title: Snacking patterns, diet quality, and cardiovascular risk factors in adults.
abstract: BACKGROUND
  The relationship of snacking patterns on nutrient intake and cardiovascular risk factors (CVRF) in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of CVRF in adults participating in the 2001-2008 National Health and Nutrition Examination Survey.
  
  
  METHODS
  24-hour dietary recalls were used to determine intake and cluster analysis was used to identify the snacking patterns. Height and weight were obtained and the health indices that were evaluated included diastolic and systolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein cholesterol, triacylglycerides, blood glucose, and insulin.
  
  
  RESULTS
  The sample was participants (n = 18,988) 19+ years (50% males; 11% African-Americans; 72% white, 12% Hispanic-Americans, and 5% other). Cluster analyses generated 12 distinct snacking patterns, explaining 61% of the variance in snacking. Comparisons of snacking patterns were made to the no snack pattern. It was found that miscellaneous snacks constituted the most common snacking pattern (17%) followed by cakes/cookies/pastries (12%) and sweets (9%). Most snacking patterns were associated with higher energy intakes. Snacking patterns cakes/cookies/pastries, vegetables/legumes, crackers/salty snacks, other grains and whole fruit were associated with lower intakes of saturated fatty acids. Added sugars intakes were higher in the cakes/cookies/pastries, sweets, milk desserts, and soft drinks patterns. Five snack patterns (cakes/cookies/pastries, sweets, vegetable/legumes, milk desserts, soft drinks) were associated with lower sodium intakes. Several snack patterns were associated with higher intakes of potassium, calcium, fiber, vitamin A, and magnesium. Five snacking patterns (miscellaneous snacks; vegetables/legumes; crackers/salty snacks; other grains; and whole fruit) were associated with better diet quality scores. Alcohol was associated with a lower body mass index and milk desserts were associated with a lower waist circumference. No snack patterns were associated with other CVRF studied.
  
  
  CONCLUSIONS
  Overall, several snacking patterns were associated with better diet quality than those consuming no snacks. Yet, the majority of the snacking patterns were not associated with CVRF. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet along with more nutrient-dense foods to be included in snacks.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, 1100 Bates Ave, Houston, TX 77030, USA. tnicklas@bcm.edu.
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Nicklas
authors.forename: Carol E
authors.initials: CE
authors.lastname: O'Neil
authors.forename: Victor L
authors.initials: VL
authors.lastname: Fulgoni
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology*; D016000:Cluster Analysis; D004034:Diet Surveys; D002149:Energy Intake / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D050177:Overweight; D012307:Risk Factors; D062410:Snacks; D014481:United States
chemical_list: D008055:Lipids
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