title: Impact of snacking pattern on overweight and obesity risk in a cohort of 11- to 13-year-old adolescents.
abstract: OBJECTIVE
  The association between snacking habits and overweight in adolescents is unclear. We evaluated the relation between snacking patterns and overweight/obesity in a cohort of 11- to 13-year-old Italian adolescents.
  
  
  METHODS
  The dietary habits of 400 randomly selected adolescents were evaluated; those with body mass index ≥ 85 th percentile were considered as overweight/obese. Participants were classified based on the percentage of caloric intake from snacks (<15%, 15%-20%, >20%), snacking frequency (1, 2, ≥ 3), and timing of consuming the most caloric snack (morning, afternoon, evening).
  
  
  RESULTS
  A minority of participants (13/400, 3.3%) did not consume any snacks; 5/13 (38.5) of them were overweight/obese. Among snackers (387/400), overweight/obesity prevalence was 10.4%, 14.4%, 20.5%, respectively, in those consuming <15%, 15% to 10%, and >20% of their energy intake from snacks. In a Poisson regression model, the overweight/obesity relative risks (RRs) were 1.35 (95% confidence interval [CI] 0.58-3.15) and 2.32 (1.10-4.89) for 15% to 20% and >20% calories/day from snacks, respectively. Overweight/obesity prevalence (from 9.6% to 22.6%) was correlated with snacking frequency (RR 2.20, 95% CI 0.92-5.27, and RR 4.17, 95% CI 1.60-10.9, for 2 and ≥ 3 snacks per day, respectively). The most caloric snacks were consumed in the morning (180/387) and afternoon (179/387); 28.6% of the predominantly evening snackers (28/387) were overweight/obese (RR 3.12, 95% CI 1.17-8.34).
  
  
  CONCLUSIONS
  Increased snacking calories, frequency, and evening snacking are independently associated with overweight/obesity in Italian middle-school adolescents.
authors.affiliation: *Department of Medical Science, University of Torino †Sport Medicine Institute of Torino, Torino, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Bo
authors.forename: Luca
authors.initials: L
authors.lastname: De Carli
authors.forename: Elena
authors.initials: E
authors.lastname: Venco
authors.forename: Ilaria
authors.initials: I
authors.lastname: Fanzola
authors.forename: Maria
authors.initials: M
authors.lastname: Maiandi
authors.forename: Franco
authors.initials: F
authors.lastname: De Michieli
authors.forename: Marilena
authors.initials: M
authors.lastname: Durazzo
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Beccuti
authors.forename: Paolo
authors.initials: P
authors.lastname: Cavallo-Perin
authors.forename: Ezio
authors.initials: E
authors.lastname: Ghigo
authors.forename: Gian P
authors.initials: GP
authors.lastname: Ganzit
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D004032:Diet; D002149:Energy Intake; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D062410:Snacks