Snacking is common in the American diet, with estimates from National Health and Nutrition Examination Survey (NHANES) data indicating that 95% of adults 20 years and older consume one or more snack foods or beverages daily, and 78% of adults consume two or more snacks per day.^1-3 People ages 40-59 have the highest snack frequency, possibly due to being in the workforce and having less time to prepare meals.⁴

Over the past few decades, the frequency and portion sizes of snacks have grown, raising concerns about their contribution to positive energy balance and weight gain. Current estimates indicate that snacks account for nearly a quarter of daily energy intake and close to half of the daily added sugar intake, highlighting their potential role in the rising prevalence of overweight and obesity, as well as chronic health conditions like type 2 diabetes, hypertension, and dyslipidemia.^4,5

Snack foods cover a broad range of options, and not all snacks lead to negative health outcomes. Some evidence suggests that snacking can enhance nutrient intake and diet quality. Compared to non-snackers, studies have shown that adults who snack have shown higher intakes of vitamin C, potassium, fiber, and protein.² In some studies, eating more frequently has also been shown to improve blood lipid profiles and blood pressure, contributing to a lower risk of cardiovascular disease.^4,6,7

As researchers struggle to come to a consensus on what makes a ‘snack’ and what types of snacks and snacking frequency help or hurt a person’s health, one thing is clear: health care professionals should be ready to talk to their clients about snacking behavior. 

Snacking’s Role in Health and Nutrition

Defining “Snacks”
Researchers have defined ‘snacks’ in varying ways, such as eating events that are either self-reported as snacks, occur outside typical meal times such as breakfast, lunch, or dinner, and/or are a small meal contributing at least 50 calories.¹ Varying definitions of snacking and lack of clear consensus on snacking as part of an overall dietary pattern from public health authorities reflect the complexity of capturing snacking behavior in nutrition research.^1,5 Studies on snacking show that snacks generally range from 50-400 calories and fall into categories such as: 

• sweet (cookies, pie, cake, brownies, candy, ice cream)
• savory (chips, crackers)
• Fruit and veggies (apple, banana, grapes, carrots, celery, cucumbers, etc)
• dairy (cheese, yogurt, milk, cheese)
• protein (nuts and seeds, eggs, protein bars, protein drinks or shakes)
• mixed dishes like sandwiches.^{2,8, 9}

Snacking and Health Outcomes
Research clearly shows that snack quality, timing, and even environment matter. Snacks that are energy-dense, high in added sugar and salt, and low in nutrients have been shown to impact health negatively.⁴ Many researchers rate snacks with scores that compare to the Healthy Eating Index (HEI) – a scoring system that measures how well a person’s diet aligns with the Dietary Guidelines for Americans – rating them as “low, medium, or high” quality.¹⁰ Lower snack scores (meaning fewer nutrients and more calories, fat, sodium, added sugars, etc) were tied to behaviors such as snacking late at night, snacking for pleasure rather than energy or hunger, and unhealthy snacking environments (such as snacking while distracted, watching television, etc).^3,11 Obesity, diabetes, cardiovascular disease, and even poor oral health are all tied to unhealthy or ‘low quality’ snack consumption.⁴

A review of studies on snacking and obesity (N=21 studies) found that the risk of being overweight and the likelihood of being obese increased as snacking frequency increased.⁸ Though more research is needed in this area, it is prudent to help your clients assess the right snacking type and frequency for their health goals. 

A large cohort study (N=1002) studying snack quality and timing related to cardiometabolic blood markers by Bermingham et al. found that lower snack quality among their participants was linked to adverse blood markers, including elevated fasting triglycerides (β = –0.02, P=0.02), postprandial triglycerides (6-hour incremental AUC, β = –400, P=0.01), fasting insulin (β = –0.15, P=0.04), insulin resistance (HOMA-IR, β = –0.04, P = 0.04), and hunger levels (scale 0–100, β = –0.52, P=0.02).⁵

Helping Your Clients Choose the Right Snack

Studies indicate that choosing snacks that are less energy-dense and richer in nutrients may help adults manage their body weight.⁸ Educating patients to prioritize snacks such as whole fruits or vegetables or foods rich in protein can help clients increase their nutrient intake and feel satiated between meals. Studies show that even though snacks like nuts are dense in calories, they also contain fiber and are satiating, so smaller portions can calm hunger and create positive health outcomes such as lowering the risk of metabolic syndrome, weight loss or maintaining weight loss, and better blood sugar control.^8,12-15 

A large cross-sectional study (n=10,112) found that protein was particularly important both at breakfast and for snacks regarding positive health outcomes. Protein intake from snacks was inversely associated with diastolic blood pressure (−0.41 ± 0.09 mmHg, P<0.0001) and cardiovascular disease risk score (−0.0018 ± 0.0004, P=0.0001).¹⁶

Supporting patients with education about higher-quality snack choices – foods rich in fiber and/or protein, consumed in the right portions for their needs – is an important starting point.⁸  Working with clients to incorporate mindful snacking and tuning into hunger and satiety between meals can also ensure that snacking behavior supports their health rather than harming it. 

Takeaways for Healthcare Providers

Snacking may be a part of life for most of your clients, so educating them on better choices and patterns for their health goals is critical when talking about nutrition or reducing the risk of chronic disease. Be sure to inquire about snacks between meals or after dinner when discussing dietary patterns and habits, and consider educating your clients about how to make the most of the snacks they choose. 

References:

1. Cowan AE, Higgins KA, Fisher JO, Tripicchio GL, Mattes RD, Zou P, Bailey RL. Examination of different definitions of snacking frequency and associations with weight status among US adults. PloS one. 2020;15(6):e0234355.
2. U.S. Department of Agriculture Agricultural Research Service. Snack Consumption by US Adults. What WeEatinAmerica, NHANES 2017–2020. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/DBrief/53_Snacks_Consumption_by_Adults_1720.pdf. Published April 2024. Accessed January 2, 2025. 
3. Bailey RL, Leidy HJ, Mattes RD, et al. Frequency of eating in the US population: a narrative review of the 2020 dietary guidelines advisory committee report. Current Developments in Nutrition. 2022;6(9):nzac132
4. Almoraie NM, Saqaan R, Alharthi R, Alamoudi A, Badh L, Shatwan IM. Snacking patterns throughout the life span: potential implications on health. Nutrition Research. 2021;91:81-94.
5. Bermingham KM, May A, Asnicar F, et al. Snack quality and snack timing are associated with cardiometabolic blood markers: the ZOE PREDICT study. European Journal of Nutrition. 2024;63(1):121-33.
6. Arora M, Singhal S, Rasane P, Singh J, Kaur S, Kumar V, Kumar A, Mishra A. Snacks and Snacking: Impact on Health of the Consumers and Opportunities for its Improvement. Current Nutrition & Food Science. 2020;16(7):1028-43.
7. Kaneko H, Itoh H, Kiriyama H, et al. Possible association between eating behaviors and cardiovascular disease in the general population: Analysis of a nationwide epidemiological database. Atherosclerosis. 2021;320:79-85.
8. Skoczek-Rubińska A, Bajerska J. The consumption of energy dense snacks and some contextual factors of snacking may contribute to higher energy intake and body weight in adults. Nutrition Research. 2021;96:20-36.
9. Hess JM, Slavin JL. The benefits of defining “snacks”. Physiology & behavior. 2018;193:284-7.
10. Shams-White MM, Pannucci TE, Lerman JL, et al. Healthy eating index-2020: review and update process to reflect the dietary guidelines for Americans, 2020-2025. Journal of the Academy of Nutrition and Dietetics. 2023;123(9):1280-8.
11. Prapkree L, Uddin R, Jaafar JA, et al. Snacking behavior is associated with snack quality, overall diet quality, and body weight among US college students. Nutrition Research. 2023;114:41-9.
12. Sumislawski K, Widmer A, Suro RR, et al Consumption of tree nuts as snacks reduces metabolic syndrome risk in young adults: a randomized trial. Nutrients. 2023;15(24):5051.
13. Wang J, Wang S, Henning SM, et al. Mixed tree nut snacks compared to refined carbohydrate snacks resulted in weight loss and increased satiety during both weight loss and weight maintenance: a 24-week randomized controlled trial. Nutrients. 202;13(5):1512.
14. Higgs J, Styles K, Carughi A, Roussell MA, Bellisle F, Elsner W, Li Z. Plant-based snacking: Research and practical applications of pistachios for health benefits. Journal of nutritional science. 2021;10:e87.
15. Brown R, Ware L, Gray AR, Chisholm A, Tey SL. Snacking on almonds lowers glycaemia and energy intake compared to a popular high-carbohydrate snack food: an acute randomised crossover study. International journal of environmental research and public health. 2021;18(20):10989.
16. Berryman CE, Lieberman HR, Fulgoni III VL, Pasiakos SM. Greater protein intake at breakfast or as snacks and less at dinner is associated with cardiometabolic health in adults. Clinical nutrition. 2021;40(6):4301-8.