Prospective study of self-reported usual snacking and weight gain in a Mediterranean cohort: The SUN project

Bes-Rastrollo, Maira; Sanchez-Villegas, Almudena; Basterra-Gortari, Francisco J.; Nunez-Cordoba, Jorge M.; Toledo, Estefania; Serrano-Martinez, Manuel

doi:10.1016/j.clnu.2009.08.017

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Volume 29, Issue 3 , Pages 323-330, June 2010

Prospective study of self-reported usual snacking and weight gain in a Mediterranean cohort: The SUN project

Maira Bes-Rastrollo
- Dept. of Preventive Medicine and Public Health, Medical School-Clinica Universitaria, University of Navarra, Pamplona, Spain
- Corresponding author. Dept. Preventive Medicine and Public Health, University of Navarra, C/Irunlarrea 1, Ed. Investigacion, 31008 Pamplona (Navarra), Spain. Tel.: +34 948425600x6602; fax: +34 948425649.
Almudena Sanchez-Villegas
- Dept. of Preventive Medicine and Public Health, Medical School-Clinica Universitaria, University of Navarra, Pamplona, Spain
- Dept. of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
Francisco J. Basterra-Gortari
- Dept. of Preventive Medicine and Public Health, Medical School-Clinica Universitaria, University of Navarra, Pamplona, Spain
- Dept. of Endocrinology, Hospital of Navarra. Pamplona, Spain
Jorge M. Nunez-Cordoba
- Dept. of Preventive Medicine and Public Health, Medical School-Clinica Universitaria, University of Navarra, Pamplona, Spain
Estefania Toledo
- Dept. of Preventive Medicine and Public Health, Medical School-Clinica Universitaria, University of Navarra, Pamplona, Spain
- Dept. of Preventive Medicine and Quality Management, Hospital Virgen del Camino, Pamplona, Spain
Manuel Serrano-Martinez
- Dept. of Preventive Medicine and Public Health, Medical School-Clinica Universitaria, University of Navarra, Pamplona, Spain

Received 12 January 2009; accepted 26 August 2009. published online 07 September 2009.

Summary

Background & aims

It has been hypothesized that snacking could be a major factor in the development of obesity. However, the relationship between snacking and the increment in body weight remains controversial. Moreover, longitudinal studies about this issue are scarce. Thus, our objective was to prospectively assess the relationship between snacking and weight gain and obesity in a middle-aged free-living population.

Methods

Longitudinal prospective Spanish dynamic cohort (10,162 university graduates; mean age: 39 years) followed-up for an average of 4.6 years. Dietary habits were ascertained through a validated 136-item food-frequency questionnaire. Usual snackers were defined as those participants who answered affirmatively when asked in the baseline assessment if they usually eat between meals. Validated self-reported weight and body mass index were collected at baseline and during follow-up.

Results

After adjusting for potential confounders, self-reported between-meal snacking was significantly associated with a higher risk of substantial weight gain (≥3kg/year; p<0.001;≥5kg/year, p<0.001;≥10% baseline weight, p<0.001). Among participants with a baseline body mass index lower than 30kg/m² (n: 9709) we observed 258 new cases of obesity. Usual snackers presented an adjusted 69% higher risk of becoming obese during follow-up (Hazard Ratio: 1.69; 95% confidence interval: 1.30–2.20).