A healthy snack of cheese and vegetables can satisfy a child's appetite while also resulting in the consumption of fewer calories, researchers found.
In a study measuring children's snack consumption when presented with various snack options while watching television, those given a combination vegetable and cheese snack consumed significantly fewer calories before being satiated than those who were served potato chips (P<0.001), according to Brian Wansink, PhD, of Cornell University in Ithaca, N.Y., and colleagues.
The effects of snacking on caloric intake were more pronounced in those who were overweight or obese (P=0.02) or who were from low-involvement families (P=0.049), they wrote online in Pediatrics.
The authors noted that, although other factors, such as reduced physical activity, contribute to childhood obesity, the increase in snacking -- up to an average of three snacks per day from one snack per day 30 years ago -- and in consumption of non-nutrient dense snacks "are considered major factors associated with childhood obesity."
They added that "strategies for curbing [non-nutrient dense snack] consumption are needed" to offset the "present and growing problem" of childhood obesity.
The researchers analyzed whether children eating a combination snack of cheese and vegetables would consume fewer calories, and require fewer calories to become satiated than children eating chips.
They also looked at whether heavier children eating the combination snack would consume fewer calories than healthier-weight children, and if children in families with low involvement would eat fewer calories of the combination snack than those from high-involvement families.
The sample size consisted of 183 children (104 female) with an average age of 8.7. The mean body mass index was 20.3 kg/m2.
Among all the participants, 38 were considered overweight (BMI ≥85th percentile), and 43 were considered obese (BMI ≥95th percentile) according to the CDC's BMI-for-age growth chart. The majority of overweight (55%) and obese (63%) children in the study were from low-involvement families.
Participants were randomized to one of four snacking conditions, including potato chips only, vegetables only, cheese only, and cheese and vegetables. The children were allowed to snack freely while watching 45 minutes of TV.
Children's satiety was measured before they were allowed to snack, immediately after watching TV and being allowed to freely snack, and 20 minutes after snacking through a three-question, 9-point scale questionnaire. Satiety was indexed by dividing calories consumed by satiety increases from the first measure to the third measure and used to determine the average number of calories of a snack required to satiate hunger.
The cheese only and vegetable only conditions were controls "to examine how much children in the combo condition consumed compared with those in the control groups."
In addition to the satiety measures, participants' parents filled out 20-item questionnaires regarding mealtime habits, including family involvement during mealtimes and mealtime activities and interactions.
Participants in both the combination and control conditions consumed significantly fewer calories than those who snacked on chips, at 170 mean calories in the cheese and vegetable group, 60 mean calories in the vegetable only group, and 200 mean calories in the cheese only group, versus 620 mean calories in the chip group (P<0.001 for all three comparisons).
"It is worth noting that children offered the combination snack consumed about the same amount of vegetables as those offered vegetables only," they wrote.
In a comparison of satiety between the combination and chip groups, combination healthy snack eaters needed significantly fewer calories before they were satiated (53 calories versus 282.4 calories, P<0.001), making the combination snack "a more calorie-effective means to attain satiety than potato chips."
When comparing effects of age, sex, weight status, and family involvement on caloric intake, only obesity or overweight and family had a significant effect on lower calorie consumption, where children in the combination snack condition ate 16-points fewer (76% versus 60%) and 10-points fewer (77% versus 67%) calories than those in the chip condition.
The authors noted that, while banning non-nutritional snacks entirely from a child's diet may not be practical, offering a healthy combination snack alternative or as a replacement should cause "less fear of backlash" than complete removal of non-nutrient dense foods.
The study had some limitations, most notably the authors did not examine the processes underlying why the combination healthy snack led to less caloric intake compared with a non-nutrient dense snack.
"Additional research is needed...to appreciate the underlying physiological and psychological processes [and] the impact of combination snacks on intake over time also needs to be explored," they said.
The study's data collection was supported by Bel Brands USA and the Cornell Food and Brand Laboratory.
The authors declared no conflicts of interest.
- Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner