Association of Healthy and Unhealthy Snack Consumption with Subclinical Atherosclerosis among Children and Adolescents with Overweight and Obesity

Introduction: Snack consumption is associated with cardiovascular disease (CVD) risk factors in children and adolescents. The aim of this study is to investigate the association of snack consumption and carotid intima media thickness (CIMT) among overweight and obesity children and adolescents. Material and Methods: In this cross sectional study, a total of 339 participants, aged 6 to 13 years with the body mass index Z score ≥1 enrolled in this study. Data on anthropometric measurements, pubertal status, and CIMT were documented. Food intakes of participants were measured by a valid and reliable food frequency questionnaire (FFQ). Linear and logistic regression were estimated.  Results: Mean age of study participants was 9.3 years and with 68.4% of obesity. After controlling for confounders, including age, sex, energy intake, puberty status, physical activity, and body mass index, one SD increase in intake of nuts decreased the CIMT, by 0.126 mm (P value=0.019). Moreover, participants in the last tertile of nuts intake had 63% lower risk of high CIMT in comparison with those who consumed less than 1.74 serving/wk of nuts (P for trend=0.006). When nuts intake was replaced by the sweet unhealthy snacks the CIMT decreased by 0.15 mm. Conclusion: Our findings emphasize the positive impact of nuts consumption as a healthy snack on subclinical stages atherosclerosis. Clinical trial studies could examine the effect of different kinds of nuts consumption on CIMT and complications of CVD risk factors.