Environmental and Intrapersonal Cues Associated with Consuming Sweetened Drinks and Snacks Among Adolescents

Introduction: Eating behaviors may become habitual such that certain cues trigger the behavior without conscious deliberation on the action. Cue-behavior links such as these could be important targets for interventions designed to improve dietary habits. Cues associated with consuming sweetened drinks and snacks among adolescents were identified in the current study using Ecological Momentary Assessment techniques. Cues of interest were environmental or intrapersonal stimuli that elicited consumption of sweetened drinks, sweet snacks, or salty snacks. Selection of these food items is expected to be under the control of the adolescent, as compared to meals prepared by a parent or guardian, and therefore, snacks may be a good target for an intervention designed for adolescents.

Methods: High school students (n=158) were recruited from lower SES neighborhoods where a minimum of 25% free or reduced cost lunches were provided to students. Participant characteristics were as follows: 57% female, 68% Hispanic, 16.0 years of age (SD=1.04), 57% were in the normal BMI range, 18% were overweight, and 25% were obese. Participants were trained on how to use PDA devices programmed to display a series of questions about location (e.g., home, friend’s house, mall), social environment, mood, cravings for food, activities (e.g. doing homework, watching TV), food-related cues (e.g., saw a snack, bought a drink), and food choices. Participants answered the questions each time they ate or drank something and each time they were randomly prompted to answer the questions. In addition, they answered a different set of questions once a day in the evening including items on stressful events during the day and a brief inventory of snack and drink type items in the home. The PDA device was deactivated on school days between 8 AM and 3 PM on school days to prevent students from disrupting class.

Results: The most common sweetened drinks, sweet snacks, and salty snacks consumed were soda, cookies/pastries/cakes, and chips, respectively. On average, participants had just a drink 0.48 times per day, a snack with or without a drink 0.72 times per day, and a meal 1.27 times per day. As might be expected, consuming sweetened drinks or unhealthy snacks was associated with feeling lonely or bored, craving a drink or a snack, being with friends, and being exposed to food-related cues. An unexpected association occurred between having a sweet drink and exercising. Surprisingly, there was no association between eating snacks and watching TV.

Conclusions: These results provide information that will be useful when developing interventions for adolescents to monitor and control their snacking habits.