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      Contribución de la merienda al patrón alimentario de escolares con exceso de peso y estado nutricional normal, en Cartago, Costa Rica

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          Abstract

          Con el fin de identificar el aporte nutricional de las meriendas al patrón alimentario de los escolares con estado nutricional normal y con exceso de peso, se estudiaron 80 escolares (40 casos con sobrepeso/obesidad y 40 controles con estado nutricional normal) costarricenses de primer a tercer grado. Se tomó peso, talla y pliegue tricipital para la valoración antropométrica y se utilizó un registro dietético de tres días para la información de consumo. Las meriendas fueron analizadas de acuerdo al tipo (lugar de preparación y consumo) y horario. Se obtuvo que las meriendas de la tarde y la “preparada y consumida en casa” son las realizadas con la mayor frecuencia por ambos grupos. En la merienda “preparada y consumida en casa” y la “merienda de la tarde” se observó un consumo significativamente mayor de energía y carbohidratos en las niñas caso. En la merienda “preparada y consumida en casa”, se reportó un consumo significativamente mayor de grasa saturada en los niños caso comparado con los niños control. Las meriendas de la tarde y las meriendas “preparadas y consumidas en casa”, podrían estar relacionadas con el desarrollo de sobrepeso/obesidad en la muestra estudiada, por lo que la educación nutricional brindada a padres y escolares, resultan claves en la prevención de ésta.

          Translated abstract

          Nutritional contribution of snacks to food patterns in school children who are overweight or obese compared to school children who are of normal weight in Cartago,Costa Rica. In order to assess the nutritional contribution of snacks to food patterns in school children, a sample of 80 Costa Rican elementary schoolchildren: 40 children who were overweight or obese (the case group) and 40 children with normal weight (the control group) were evaluated. The anthropometric evaluation included weight, height, and triceps skinfold thickness. Food patterns were determined using a 3-day food diary.Snacks consumed throughout the day were classified and analyzed according to their place of preparation and location of consumption and to the time of the day in which they were consumed. The results of this study revealed that “afternoon snacks” and “snacks prepared and eaten at home” were the most frequently consumed snacks by both case and control groups.The girls in the case group had a significantly larger intake of energy and carbohydrates in their “afternoon snacks” and the “snacks prepared and eaten at home” as compared to girls in the control group. Boys in the case group showed a significantly greater consumption of saturated fat in the “snacks prepared and eaten at home” as compared to boys in the control group. It was concluded that the intake of “afternoon snacks” and of those “prepared and eaten at home” could be related with the incidence of overweight/obesity in the sample of study and therefore nutrition education aimed at parents and children is crucial and could play an important role in its prevention.

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          Most cited references28

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          The increasing prevalence of snacking among US children from 1977 to 1996.

          To determine snacking trends and changes in nutrient contribution of snacking over time. Nationally representative data from the 1977-78 Nationwide Food Consumption Survey (NFCS77), 1989-91 Continuing Survey of Food Intake by Individuals (CSFII89), and 1994-96 (CSFII96) were used. The sample consisted of 21,236 individuals aged 2 to 18 years. For each survey year, mean numbers of snacks consumed, mean grams consumed per snack, and mean energy intake from snacks were computed, as was contribution of snacking to total energy intake and fat intake. Snacking was self-defined, and a snacking occasion consisted of all snack foods consumed during a 15-minute period. Differences in means between age groups and across survey years were compared. The prevalence of snacking increased in all age groups. The average size of snacks and energy per snack remained relatively constant; however, the number of snacking occasions increased significantly, therefore increasing the average daily energy from snacks. Compared with non-snack eating occasions, the nutrient contribution of snacks decreased in calcium density and increased in energy density and proportion of energy from fat. Snacking is extremely prevalent in our society. Healthy snack food choices should be emphasized over high-energy density convenience snacks for children.
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            Snack food intake does not predict weight change among children and adolescents.

            To assess whether intake of snack foods was associated with weight change among children and adolescents. Prospective study of 8,203 girls and 6,774 boys, 9-14 y of age in 1996, in an ongoing cohort study who completed at least two questionnaires between 1996 and 1999. Intake of snack foods was assessed in 1996-1998 with a validated food frequency questionnaire designed specifically for children and adolescents. The outcome measure was change in age- and gender-specific z-score of body mass index (BMI). Boys consumed more snack foods than girls during the entire study period. After controlling for Tanner stage of development, age, height change, activity, and inactivity, there was no relation between intake of snack foods and subsequent changes in BMI z-score among the boys (beta=-0.004), but snack foods had a weak inverse association (beta=-0.007, P<0.05) with weight change among the girls. However, the results were confounded by dieting status, which had a significant positive independent association with BMI change. After controlling for dieting status and whether the mother was overweight, the association between servings per day of snack foods and subsequent changes in BMI z-score were not significant in either gender. Our results suggest that although snack foods may have low nutritional value, they were not an important independent determinant of weight gain among children and adolescents.
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              Children's meal patterns have changed over a 21-year period: the Bogalusa Heart Study.

              The objective of this study was to analyze children's meal patterns over 2 decades. One 24-hour dietary recall was collected on each child who participated in one of seven cross-sectional surveys. Dietary intake data were collected on 1,584 10-year-old children (65% white, 35% African American), in Bogalusa, LA, from 1973 to 1994. Descriptive statistics and one-way analysis of variance adjusting for gender and ethnicity. From 1973 to 1978, there was a marked increase (P<.0001) in the percentage of children who skipped breakfast, from 8.2% to 29.6%. When school breakfast was introduced in 1981, the proportion of children skipping breakfast declined to 12.5% (P<.01). From 1973-1974 to 1993-1994, the percentage of children eating a school lunch declined from 89.7% (1973-1974) to 78.2% (1993-1994) (P<.001); eating lunch brought from home increased from 5.9% to 11.1% (P<.01); consuming a home dinner decreased from 89.2% to 75.9% (P<.01); eating a dinner prepared outside the home increased from 5.4% to 19.0% (P<.01); consuming a meal at a restaurant increased from 0.3% to 5.4% (P<.0001); consuming snacks decreased (P<.0001); total eating episodes decreased from 6.6 to 5.2 (P<.0001); and eating time span significantly decreased from 12.4 hours to 11.5 hours (P<.0001). Despite these changes in meal patterns, no associations were found between meal patterns and overweight status. Striking alterations in the meal patterns of children occurred over the 2-decade period. These changes may have implications for the changes in the dietary intakes of children during the same time. However, data from this study do not support an association between meal patterns and children's overweight status. Further research with multiple days of assessment is needed to better understand the complexity of diet as it relates to childhood obesity.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                alan
                Archivos Latinoamericanos de Nutrición
                ALAN
                Sociedad Latinoamericana de Nutrición (Caracas )
                0004-0622
                December 2012
                : 62
                : 4
                : 339-346
                Article
                S0004-06222012000400004
                45fe8ad9-066b-46bc-a664-9bdd3da2c447

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0622&lng=en
                Categories
                NUTRITION & DIETETICS

                Nutrition & Dietetics
                Snacks,food pattern,childhood obesity,Merienda escolar,patrón de con-sumo escolar,obesidad infantil

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