, WC, and SAD with snacking frequency and % of energy contributed by snacks. One snack per day was used 5–15% of daily energy from snacks were used as reference values. Consumption of 3 or 4 snacks per day versus 1 snack per day was associated with decreased odds of OW/OB among women when a snack was defined as an event contributing <15% of today daily energy intake when controlled for demographic characteristics (OR, 95% CI = 0.64 (0.49, 0.84) and 0.72 (0.55, 0.94) for 3 and 4 snacks, respectively) but not when controlling for accuracy of energy intake reporting (0.75 (0.57, 0.99) and 0.93 (0.71, 1.22)). Snacking frequency was not associated with odds of OW/OB among women with any other snack definition. Snack frequency was not associated with odds of OW/OB for men regardless of snack definition. The association between snacking frequency and weight status and central adiposity is inconsistent and varies by snack definition among men and women. Clarification of snack definition should be emphasized when examining effects of snacking patterns and obesity and health outcomes. NA