title: The effect of snacking and eating frequency on dietary quality in British adolescents.
abstract: OBJECTIVE
  To describe the effects of number of eating occasions and snacks on dietary quality (DQ), defined as adherence to dietary recommendations.
  
  
  METHODS
  A sample of 884 adolescents (11-18 years) in the UK National Diet and Nutrition Survey (NDNS) were included. The Diet Quality Index for Adolescents (DQI-A) was implemented. The total number of eating occasions and snacks was frequency of food or beverages consumed over 24 h and frequency of foods or beverages consumed outside of the three mealtimes, respectively. Results were generated with and without low-energy food under 210 kJ (50 kcal). Regression models were generated with DQ score as the outcome variable and number of eating occasions and snacks as predictors.
  
  
  RESULTS
  The mean (95 % CI) DQ score was 31.1 % (30.2, 32.0). The mean number of eating occasions and snacks was 7.5 (7.3, 7.7) and 2.6 (2.6, 2.7) times/day, respectively. When low-energy events were excluded, the mean number of eating occasions and snacks reduced to 6.2 (6.1, 6.4) and 2.0 (2.0, 2.1) times/day, respectively. DQ score increased by 0.74 points (0.42, 1.05; p < 0.01) and 0.55 points (-0.08, 0.69; p = 0.17) for total eating occasions and snacks, respectively. When low-energy events were excluded, DQ score increased by 0.30 points (-0.84, 0.69; p = 0.13) for each eating occasion and decreased by 1.20 points (-2.1, -0.3; p < 0.01) for each snack.
  
  
  CONCLUSIONS
  Eating more frequently improves dietary quality especially if some eating occasions are low in energy. A focus on replacing high-energy snacks with low-energy alternatives rather than reducing the number of eating occasions may result in improved dietary quality in adolescents.
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, Food Science Building, University of Leeds, Leeds, LS2 9JT, UK. elisabet.llaurado@urv.cat.|Health Education and Promotion, Facultat de Medicina i Ciencies de la Salut, Universitat Rovira i Virgili, C/Sant Llorenç 21, 43201, Reus, Spain. elisabet.llaurado@urv.cat.
authors.forename: E
authors.initials: E
authors.lastname: Llauradó
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, Food Science Building, University of Leeds, Leeds, LS2 9JT, UK.|School of Food Science and Nutrition, King Abdul-Aziz University, PO Box 42807, Jeddah, 21551, Saudi Arabia.
authors.forename: S A
authors.initials: SA
authors.lastname: Albar
authors.affiliation: Unit of Farmacobiology, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Giralt
authors.affiliation: Unit of Arteriosclerosis Research, CIBERDEM, Hospital Universitari Sant Joan de Reus, IISPV, Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Reus, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Solà
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, Food Science Building, University of Leeds, Leeds, LS2 9JT, UK. c.e.l.evans@leeds.ac.uk.
authors.forename: C E L
authors.initials: CE
authors.lastname: Evans
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D062410:Snacks; D006113:United Kingdom
chemical_list: D004041:Dietary Fats; D004044:Dietary Proteins
keywords: Adolescents; Cross-sectional data; Dietary quality; Eating occasions; Snacking