Snacking is associated with overall diet quality among adults.

Snacking occasions are considered to contribute little more than energy to the diet; however, few studies have examined the role of snacking on overall diet quality. The purpose of this study was to examine the association between snacking frequency and overall diet quality. This study included 11,209 adults aged 20 years and older who participated in the 1999-2004 National Health and Nutrition Examination Survey. Twenty-four-hour dietary recall data from the National Health and Nutrition Examination Survey 1999-2004 were used to assess snacking frequency and diet quality. Diet quality was assessed with the US Department of Agriculture's Healthy Eating Index-2005 (HEI-2005). To adjust for confounding variables, multiple linear regression models were used to estimate the association between snacking frequency and HEI-2005 score, whereas the relationship between snacking frequency and HEI-2005 component scores were examined with Tobit regression models. Contrary to expectation, snacking was modestly associated (P<0.001) with higher total HEI-2005 scores (49.3±0.5, 49.9±0.3, 50.9±0.3, 51.9±0.4, and 51.6±0.6 for snacking zero, one, two, three, and four or more times per day, respectively). Total fruit (P<0.001), whole fruit (P<0.001), whole grains (P<0.001), milk (P<0.001), oils (P<0.001), and sodium (P<0.001) component scores were positively associated with snacking frequency. Inverse associations between snacking frequency and total vegetables (P=0.009); meat and beans (P=0.045); and the energy from solid fat, alcohol, and added sugars (P=0.007) components were observed. Although the magnitude of the association between snacking and overall diet quality was modest, snacking was associated with a more nutrient-dense diet. Focusing on the contribution snacking may have on single nutrient intakes may overlook its total nutritional impact.