Income Disparities in Snacking Characteristics Among U.S. Adolescents 12 to 19 Years: National Health and Nutrition Examination Survey 2005–2018

Abstract Objectives Adolescents from low-income homes are shown to consume energy-dense snacks. However, less is known about the nutrient composition of snacks and the types of foods/beverages consumed as snacks. The overall aim of this study is to examine income disparities in, 1) nutrients consumed from snacks and 2) food/beverages consumed as snacks, among a nationally representative sample of U.S. adolescents. Methods Adolescents (12–19 years) who participated in the National Health and Nutrition Examination Survey 2005–2018, had reliable Day 1 24-h diet recall data, and reported at least 1 snacking occasion were included in the analyses (n = 7132). Nutrient density (g or mg/100 kcal) of snacks was reported for the following: protein, total fat, saturated fat, carbohydrates, total sugar, added sugar, fiber, sodium. We also reported the proportion of adolescents that consume various foods/beverages as snacks, using What We Eat in America (WWEIA) categories. We examined disparities in the aforementioned snacking characteristics by household poverty-to-income ratio (PIR): low-income (PIR ≤ 1.3), middle-income (PIR > 1.3–3.5), and high-income (PIR > 3.5). Data were analyzed using multiple linear and logistic regression models, adjusting for age, sex, and race/ethnicity. Significance was set at P < 0.05. Results On average, adolescents consumed 185.35 kcal (9.30% of total energy intake) per snacking occasion. For every 100 kcals, adolescent consumed 2.02g protein, 2.87g total fat, 0.99g saturated fat, 17.16g carbohydrates, 10.62g total sugar, 1.69g added sugar, 0.88g fiber, and 120.11mg sodium. Adolescents from low-income homes consumed more energy (9.63%) and added sugar (1.76g) per 100 kcals than those from high-income homes (8.52%, 1.49g, respectively; P< 0.05). The top 3 WWEIA categories of snacks were Snacks & Sweets (e.g., potato chips, cakes and pies; 73.3%), Beverages (51.9%), and Milk & Dairy (25.0%). Compared to adolescents from low-income homes, those from high-income homes were more likely to consume Snacks & Sweets (OR: 1.34, 95% CI: 1.05–1.71), but less likely to consume Beverages (OR: 0.69, 95% CI: 0.57–0.84). Conclusions Among U.S. adolescents, there exist income disparities in both the nutrient density of snacks and the types of foods/beverages consumed as snacks. Funding Sources N/A.