disclosures - today's dietitian magazine · 2015-12-16 · disclosures 2 karen ansel, ms, rdn,...
TRANSCRIPT
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Disclosures 2
Karen Ansel, MS, RDN, CDN
Karen Ansel reports the following relevant disclosure: She serves as a content developer for Kellogg’s.
David R. Just, PhD
David Just has no disclosures for this program.
The presenters have certified that no conflict of interest exists for this program.
Learning Objectives
Suggested CDR Learning Codes: 4010, 5370, 6000, 8100; Level 2
Suggested CDR Performance Indicators: 8.1.2, 8.2.3, 8.3.6, 12.4.3
1. Evaluate the most recent trends regarding snacking.
2. Assess the impact of the food environment on
snacking.
3. Interpret the latest research regarding snacking on
measures of health and body weight.
4. Provide clients with evidence-based recommendations
for healthful snacking.
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Snacking Trends
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Thirty-Five Years Ago
• The average American
ate one snack a day
• 40 percent of adults and
teens didn’t eat any
snacks at all.
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(USDA Food Surveys Research Group, 2010 & 2011)
Today
• Thirty percent more people snack today than
they did four decades ago
• Most people snack at least twice a day
• The majority snack even more
– Nearly half of adults snack two or three times
a day. The snacking trend continues to rise.
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(USDA Food Surveys Research Group, 2010 & 2011; Piernas, J Nutr, 2010)
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Perc
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du
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Number of Snacks a Day
Changes in Snacking Frequency of US Adults Over the Past 35 Years
1977-1978
2007-2008
(USDA Food Surveys Research Group, 2011)
Reasons We Love to Snack
Physiological
• To satisfy a craving
• To satisfy hunger
• For better nutrition
– 66 percent of people surveyed listed nutrition as one of their top reasons for snacking according to a 2014 Nielsen report.
Emotional
For fun and enjoyment
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(Nielsen website, 2014)
Are Snacks the New Meals?
• Many people are eating snacks in place of
meals.
• Adults who snack multiple times a day, are
especially likely to snack all day instead of
eating regular meals.
• Some adults believe it’s healthier to snack
throughout the day than to eat three meals.
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Time Use and Calories Consumed
Time Use (in minutes) Calories Activity All days Mon-Fri Sat-Sun All days Mon-Fri Sat-Sun
Eating/drinking only 57.1 53.0 69.4 922.3 858.7 1115.7
Going to bed/sleeping 493.0 472.3 525.7 27.5 30.5 18.6
Personal care 55.7 56.2 54.2 60.0 53.4 80.0
Working 147.5 177.2 57.0 112.3 137.6 35.3
Home production 158.2 154.5 169.5 195.5 199.3 184.0
Caring 45.5 45.9 44.4 56.8 62.5 39.5
Education 12.1 13.0 9.0 10.8 14.3 0.0
Travel 79.2 82.0 70.5 127.5 128.8 123.6
Relaxation and leisure (excluding TV and attending events) 80.1 79.4 82.4 97.2 100.2 88.0
Watching TV 167.7 163.5 180.2 221.3 234.2 182.0
Attending art and sports 4.0 3.0 7.1 8.5 8.8 7.9
Socializing 50.2 46.1 62.7 111.7 82.9 199.3
Sports and exercise 11.5 11.1 12.9 4.3 3.9 5.6
Phone 14.8 15.8 11.8 25.9 26.1 25.3
Shopping 24.7 23.1 29.3 28.4 30.5 22.1
Services 12.7 13.8 9.1 14.1 16.6 6.5
Voluntary/civic/religious activities 16.7 11.1 33.7 3.9 2.6 7.8
NA 8.4 8.0 9.8 17.0 12.2 31.5
(Bertrand and Schanzenbach, Am Econ Rev, 2009)
Time Use and Calories Consumed
• On high calorie days: overweight individuals
taking in the excess calories by snacking while
doing chores or socializing. For normal weight
high calorie days occur almost always along with
socializing.
• How much you eat in front of the TV is
unaffected by how much you ate in the previous
6 hours—you are focused on the TV and not on
how much you eat.
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Early Morning Morning Afternoon Evening Late Evening
Perc
en
t o
f p
eo
ple
sn
ackin
g
Time of day
Change in Snacking Frequency Since 2010
2010
2015
(IRI Worldwide website, 2015)
Generational Snack Habits
Even though everyone
is snacking more often,
Millennials are most
likely to snack all day
and evening long
compared to Baby
Boomers who snack
less in the morning or
late at night.
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(IRI Worldwide website, 2015)
Foods We’re Snacking On 10 Most Popular Snacks
Fresh fruit
Chocolate
Potato & Tortilla Chips
Bread & sandwiches
Cheese
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Ice cream
Vegetables
Yogurt
Cookies
Nuts & seeds
(Nielsen website, 2014)
Snacks Aren’t Always
Traditional Snack Foods
People seek out snack-sized versions of foods we usually eat as, or with, meals:
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salads
soups
pastas
sandwiches
burgers
pizzas
breakfast foods
desserts
Healthier Options
Many people are also seeking healthier snack
options, such as snacks that are:
– Naturally flavored
– Low in sugar and sodium
– Free of high fructose corn syrup
– Made with whole grains
– High in fiber
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(Nielsen website, 2014)
Snacks and
Weight Management
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Snack Calories
Roughly a quarter of our
daily calories come from
snacks.
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(USDA Food Surveys Research Group, 2010 & 2011;
Piernas and Popkin, Health Aff, 2010)
Snacking Research
Research on the impact of snacking and eating
frequency on body weight is mixed
This may be partially due to:
– Different definitions of snacking among
studies.
– Inclusion or exclusion of beverages and
alcoholic drinks as snacks.
– Reporting errors by study participants.
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Snacking, Calories and Obesity
Even though people who
snack more frequently
take in more calories, the
USDA reports that normal
weight men and women
actually snack slightly
more often than people
who are overweight or
obese.
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(USDA Food Surveys Research Group, 2010 & 2011)
Snacking & Weight Management
Among Adults
• Eating frequent meals and snacks has been
proposed to help control appetite and food
intake.
• However, a review of controlled feeding studies
in adults found:
– Eating more than 3 times a day had little, if
any, impact on appetite or food intake.
– Eating fewer than 3 times a day increased
appetite.
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(Leidy and Campbell, J Nutr, 2011)
Snack Choices and Body Weight
In Adults
Snacking on cakes, cookies,
candy, chocolate and desserts
is associated with increased
snacking energy intake.
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(Bertéus et al, Int J Obes, 2005; Murakami and Livingstone, Int J Obes, 2014)
Snacking and Body Weight
Among Children
• Unlike adults, eating
frequency may not be
related to overweight and
obesity in children.
• Some studies suggest that
children and adolescents
who eat more often may
have a smaller waist
circumference and lower
BMI.
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(Academy of Nutrition and Dietetics EAL; Toschke et al, Obes Res, 2005; Toschke et al, Int J
Pediatr Obes, 2009; Barba et al, Int J Obes, 2006; Mota et al, Ann Hum Biol, 2008;)
Snacking & Disease Prevention
Research on snacking and
prevention or treatment of
type 2 diabetes or high
triglyceride and cholesterol
levels is not consistent
enough to conclude whether
snacking has positive or
negative benefits.
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(Rashidi et al, Saudi Med J, 2003; Jenkins et al, Metabolism, 1995; Mekary et al, Am J
Clin Nutr, 2013; Mekary et al, Am J Clin Nutr, 2012; Smith et al, Br J Nutr, 2012)
Snacks and Nutrition
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Snacks Provide Nutrients
Snacks can deliver nutrients people don’t get
enough of.
• When meals don’t supply all the nutrition people need, nutrient-dense snacks can help fill those gaps.
• Adults and teens who snack on whole fruit, vegetables, legumes, grains, crackers and salty snacks tend to have better diet quality than people who don’t snack or who snacked on other foods.
• Adults who eat breakfast, lunch, dinner plus 1 or 2 snacks a day obtain more key nutrients including protein, fiber, folic acid, vitamin C, calcium, magnesium, iron and potassium.
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(Nicklas et al, BMC Public Health, 2014; Kerver et al, J Am Diet Assoc, 2006)
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30%
D
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Nutrient
Nutrients provided by snacks
Teens
Adults
(USDA Food Surveys Research Group, 2010 & 2011)
Sugar, Sodium & Snacking
Snacks provide nearly
40% of the added sugar
and 16% of the sodium
in children’s diets.
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(Hess and Slavin, Nutrients, 2014; Cogswell et al, MMWR Morb Mortal Wkly Rep, 2014)
Who Benefits
From Snacking?
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Children and Teens
Most children and teens’ diets are lacking in whole
fruit, vegetables, beans and whole grains.
• Snacks that provide these can improve diet quality.
Physically active children and teens
• Require fuel for growth
• Additional carbohydrates for energy as they store
less carbohydrate than adults.
• A carbohydrate-rich pre or post workout snack can
help provide both of these nutrients.
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(Federal Interagency Forum on Child and Family Statistics, 2015; Jeukendrup and Cronin,
Med Sport Sci, 2011; Meyer and Shirreffs, J Sports Sci, 2007)
Active Adults
• Adults who exercise require carbohydrates for
energy.
• For exercising adults who have not eaten 3-4
hours before working out, a pre-exercise snack
or meal that is rich in carbohydrates can provide
needed fuel.
• Post exercise, a snack containing carbohydrates
plus protein can help refuel and repair muscles.
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(Hargreaves, Can J Appl Physiol, 2001; Betts and Williams, Sports Med, 2010)
The Elderly
• Adult 65 and older who snack have been
shown to obtain 14% of their day’s protein from
snacks.
• They also take in more calories, carbohydrate
and fat.
• The more frequently they snack, the more
vitamins A, C and E, beta carotene, magnesium,
copper and potassium they consume.
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(Zizza et al, J Am Diet Assoc, 2007; Zizza et al, J Am Diet Assoc, 2010)
Snacking and
Consumer Behavior
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How Do We Know
What To Eat?
• 285 variety of cookies
• 75 iced teas
• 230 soups
• 175 salad dressings
• Information?
• Prices?
• Weighing taste and
convenience?
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Why Behavior Matters
• Making deliberate decisions for each
would be impossible
• We fall back on rules of thumb and
habit
• What would happen if we did rationally
consider each decision?
• How could cognitively strategies
engage the unthinking?
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Individuals make hundreds of food decisions a day.
Hot vs. Cold Decisions
Cold State
We consider:
– Prices
– Health information
– Logic
We buy:
– Smaller portions
– Moderate foods
Hot State
We eat for:
– Taste
– Convenience
– Size
– Visual effect
– This decision is an
exception
We buy:
– Bigger
– More hedonic
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Hot/Cold Study Behavioral Interrupt
• Upstate NY schools with pre-
ordering of lunch items through
SmartBoards
• Students who did NOT pre-order
(Hot State):
11.8% less likely to take a fruit
8.9% more like to take a snack food
25% more likely to take a starchy side
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(Hank et al, JAMA Pediatrics, 2013)
Visibility
• Simply seeing a brownie can lead to
unplanned consumption
• The image or presence of a healthy food
option can lead to consumption of
healthier foods.
• Making fruit more visible can more than
double fruit consumption
• We often don’t know what we want until
we see it
.
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(Just and Wansink, Choices, 2009; Wansink and Sobal,
Environ Behav, 2007 )
Convenience
0
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100
150
200
250
300
350
AfterFruit…
• A little convenience goes a long way
• Opening the cooler door increases ice cream selection by 30%
• Moving the candy bowl 3 feet from your desk can reduce snacking by more than 50%
• Pre-slicing apples increases consumption
• Placing white milk in front of chocolate can increase consumption by more than 25%
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(Just and Wansink, Choices, 2009; Meyers et al, Arch Gen Psychiatry,
1980; Painter et al, Appetite, 2002; Wansink et al, Am J Prev Med, 2013)
Perceived Abundance Matters
7.32%
28.81%
0%
5%
10%
15%
20%
25%
30%
35%
3 Visible All Visible
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(Wilson et al, Cornell University, 2015)
Knowing When to Stop
• It is difficult to know how much we have eaten
• We tend not to consider except at convenient stopping points
• Visible cues can help
• Creating natural stopping points
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(Geier et al, Health Psychol, 2012; Wansink and Payne, Percept Mot Skills, 2007)
Conclusion
• No one is immune when it comes to thoughtless
behaviors
• The keys are setting up the choices ahead of time:
– Convenience
– Visibility
– Scarcity
– Stopping points
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Questions?
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Credit Claiming
You must complete a brief evaluation of the
program in order to download your certificate. The
evaluation survey will be available on
www.CE.TodaysDietitian.com for 1 year
following the live presentation.
RDs should list CPE activity type 175 in their
professional development portfolio.
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