title: Multicontextual correlates of energy-dense, nutrient-poor snack food consumption by adolescents.
abstract: Frequent consumption of energy-dense, nutrient-poor snack foods is an eating behavior of public health concern. This study was designed to inform strategies for reducing adolescent intake of energy-dense snack foods by identifying individual and environmental influences. Surveys were completed in 2009-2010 by 2540 adolescents (54% females, mean age = 14.5 ± 2.0, 80% nonwhite) in Minneapolis-St. Paul, Minnesota schools. Daily servings of energy-dense snack food was assessed using a food frequency questionnaire that asked about consumption of 21 common snack food items, such as potato chips, cookies, and candy. Data representing characteristics of adolescents' environments were collected from parents/caregivers, friends, school personnel, Geographic Information System sources, and a content analysis of favorite television shows. Linear regression was used to examine relationships between each individual or environmental characteristic and snack food consumption in separate models and also to examine relationships in a model including all of the characteristics simultaneously. The factors found to be significantly associated with higher energy-dense snack food intake represented individual attitudes/behaviors (e.g., snacking while watching television) and characteristics of home/family (e.g., home unhealthy food availability), peer (friends' energy-dense snack food consumption), and school (e.g., student snack consumption norms) environments. In total, 25.5% of the variance in adolescents' energy-dense snack food consumption was explained when factors from within each context were examined together. The results suggest that the design of interventions targeting improvement in the dietary quality of adolescents' snack food choices should address relevant individual factors (e.g., eating while watching television) along with characteristics of their home/family (e.g., limiting the availability of unhealthy foods), peer (e.g., guiding the efforts of a peer leader in making healthy choices), and school environments (e.g., establishing student norms for selecting nutrient-dense snack foods).
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States. Electronic address: larsonn@umn.edu.
authors.forename: Nicole
authors.initials: N
authors.lastname: Larson
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States. Electronic address: mill5687@umn.edu.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Miller
authors.affiliation: Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, United States. Electronic address: eisen012@umn.edu.
authors.forename: Marla E
authors.initials: ME
authors.lastname: Eisenberg
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States. Electronic address: awwatts@umn.edu.
authors.forename: Allison W
authors.initials: AW
authors.lastname: Watts
authors.affiliation: Global Health and Community and Family Medicine, Duke Global Health Institute, Duke University, 112 Trent Hall, 310 Trent Drive, Box 90519, Durham, NC 27708, United States. Electronic address: mary.story@duke.edu.
authors.forename: Mary
authors.initials: M
authors.lastname: Story
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States. Electronic address: neuma011@umn.edu.
authors.forename: Dianne
authors.initials: D
authors.lastname: Neumark-Sztainer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001290:Attitude; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D004435:Eating; D002149:Energy Intake; D005190:Family; D005247:Feeding Behavior; D005260:Female; D005523:Food Supply; D033062:Friends; D006801:Humans; D008297:Male; D008910:Minnesota; D008954:Models, Biological; D009765:Obesity / Q000517:prevention & control; D010379:Peer Group; D012574:Schools; D062410:Snacks; D012931:Social Environment
keywords: Adolescents; Home environment; Media; Neighborhood; Peers; School environment; Snack food