Children Eat Fewer Calories When Offered Healthier Snacks

Barbara Boughton

December 27, 2012

Children who were offered nutrient-dense snacks, such as vegetables or a combination of vegetables and cheese, consume fewer calories than those who snack on less nutritious foods, such as potato chips. These conclusions come from a study conducted in 201 children by Brian Wansink, PhD, and fellow researchers at Cornell University, and published online December 17 and in the January 2013 issue of Pediatrics.

In the study, children were randomly assigned to 1 of 4 different groups to test their calorie intake and satiety when consuming snacks while watching television programs for 45 minutes. Each group was offered a different snack: vegetables only, cheese only, potato chips only, or a combination snack of vegetables and cheese.

Children in each group were asked to assess their satiety at 3 different times: before they were offered the snacks, during a break between 2 different television programs, and after the television programs had ended. At the same time, their parents completed a 20-item questionnaire concerning how many days they engaged in mealtime activities together during a typical week.

Not surprisingly, children who were offered vegetables consumed the fewest calories when compared with those offered potato chips (P < .001). In addition, children offered the combination snack ate 72% fewer calories than those who were served potato chips (P < .001).

Children who ate vegetables only needed the fewest calories to achieve satiety, yet those offered the combination snack also needed significantly fewer calories to achieve satiety than those who ate potato chips (P < .001).

Children who ate cheese only consumed approximately the same amount of calories as those offered the combination snack (P = .91) and also needed a similar number of calories to achieve satiety when compared with those offered the combination snack.

Previous research has demonstrated that a variety of foods slows down snacking, the researchers said, However, other studies that have examined whether parental control, such as restricting access to snacks with few nutrients, actually reduces children's intake of these foods have had mixed results. Therefore, an alternative to strictly reducing snack foods with few nutrients is to offer children a variety of healthy snacks, the researchers noted.

The researchers examined whether sex, age, body mass index, or family involvement in mealtime activities moderated the children's caloric intake during snacking. They found that children who were overweight or obese were more likely to need fewer calories to achieve satiety when consuming the combination healthy snack of cheese and vegetables than those of normal weight (P = .02) but ate more when offered potato chips.

Children whose parents' reported low family involvement in meal times were more likely to consume fewer calories when offered healthy snacks than those with high family involvement (P = .049). However, they ate more when offered potato chips than those with high family involvement.

The children who ate the combination snack consumed the same amounts of vegetables as those offered vegetables only, the researchers note. "This suggests that the children did not replace vegetables with cheese, but rather, they complemented their vegetable intake with a source of protein and calcium," they write.

The researchers also note that their study was limited by the fact that it did not examine why the combination snack of vegetables and cheese led to less caloric intake than the potato chips. They also write that more research is needed to examine the effect of various combinations of nutrient dense snacks on caloric intake.

"This is a well-done study, and its limitations are acknowledged," commented Jatinder Bhatia, MD, professor and chief in the Department of Pediatrics at Georgia Health Sciences University in Augusta. Dr. Bhatia is also chair of the committee on nutrition for the American Academy of Pediatrics.

"The study does not account for the bulk of the snacks, in vegetables vs chips, in terms of satiety achieved, but does indicate the same consumption of vegetables whether given alone or in a combination," Dr. Bhatia told Medscape Medical News.

Providing nutrient-dense snacks in combination with a healthy diet can be helpful in decreasing caloric intake among children and reducing the risk for obesity, Dr. Bhatia said. However, this study should be followed up by more research on snacking habits that also examine other factors such as parental obesity, eating habits, and overall physical activity, he noted.

Data collection in the study was funded by Bel Brands USA and the Cornell Food and Brand Laboratory. The authors and Dr. Bhatia have disclosed no relevant financial relationships.

Pediatrics. 2013;131:22-29. Full text