growth faltering of preschool-aged children with poor appetite is associated with snacking behaviors

background: the association between snacking patterns, sleep hours, and physical activity with growth status and appetite of preschool children was investigated. methods: sixty three children aged 3-7 years with low appetite and weight for age ratio below the 25th percentile were enrolled from those referring to nader kazemi polyclinic in shiraz. information regarding the parents’ education, sleep hours, physical activity, appetite, and snacking patterns was obtained by interview. height and weight were measured and energy intake was estimated by 2-day food recall. appetite was rated on a 5-point scale based on the maternal report. results: mother’s education, the number of children in the household, and physical activity were not associated with either growth failure, energy intake, or appetite, but the fathers’ education more than diploma was associated with higher energy intake in children (p=0.015). children who slept <11 hours a day had higher energy intake (p=0.026) but worse weight status (p=0.015). children who always ate snacks close to the main meals had significantly higher energy intake but more severe growth failure. high consumption of fruit drinks, cakes, and potato chips was associated with exacerbated growth faltering whereas nuts consumption was related to better height status. none of the evaluated parameters was associated with children’s appetite. conclusion: overall, the results suggest the importance of sufficient sleep, limited consumption of snacks, and the type and time of snack consumption in growth of children with poor appetite. nutritious snacks such as nuts may be more beneficial than nutrient-poor snacks for growth of children.