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Calorie-heavy snacks help push childhood obesity rate up

Carolyn Butler
Tuesday, April 20, 2010; HE02

Lately, my 4-year-old's favorite refrain is, "Mom, I need a snack!" with an extreme emphasis on the need, occasionally accompanied by a funny little dance meant to express the true urgency of the situation. And regardless of how I feel about his constant nibbling, it seems that society is only too happy to oblige: He has snack breaks during school, soccer class, birthday parties and play dates, while special events such as the movies or a baseball game are associated with popcorn and "treats," too.

Eli isn't the only kid after more cookies, chips, cheese sticks and granola bars. According to a study published in last month's Health Affairs, American children are consuming nearly three snacks a day, on average, in addition to three regular meals. The research, which looked at data on more than 31,000 young people between the ages of 2 and 18 from four federal diet surveys done between 1977 and 2006, also found that up to 27 percent of children's daily calories today come from snacks.

An increase in snacking behavior was seen across all age groups, and the changes over nearly three decades are striking: The prevalence of snacking jumped from 74 percent in 1977-78 to 98 percent in 2003-06, for example, while calorie count per snack grew from 185 to 231, and the total calories from a day's worth of snacking from 418 to 586.

"We are at the point where every age group in America is moving towards constant eating," says one the study's co-authors, Barry Popkin, professor of nutrition and director of the Interdisciplinary Center for Obesity at the University of North Carolina, citing the study's finding that a quarter of children actually eat something every hour. "The increases [in snacking] that we found between the 1980s and '90s have, if anything, accelerated towards eating more times a day, and we see no evidence that's going to slow down."

While it is worrisome that children are eating much more frequently and adding calories to their diets, even more alarming is what they're actually snacking on. "They are shifting to very low-quality food -- essentially junk food," says Popkin. The study showed that children are consuming less fruit and milk and more salty snacks such as potato chips, as well as more candy, juice and soft drinks. "It's the worst of both worlds," he says. "We're getting more calories, and we're getting them from all the wrong things."

It's not necessarily hunger that's driving all of this noshing. Indeed, researchers and doctors worry that the trend toward near-constant snacking is actually disrupting the body's ability to sense when it is full.

Eating is supposed to satisfy a physiological need: When things are working properly, you consume something and it takes a while for your body to digest and process it. Only when it finally does so should you start to crave more sustenance. "But the number of times these kids [in the study] are eating, they don't have a chance to be hungry," says Popkin, who believes that many children no longer eat for satiety's sake. "They're just eating because it's there, and the danger is that you lose all calorie control and just keep consuming, and it becomes a part of the mindless routines of your day."

These new eating patterns coincide with an explosion in the country's childhood obesity rate, which grew from 14.8 percent in 2003 to 16.4 percent in 2007 among children 10 to 17, according to another study published in last month's Health Affairs. "Snacking definitely plays a role" in obesity, along with poor dietary choices, "portion distortion" (or the super-sizing of foods and meals) and a decline in physical activity, says pediatrician Nazrat Mirza, director of an obesity clinic at Children's National Medical Center in the District. She lists a plethora of potential health complications that come along with obesity, including asthma; joint pains; sleep apnea; increased blood pressure, cholesterol and insulin levels (which translate into a higher risk of cardiovascular disease); and diabetes.

"You think it's just an extra little candy bar, but that, plus more sedentary behavior, plus increased portion sizes -- it all adds up," says Mirza. "Even if you just have a 50-calorie increase per day, that leads to a gain of five pounds in a year -- it can come as insidiously as that -- and we see children who are sometimes consuming an excess of [200,] 300, even 400 calories a day . . . [which] has a huge impact on health and well-being."

Still, that's not to say your kids shouldn't be eating a little something between meals. "Snacks do play a role in healthy eating," says pediatric dietitian Kelly Sinclair, who also practices at Children's. "I don't think you can expect, especially with smaller children, them to eat just three meals a day; in fact, nobody should go more than about four hours without eating, because when you do that, it leads to a really voracious appetite, not being able to make healthy choices, and overeating of food." A morning snack may be necessary, depending on wakeup time and meal pattern, but Sinclair believes that almost all kids need an afternoon snack, to help them through that often interminable stretch between lunch and dinner.

But before you bust open that bag of Pirate's Booty or my son's favorite "Scooby Snacks" (chewy "fruit" snacks in the shape of the Scooby Doo gang -- don't ask!), remember that the quality of the nibble is more important than the quantity. Sinclair, for one, recommends a 100-to-200-calorie snack that is more of a "mini meal" -- small and substantial, as opposed to a full-blown second breakfast, or cookies or sweets, "which are desserts, not snacks."

And while she acknowledges that it can be difficult for parents to insist on more-healthful options, especially if they have not done that before, she says it is absolutely essential to good long-term eating habits. So go for half a turkey sandwich, cheese and crackers, or an array of colorful vegetables with bean dip or hummus.

"Snacks should be something to satisfy hunger -- just a little fuel in your system so you don't overeat later," she says, noting that in her opinion soda is an absolute no-no and juice is equally as unhealthy. "We want kids to eat their fruit, not drink it," Sinclair says. "Give them an apple or an orange and have their body turn that into juice, because they need the fiber and it's going to be more satisfying and stick with them longer, and it's not going to give them a sugar spike like juice."

Not surprisingly, the best advice Sinclair has to offer is also the hardest for time-stretched caregivers and parents like me who are quick to grab the pre-portioned packs of processed crackers, cookies and TV-show-inspired treats at the grocery -- and, if I'm being entirely honest, to also join my sons in eating these things at least once or twice a day: Model good snacking behavior for your children. "It doesn't matter what I say or what anyone else says," she explains, "it matters what you serve [for snacks and meals], and what you yourself eat."

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