Secular Trends in Meal and Snack Patterns among Adolescents from 1999 to 2010

Background: Linkages between snack patterns, diet, and obesity in adolescents likely depend on the consumption of main meals, how often snacks are prepared away from home, and whether energy-dense, nutrient-poor snack foods and sugary drinks are frequently consumed. Nutrition-based interventions need to be informed by an understanding of how secular changes in the contribution of snacks to dietary intake may be related to changes in meal frequency as well as how these trends differ by sociodemographic characteristics. Objectives: To examine secular trends from 1999 to 2010 in meal and snack patterns among adolescents. Design: A repeated cross-sectional design was used. Participants/setting: Participants from Minneapolis/St Paul, MN, secondary schools completed classroom-administered surveys and food frequency questionnaires in 1999 (n=2,598) and 2010 (n=2,540). Main outcome measures: Weekly meal frequencies; number of snacks consumed on school and vacation/weekend days; frequent consumption of snacks prepared away from home (≥3 times/week); and daily servings of energy-dense, nutrient-poor food/drinks that are commonly consumed at snack occasions. Statistical analyses performed: Trends from 1999 to 2010 were examined using inverse probability weighting to control for differences in sociodemographic characteristics in the two samples. Results: Mean frequencies of breakfast and lunch increased modestly in the overall population (both P values <0.001), and there were decreases in the number of snacks consumed on schools days (P<0.001) and vacation/weekend days (P=0.003). Although there was no change in the proportion of adolescents who reported frequent consumption of snacks prepared away from home, there was a secular decrease in energy-dense, nutrient-poor food/drink consumption (P<0.001). Sociodemographic differences in the identified trends were evident. Conclusions: The observed pattern of sociodemographic characteristic differences in meal and snack trends among adolescents suggests the need for targeted efforts to ensure public health messages reach low-income and ethnic/racial minority population subgroups most vulnerable to poor nutrition and the development of obesity.