title: Snacking Behavior and Obesity among Female Adolescents in Isfahan, Iran.
abstract: The high prevalence of obesity in the pediatric age groups draws attention to lifestyle factors including diet and physical activity. Data on obesity in adolescents and their snacking behavior are conflicting. This study aimed to assess the association of snacking behavior and obesity among female adolescents in Isfahan, Iran.
  
  
  
  This cross-sectional study was carried out on 265 female Isfahanian students who were chosen by systematic cluster random sampling. Dietary intake was assessed using a validated self-administered semiquantitative food frequency questionnaire that included 53 food items. Snacking behavior was defined by healthy snack score in combination with the frequency of snack intake.
  
  
  
  Individuals who consumed more healthy snacks and those with snacking frequency of 4 times a day or more had significantly lower weight, body mass index (BMI), and waist circumference (p < 0.001). Decreased consumption of healthy snacks was significantly associated with a greater chance of being overweight, generally obese, and abdominally obese among adolescents (odds ratio [OR] = 1.98; 95% confidence interval [CI], 1.00-3.14, ptrend = 0.04 and OR = 2.10; 95% CI, 1.01-3.13, ptrend = 0.04, respectively). Frequency of snack intake was inversely related to overweight, general obesity, and abdominal obesity (OR = 3.23; 95% CI, 1.73-5.61, ptrend = 0.03 and OR = 1.84; 95% CI, 1.05-3.20, ptrend = 0.04, respectively). Healthy snack score in combination with frequency of snacking showed that those in the lowest tertile of snacking who consumed snacks less than 4 times/day had the highest risk of obesity compared to other categories (OR = 2.09, 95% CI, 1.11-3.20, p < 0.001).
  
  
  
  More frequent consumption of healthy snacks is associated with decreased prevalence of overweight, general obesity, and abdominal obesity in adolescents. Further studies, in particular of a prospective nature, are required to examine this association in other populations.
authors.affiliation: a Food Security Research Center (L.A., M.H., A.E.).|b Department of Community Nutrition (L.A., M.H., A.E).|d Isfahan University of Medical Sciences , Isfahan , IRAN.
authors.forename: Leila
authors.initials: L
authors.lastname: Azadbakht
authors.affiliation: a Food Security Research Center (L.A., M.H., A.E.).|b Department of Community Nutrition (L.A., M.H., A.E).|d Isfahan University of Medical Sciences , Isfahan , IRAN.
authors.forename: Maryam
authors.initials: M
authors.lastname: Hajishafiee
authors.affiliation: c Isfahan Cardiovascular Research Center, Cardiovascular Research Institute and Department of Cardiology, School of Medicine (J.G.).|d Isfahan University of Medical Sciences , Isfahan , IRAN.
authors.forename: Jafar
authors.initials: J
authors.lastname: Golshahi
authors.affiliation: a Food Security Research Center (L.A., M.H., A.E.).|b Department of Community Nutrition (L.A., M.H., A.E).|d Isfahan University of Medical Sciences , Isfahan , IRAN.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Esmaillzadeh
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D015930:Diet Records; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D007492:Iran / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D056128:Obesity, Abdominal / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D062410:Snacks; D011795:Surveys and Questionnaires; D055105:Waist Circumference
keywords: diet; healthy snack score; obesity; snack