Disclosures - Today's Dietitian Magazine · 2015-12-16 · Disclosures 2 Karen Ansel, MS, RDN, CDN Karen Ansel reports the following relevant disclosure: She serves as a content developer

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Disclosures 2

Karen Ansel, MS, RDN, CDN

Karen Ansel reports the following relevant disclosure: She serves as a content developer for Kellogg’s.

David R. Just, PhD

David Just has no disclosures for this program.

The presenters have certified that no conflict of interest exists for this program.

Learning Objectives

Suggested CDR Learning Codes: 4010, 5370, 6000, 8100; Level 2

Suggested CDR Performance Indicators: 8.1.2, 8.2.3, 8.3.6, 12.4.3

1. Evaluate the most recent trends regarding snacking.

2. Assess the impact of the food environment on

snacking.

3. Interpret the latest research regarding snacking on

measures of health and body weight.

4. Provide clients with evidence-based recommendations

for healthful snacking.

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Snacking Trends

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Thirty-Five Years Ago

• The average American

ate one snack a day

• 40 percent of adults and

teens didn’t eat any

snacks at all.

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(USDA Food Surveys Research Group, 2010 & 2011)

Today

• Thirty percent more people snack today than

they did four decades ago

• Most people snack at least twice a day

• The majority snack even more

– Nearly half of adults snack two or three times

a day. The snacking trend continues to rise.

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(USDA Food Surveys Research Group, 2010 & 2011; Piernas, J Nutr, 2010)

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Number of Snacks a Day

Changes in Snacking Frequency of US Adults Over the Past 35 Years

1977-1978

2007-2008

(USDA Food Surveys Research Group, 2011)

Reasons We Love to Snack

Physiological

• To satisfy a craving

• To satisfy hunger

• For better nutrition

– 66 percent of people surveyed listed nutrition as one of their top reasons for snacking according to a 2014 Nielsen report.

Emotional

For fun and enjoyment

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(Nielsen website, 2014)

Are Snacks the New Meals?

• Many people are eating snacks in place of

meals.

• Adults who snack multiple times a day, are

especially likely to snack all day instead of

eating regular meals.

• Some adults believe it’s healthier to snack

throughout the day than to eat three meals.

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Time Use and Calories Consumed

Time Use (in minutes) Calories Activity All days Mon-Fri Sat-Sun All days Mon-Fri Sat-Sun

Eating/drinking only 57.1 53.0 69.4 922.3 858.7 1115.7

Going to bed/sleeping 493.0 472.3 525.7 27.5 30.5 18.6

Personal care 55.7 56.2 54.2 60.0 53.4 80.0

Working 147.5 177.2 57.0 112.3 137.6 35.3

Home production 158.2 154.5 169.5 195.5 199.3 184.0

Caring 45.5 45.9 44.4 56.8 62.5 39.5

Education 12.1 13.0 9.0 10.8 14.3 0.0

Travel 79.2 82.0 70.5 127.5 128.8 123.6

Relaxation and leisure (excluding TV and attending events) 80.1 79.4 82.4 97.2 100.2 88.0

Watching TV 167.7 163.5 180.2 221.3 234.2 182.0

Attending art and sports 4.0 3.0 7.1 8.5 8.8 7.9

Socializing 50.2 46.1 62.7 111.7 82.9 199.3

Sports and exercise 11.5 11.1 12.9 4.3 3.9 5.6

Phone 14.8 15.8 11.8 25.9 26.1 25.3

Shopping 24.7 23.1 29.3 28.4 30.5 22.1

Services 12.7 13.8 9.1 14.1 16.6 6.5

Voluntary/civic/religious activities 16.7 11.1 33.7 3.9 2.6 7.8

NA 8.4 8.0 9.8 17.0 12.2 31.5

(Bertrand and Schanzenbach, Am Econ Rev, 2009)

Time Use and Calories Consumed

• On high calorie days: overweight individuals

taking in the excess calories by snacking while

doing chores or socializing. For normal weight

high calorie days occur almost always along with

socializing.

• How much you eat in front of the TV is

unaffected by how much you ate in the previous

6 hours—you are focused on the TV and not on

how much you eat.

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Early Morning Morning Afternoon Evening Late Evening

Perc

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sn

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Time of day

Change in Snacking Frequency Since 2010

2010

2015

(IRI Worldwide website, 2015)

Generational Snack Habits

Even though everyone

is snacking more often,

Millennials are most

likely to snack all day

and evening long

compared to Baby

Boomers who snack

less in the morning or

late at night.

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(IRI Worldwide website, 2015)

Foods We’re Snacking On 10 Most Popular Snacks

Fresh fruit

Chocolate

Potato & Tortilla Chips

Bread & sandwiches

Cheese

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Ice cream

Vegetables

Yogurt

Cookies

Nuts & seeds

(Nielsen website, 2014)

Snacks Aren’t Always

Traditional Snack Foods

People seek out snack-sized versions of foods we usually eat as, or with, meals:

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salads

soups

pastas

sandwiches

burgers

pizzas

breakfast foods

desserts

Healthier Options

Many people are also seeking healthier snack

options, such as snacks that are:

– Naturally flavored

– Low in sugar and sodium

– Free of high fructose corn syrup

– Made with whole grains

– High in fiber

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(Nielsen website, 2014)

Snacks and

Weight Management

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Snack Calories

Roughly a quarter of our

daily calories come from

snacks.

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(USDA Food Surveys Research Group, 2010 & 2011;

Piernas and Popkin, Health Aff, 2010)

Snacking Research

Research on the impact of snacking and eating

frequency on body weight is mixed

This may be partially due to:

– Different definitions of snacking among

studies.

– Inclusion or exclusion of beverages and

alcoholic drinks as snacks.

– Reporting errors by study participants.

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Snacking, Calories and Obesity

Even though people who

snack more frequently

take in more calories, the

USDA reports that normal

weight men and women

actually snack slightly

more often than people

who are overweight or

obese.

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(USDA Food Surveys Research Group, 2010 & 2011)

Snacking & Weight Management

Among Adults

• Eating frequent meals and snacks has been

proposed to help control appetite and food

intake.

• However, a review of controlled feeding studies

in adults found:

– Eating more than 3 times a day had little, if

any, impact on appetite or food intake.

– Eating fewer than 3 times a day increased

appetite.

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(Leidy and Campbell, J Nutr, 2011)

Snack Choices and Body Weight

In Adults

Snacking on cakes, cookies,

candy, chocolate and desserts

is associated with increased

snacking energy intake.

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(Bertéus et al, Int J Obes, 2005; Murakami and Livingstone, Int J Obes, 2014)

Snacking and Body Weight

Among Children

• Unlike adults, eating

frequency may not be

related to overweight and

obesity in children.

• Some studies suggest that

children and adolescents

who eat more often may

have a smaller waist

circumference and lower

BMI.

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(Academy of Nutrition and Dietetics EAL; Toschke et al, Obes Res, 2005; Toschke et al, Int J

Pediatr Obes, 2009; Barba et al, Int J Obes, 2006; Mota et al, Ann Hum Biol, 2008;)

Snacking & Disease Prevention

Research on snacking and

prevention or treatment of

type 2 diabetes or high

triglyceride and cholesterol

levels is not consistent

enough to conclude whether

snacking has positive or

negative benefits.

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(Rashidi et al, Saudi Med J, 2003; Jenkins et al, Metabolism, 1995; Mekary et al, Am J

Clin Nutr, 2013; Mekary et al, Am J Clin Nutr, 2012; Smith et al, Br J Nutr, 2012)

Snacks and Nutrition

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Snacks Provide Nutrients

Snacks can deliver nutrients people don’t get

enough of.

• When meals don’t supply all the nutrition people need, nutrient-dense snacks can help fill those gaps.

• Adults and teens who snack on whole fruit, vegetables, legumes, grains, crackers and salty snacks tend to have better diet quality than people who don’t snack or who snacked on other foods.

• Adults who eat breakfast, lunch, dinner plus 1 or 2 snacks a day obtain more key nutrients including protein, fiber, folic acid, vitamin C, calcium, magnesium, iron and potassium.

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(Nicklas et al, BMC Public Health, 2014; Kerver et al, J Am Diet Assoc, 2006)

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Nutrient

Nutrients provided by snacks

Teens

Adults

(USDA Food Surveys Research Group, 2010 & 2011)

Sugar, Sodium & Snacking

Snacks provide nearly

40% of the added sugar

and 16% of the sodium

in children’s diets.

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(Hess and Slavin, Nutrients, 2014; Cogswell et al, MMWR Morb Mortal Wkly Rep, 2014)

Who Benefits

From Snacking?

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Children and Teens

Most children and teens’ diets are lacking in whole

fruit, vegetables, beans and whole grains.

• Snacks that provide these can improve diet quality.

Physically active children and teens

• Require fuel for growth

• Additional carbohydrates for energy as they store

less carbohydrate than adults.

• A carbohydrate-rich pre or post workout snack can

help provide both of these nutrients.

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(Federal Interagency Forum on Child and Family Statistics, 2015; Jeukendrup and Cronin,

Med Sport Sci, 2011; Meyer and Shirreffs, J Sports Sci, 2007)

Active Adults

• Adults who exercise require carbohydrates for

energy.

• For exercising adults who have not eaten 3-4

hours before working out, a pre-exercise snack

or meal that is rich in carbohydrates can provide

needed fuel.

• Post exercise, a snack containing carbohydrates

plus protein can help refuel and repair muscles.

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(Hargreaves, Can J Appl Physiol, 2001; Betts and Williams, Sports Med, 2010)

The Elderly

• Adult 65 and older who snack have been

shown to obtain 14% of their day’s protein from

snacks.

• They also take in more calories, carbohydrate

and fat.

• The more frequently they snack, the more

vitamins A, C and E, beta carotene, magnesium,

copper and potassium they consume.

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(Zizza et al, J Am Diet Assoc, 2007; Zizza et al, J Am Diet Assoc, 2010)

Snacking and

Consumer Behavior

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How Do We Know

What To Eat?

• 285 variety of cookies

• 75 iced teas

• 230 soups

• 175 salad dressings

• Information?

• Prices?

• Weighing taste and

convenience?

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Why Behavior Matters

• Making deliberate decisions for each

would be impossible

• We fall back on rules of thumb and

habit

• What would happen if we did rationally

consider each decision?

• How could cognitively strategies

engage the unthinking?

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Individuals make hundreds of food decisions a day.

Hot vs. Cold Decisions

Cold State

We consider:

– Prices

– Health information

– Logic

We buy:

– Smaller portions

– Moderate foods

Hot State

We eat for:

– Taste

– Convenience

– Size

– Visual effect

– This decision is an

exception

We buy:

– Bigger

– More hedonic

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Hot/Cold Study Behavioral Interrupt

• Upstate NY schools with pre-

ordering of lunch items through

SmartBoards

• Students who did NOT pre-order

(Hot State):

11.8% less likely to take a fruit

8.9% more like to take a snack food

25% more likely to take a starchy side

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(Hank et al, JAMA Pediatrics, 2013)

Visibility

• Simply seeing a brownie can lead to

unplanned consumption

• The image or presence of a healthy food

option can lead to consumption of

healthier foods.

• Making fruit more visible can more than

double fruit consumption

• We often don’t know what we want until

we see it

.

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(Just and Wansink, Choices, 2009; Wansink and Sobal,

Environ Behav, 2007 )

Convenience

0

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350

AfterFruit…

• A little convenience goes a long way

• Opening the cooler door increases ice cream selection by 30%

• Moving the candy bowl 3 feet from your desk can reduce snacking by more than 50%

• Pre-slicing apples increases consumption

• Placing white milk in front of chocolate can increase consumption by more than 25%

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(Just and Wansink, Choices, 2009; Meyers et al, Arch Gen Psychiatry,

1980; Painter et al, Appetite, 2002; Wansink et al, Am J Prev Med, 2013)

Perceived Abundance Matters

7.32%

28.81%

0%

5%

10%

15%

20%

25%

30%

35%

3 Visible All Visible

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(Wilson et al, Cornell University, 2015)

Knowing When to Stop

• It is difficult to know how much we have eaten

• We tend not to consider except at convenient stopping points

• Visible cues can help

• Creating natural stopping points

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(Geier et al, Health Psychol, 2012; Wansink and Payne, Percept Mot Skills, 2007)

Conclusion

• No one is immune when it comes to thoughtless

behaviors

• The keys are setting up the choices ahead of time:

– Convenience

– Visibility

– Scarcity

– Stopping points

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Questions?

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Credit Claiming

You must complete a brief evaluation of the

program in order to download your certificate. The

evaluation survey will be available on

www.CE.TodaysDietitian.com for 1 year

following the live presentation.

RDs should list CPE activity type 175 in their

professional development portfolio.

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