In the United States children aged 2–12 years are consuming snack foods more frequently [1] and in greater quantities than ever before, eating an estimated 30% of daily calories in the form of sweet and salty snacks and up to 40% when sugar sweetened beverages are considered [2,3]. Snack foods tend to be low in fiber, vitamins, and minerals and high in refined flour, sodium, and sugar [4]. Greater snacking frequency has been associated with consumption of energy-dense foods (e.g., cookies, chips, sweets) and an increased risk for excessive weight gain in childhood [5,6,7,8]. Although large-scale public health efforts may be slowing the incidence of obesity in young children, nearly one in three American children are already overweight or obese by the time they begin elementary school [9,10]. Low-income Hispanic/Latino and African American children are disproportionately more likely than white children to experience obesity and its related complications [11,12].

Although children’s snacking habits are believed to be significant in the context of obesity risk, little is known about intentions of parents in promoting child snacking [8,13]. Additionally, the knowledge gap regarding parents’ snacking intentions is widest for families from low socioeconomic and racially/ethnically diverse backgrounds, where children are most likely to be overweight or obese [11,14,15,16]. The reasons parents offer snacks are important because they shape contexts in which children learn to eat. It has been hypothesized that non-nutritive feeding strategies which focus on outcomes unrelated to a child’s growth and hunger (e.g., behavior management, rewards) may lead to children having more frequent opportunities to eat in the absence of hunger, thus limiting their ability to successfully assess their own fullness [8]. Routine use of non-nutritive feeding practices has been associated with children’s increased energy intake, higher body mass index (BMI), and aversions to eating healthy foods [17,18,19]. Conversely, less is known about the influence of nutritive feeding purposes in which parents offer children snacks based on reasons which focus on a child’s health (e.g., satiate hunger, encourage growth).

We present baseline data collected as part of a community intervention to prevent and control obesity among multi-ethnic children aged 2–12 years from predominantly low-income communities in Massachusetts. Using self-reported survey data from a sample of low-income parents of children (n = 271), we present our findings based on the following research questions: (1) How frequently do parents offer snacks for nutritive and non-nutritive purposes? (2) What parent, child, and family-level characteristics are associated with low-income parents offering snacks to children for nutritive and non-nutritive purposes? (3) Are parent reasons for offering snacks associated with children’s adherence to obesity-related dietary recommendations? We hypothesized that parents who offered more snacks for non-nutritive reasons would be more likely to have children who fail to meet dietary recommendations related to obesity prevention. Understanding the motivation for and frequency with which parents offer snacks to children is essential to developing public health interventions that can address child snacking in the context of healthy eating.

This is the first study of its kind to describe low-income parents’ frequency and rationales for offering their children snacks, as well as the association between parent reasons for providing snacks and child adherence to dietary recommendations. We found that parents reported offering their children snacks for a variety of both nutritive and non-nutritive reasons that differed by child age, weight status, and race/ethnicity. The reasons parents report offering snacks may influence the likelihood of children adhering to dietary recommendations. Children of parents who reported offering non-nutritive snacks more frequently were less likely to adhere to current dietary recommendations related to obesity prevention than parents who didn’t report offering snacks for these reasons.

One encouraging finding of our study is that low-income parents reported offering snacks for nutritive reasons (e.g., because child is hungry) more frequently in a usual week than non-nutritive reasons. A recent qualitative study of low-income white, Hispanic, and African American parents found that parents who described their preschooler’s hunger as an important reason for offering snack foods also described offering more healthy foods to their children [30]. We also found that a majority of parents reported that their child’s diet met recommendations for consumption of fast food, soda, and juice in the previous month (e.g., limited consumption to less than once per day or week). Parent education should build upon these practices by emphasizing the benefits of low-cost, healthy, nutrient-dense snacks like fruits, vegetables, whole grains, and lean proteins.

We found that parents reported offering snacks to preschool-aged children (2–5 years) at a significantly greater frequency than older children (6–12 years). In some respects, these findings are expected and even appropriate. To prevent obesity, the American Academy of Pediatrics recommends structured “healthy and nutritious” snacking, as opposed to ongoing grazing, suggesting that elementary-aged children have 1–2 snacks daily and toddlers up to three snacks [6]. Therefore, younger children may be more likely to consume a greater number of snacks in a given week simply due to their dietary needs perceived by parents. However, parents reported offering numerous snacks to young children for non-nutritive reasons (e.g., to reward behavior, keep child quiet, celebrate an accomplishment). Occasional rewards or celebrations may not be cause for concern, but cumulative opportunities to snack in a given week (e.g., reward for potty training, distraction to sit quietly through church, birthday party, holiday celebration) may cue young children to eat regardless of hunger. Exposure to healthy foods in early childhood is critical because children’s taste preferences may be established prior to entering elementary school [31] and using unhealthy foods to reward behavior has been shown to increase children’s preferences for such foods [32]. Parents of older children may also benefit from reminders about the importance of focusing on their children’s growth and hunger as a primary purpose in offering snacks, especially in light of the fact that consumption of sugary drinks nearly doubles once children reach elementary school [2].

Parents of black children reported offering fewer snacks for nutritive purposes and parents of Hispanic/Latino children offered a greater number of snacks for non-nutritive purposes when compared with white children. Our findings are consistent with other literature that has examined feeding intentions among low-income mothers of color. In one small qualitative study of low-income African American mothers of preschoolers, a participant explained that, “Snacks are not food,” describing the general consensus that snacks were important tools to manage a child’s behavior and did not require as much consideration for nutrient content compared with meals [33]. In addition to black parents, our sample represented a substantial proportion of Hispanic/Latino parents who were born outside of the United States (44%). A study of immigrant Latina mothers found that many reported offering more foods and snacks to their children upon arriving to the United States, especially fast food [34]. Findings from another study of low-income parents of preschoolers, 20% of whom were Hispanic/Latino immigrants, found that fast food items, even entire meals (e.g., Happy Meal^® including burger, fries, and drink) were categorized by some participants as “snacks” rather than meals. Half of the participants agreed that pizza was not a meal food [35]. Consequently, when the frequency of snacking is assessed it is important to also consider the content of these snacks.

We found that increases in snacking opportunities, specifically snacks offered for non-nutritive purposes, may reduce adherence to dietary recommendations which reduce the risk of childhood obesity, including limiting consumption of caloric beverages (e.g., soda, juice drinks, juice) and fast food, and consuming fruits and non-starchy vegetables. Perhaps parents who offer children snacks for non-nutritive reasons are more likely to use appealing foods that have more currency with respect to behavior modification (e.g., cake versus fruit), or that increased eating opportunities are paired with caloric beverages. To combat the rising rates of childhood obesity, parents of children of all ages should be encouraged to consider snack times as important opportunities to nourish children and limit “empty” calorie foods which are nutrient poor. Snacks with higher glycemic loads, such as sugary drinks, potato chips or candy, may contribute to increased cravings for more food and reduced satiety, with a possible consequence of overeating at future eating occasions [36,37,38]. A study of 115 elementary-school girls found that when snacks were offered ad libitum, girls offered lower glycemic snacks of cheese and vegetables consumed 72% fewer calories than girls offered potato chips [39]. Food insecure families may also be more likely to allow children unrestricted access to such snack foods when they are available, thus contributing to the observation of the “food insecurity-obesity paradox” [30,40,41].

Our study has limitations. Parents were asked about frequency of offering snacks to their children using items developed for this study, as a validated assessment tool was not available at the time. Since snacks were self-defined by parents, it is possible that variations in interpretation of the word “snack” may have influenced the observed outcomes. Additionally, our measurement of snacks came only from one parent’s perspective, and did not include other snacks a child might receive in school, day care, or from other family members. Desirability bias is also a possibility, as parents may be reluctant to quantify the frequency with which they provide snacks for socially undesirable reasons (e.g., to keep a child quiet), although the absolute frequency of snacks reported in our study appears to reflect national estimates for child snacking [3]. Forthcoming work should include the use of validated measures to assess parents’ snack feeding behaviors, including the specific quantity, quality, and context in which child snacking is occurring. Such measures could also be triangulated with parent food diaries or shopping receipts in order to determine which snacks are offered for nutritive versus non-nutritive purposes [42,43]. Since this was a cross-sectional analysis, reverse causation may exist with respect to child or parent weight status, as parents may already be restricting a child’s snack intake or adjusting their own behaviors in response to a perceived weight problem. Therefore, trends towards less reported snacks offered to overweight or obese children may not actually reflect the anticipated positive association, a phenomenon that has been described elsewhere in child snacking literature [8]. As this study only assessed snacks provided by one parent, we are unable to determine if overweight or obese children consumed more snacks when they were available in other contexts like school, day care, convenience stores, or at the homes of extended family members. Additionally, race/ethnicity was only collected for the child of interest, rather than the parent, so we are unable to identify differences in feeding practices by parent race/ethnicity. Nevertheless, this study is the first of its kind to describe multi-ethnic low-income parents’ motivations for offering snacks to their children.

Parent reasons for feeding children snacks may influence both the frequency of eating opportunities as well as the quality of a child’s diet. Future investigations should assess the longitudinal influence of parent snack feeding rationales on changes in children’s diet quality, food preferences, and body mass index. Validated measures of parent-derived definitions of snacks should be used, taking care to ensure tools capture nuanced interpretations that may differ by parent race/ethnicity, education, and income status. Early childhood obesity prevention efforts must consider the role of parents in promoting child snacking and provide capacity building around parenting strategies that utilize non-food rewards. Comprehensive approaches to obesity prevention should also address parents’ snack feeding strategies while working to improve environmental barriers to offering healthy snacks such as food security, access, and availability.