scholarly journals Adherence to dietary guidelines and 15-year risk of all-cause mortality

2012 ◽  
Vol 109 (3) ◽  
pp. 547-555 ◽  
Author(s):  
Joanna Russell ◽  
Victoria Flood ◽  
Elena Rochtchina ◽  
Bamini Gopinath ◽  
Margaret Allman-Farinelli ◽  
...  
Keyword(s):  
Diet Quality ◽  
Population Based ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Mortality Data ◽  
Food Groups ◽  
Multiple Data ◽  
All Cause Mortality ◽  
The Relationship ◽  
Reduced Risk

Past investigation of diet in relation to disease or mortality has tended to focus on individual nutrients. However, there has been a recent shift to now focus on overall patterns of food intake. The present study aims to investigate the relationship between diet quality reflecting adherence to dietary guidelines and mortality in a sample of older Australians, and to report on the relationship between core food groups and diet quality. This was a population-based cohort study of persons aged 49 years or older at baseline, living in two postcode areas west of Sydney, Australia. Baseline dietary data were collected during 1992–4, from 2897 people using a 145-item Willett-derived FFQ. A modified version of the Healthy Eating Index for Australians was developed to determine diet quality scores. The Australian National Death Index provided 15-year mortality data using multiple data linkage steps. Hazard risk (HR) ratios and 95 % CI for mortality were assessed for diet quality. Subjects in quintile 5 (highest) of the Total Diet Score had a 21 % reduced risk of all-cause mortality (HR 0·79, 95 % CI 0·63, 0·98, Ptrend= 0·04) compared with those in quintile 1 (lowest) after multivariate adjustment. The present study provides longitudinal support for a reduced risk of all-cause mortality in an older population who have greater compliance with published dietary guidelines.

scholarly journals Diet Quality in Association with All-Cause, Cardiovascular, and Cancer Mortality Among US Adults: NHANES 1999–2010 (OR14-04-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jiaqi Wang ◽  
Danielle Haslam ◽  
Mengyuan Ruan ◽  
Fan Chen ◽  
Mengxi Du ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Cancer Mortality ◽  
Lower Risk ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Mortality Data ◽  
Eating Pattern ◽  
All Cause Mortality ◽  
Risk Of Cancer

Abstract Objectives The 2015 Dietary Guidelines for Americans (DGA) recommend a healthy eating pattern for chronic disease prevention. This study aimed to prospectively evaluate diet quality by adherence to the 2015 DGA in association with mortality outcomes among a representative sample of US adults. Methods Using dietary data collected by 24-hour diet recalls among 29,098 US adults aged 20+ years from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2010, we estimated adherence to the 2015 DGA using the Healthy Eating Index-2015 (HEI-2015). Mortality from all cause, cardiovascular diseases (CVD), and cancer were obtained from linkage to the National Death Index Mortality data. Cox proportional-hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after multivariable adjustments. Results The mean (SE) of total HEI-2015 was 50.1 (0.2). During a median follow-up of 6.2 years, 2861 total deaths occurred, including 726 CVD and 671 cancer deaths. Compared to individuals in the lowest quartile of HEI-2015, those in the highest quartile had a 16% lower risk of all-cause mortality (Q4 vs. Q1: HR = 0.84; 95% CI: 0.72–0.90; P-trend = 0.04) and a 31% lower risk of cancer mortality (Q4 vs. Q1: HR = 0.69; 95% CI: 0.50–0.95; P-trend = 0.06). The lower all-cause and cancer mortality among those with higher HEI-2015 scores was confined to individuals with comorbidity conditions at baseline (all-cause mortality: Q4 vs. Q1: HR = 0.79; 95% CI: 0.67–0.94; p-trend = 0.005; cancer mortality: Q4 vs. Q1: HR = 0.46; 95% CI: 0.30–0.69; p-trend = 0.001), former smokers (all-cause mortality: Q4 vs. Q1: HR = 0.65; 95% CI: 0.49–0.88; p-trend = 0.006; cancer mortality: Q4 vs. Q1: HR = 0.47; 95% CI: 0.29–0.74; p-trend = 0.005), and those with a body mass index of 18.5–25 kg/m2 (all-cause mortality: Q4 vs. Q1: HR = 0.60; 95% CI: 0.46–0.79; p-trend < 0.001; cancer mortality: Q4 vs. Q1: HR = 0.40; 95% CI: 0.22–0.70; p-trend = 0.001). Similar associations were found between men and women. No significant associations were observed between HEI-2015 and CVD mortality. Conclusions Better adherence to the 2015 Dietary Guidelines of Americans is associated with lower all-cause and cancer mortality among US adults. Funding Sources National Institute of Health/National Institute of Minority Health and Health Disparities. Supporting Tables, Images and/or Graphs    

scholarly journals Defining Diet Quality: A Review of Diet Metrics as Applied to the Double Burden of Malnutrition (OR17-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Victoria Miller ◽  
Patrick Webb ◽  
Renata Micha ◽  
Dariush Mozaffarian
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Fruits And Vegetables ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Healthy Diet ◽  
Food Groups ◽  
Policy Action ◽  
Double Burden ◽  
Meta Analyses

Abstract Objectives Meeting most of the UN Sustainable Development Goals (SGDs) will require a strong focus on tackling all forms of malnutrition─ addressing maternal and child health (MCH) as well as diet-related non-communicable diseases (NCDs). Yet, the optimal metrics to define a healthy diet remain unclear. Our aim was to comprehensively review diet metrics and assess the evidence on each metric's association with MCH and NCDs. Methods Using comprehensive searches and expert discussions, we identified metrics that i) are used in ≥3 countries to link diet to health, ii) quantify the number of foods/food groups consumed and/or iii) quantify recommended nutrient intakes. We reviewed and summarized each metric's development, components and scoring. For each identified metric, we systematically searched PubMed to identify meta-analyses or narrative reviews evaluating these metrics with nutrient adequacy and health outcomes. We assessed validity by grading the number of studies included and the consistency of the diet metric-disease relationship. Results We identified 6 MCH, 13 NCD and 0 MCH/NCD metrics. Most were developed for describing adherence to dietary guidelines or patterns, and others were developed for predicting micronutrient adequacy. On average, the metrics included 14 food groups/nutrients (range 4–45), with 10 food-group only metrics and 0 nutrient-only metrics. The most frequent metric components were grains/roots/tubers, fruits and vegetables. We identified 16 meta-analyses and 14 narrative reviews representing 102 metric-disease relationships (98 metric-NCD and 4 metric-MCH relationships, respectively). We found 5 metrics that have been consistently validated in meta-analyses and narrative reviews for NCDs, 1 metric with limited evidence for MCH, but 0 metrics for both. Of the metrics, the Alternative Healthy Eating Index (aHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Mediterranean Diet Score (MED) were most commonly validated, especially for all-cause mortality and cardiovascular disease (Figure 1). Conclusions Few diet metrics have been used in multiple countries to define a healthy diet. This suggests a serious gap in global analyses of diet quality relating to malnutrition in all its forms, which hinders effective policy action. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs

scholarly journals Association between energy-dense food consumption at 2 years of age and diet quality at 4 years of age

2013 ◽  
Vol 111 (7) ◽  
pp. 1275-1282 ◽  
Author(s):  
Sofia Vilela ◽  
Andreia Oliveira ◽  
Elisabete Ramos ◽  
Pedro Moreira ◽  
Henrique Barros ◽  
...  
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Population Based ◽  
Healthy Eating Index ◽  
Soft Drinks ◽  
Inverse Association ◽  
Food Groups ◽  
Dietary Recommendations ◽  
Daily Consumption ◽  
Energy Dense Food

The present study aimed to evaluate the association between the consumption of energy-dense foods at 2 years of age and the consumption of foods and diet quality at 4 years of age. The sample included 705 children evaluated at 2 and 4 years of age, as part of the population-based birth cohort Generation XXI (Porto, Portugal). Data on sociodemographic and lifestyle factors of both children and mothers were collected by face-to-face interviews. The weight and height of children were measured by trained professionals. Based on FFQ, four energy-dense food groups were defined: soft drinks; sweets; cakes; salty snacks. A healthy eating index was developed using the WHO dietary recommendations for children (2006) aged 4 years. The associations were evaluated through Poisson regression models. After adjustment for maternal age and education, child's carer, child's siblings and child's BMI, higher consumption of energy-dense foods at 2 years of age was found to be associated with higher consumption of the same foods 2 years later. An inverse association was found between the intake ( ≥ median) of soft drinks (incidence rate ratio (IRR) = 0·74, 95 % CI 0·58, 0·95), salty snacks (IRR = 0·80, 95 % CI 0·65, 1·00) and sweets (IRR = 0·73, 95 % CI 0·58, 0·91) at 2 years of age and the consumption of fruit and vegetables at 4 years of age ( ≥ 5 times/d). Weekly and daily consumption of energy-dense foods at 2 years of age was associated with a lower healthy eating score at 4 years of age (IRR = 0·75, 95 % CI 0·58, 0·96; IRR = 0·56, 95 % CI 0·41, 0·77, respectively). The consumption of energy-dense foods at young ages is negatively associated with the diet quality of children a few years later.

scholarly journals Diet quality and change in anthropometric measures: 15-year longitudinal study in Australian adults

2011 ◽  
Vol 107 (9) ◽  
pp. 1376-1385 ◽  
Author(s):  
Simin Arabshahi ◽  
Jolieke C. van der Pols ◽  
Gail M. Williams ◽  
Geoffrey C. Marks ◽  
Petra H. Lahmann
Keyword(s):  
Diet Quality ◽  
Population Based ◽  
Dietary Guidelines ◽  
Anthropometric Measures ◽  
Dietary Index ◽  
Dietary Guideline ◽  
Quality Diet ◽  
Adjusted Model ◽  
The Relationship

Evidence from longitudinal studies on the association between diet quality and change in anthropometric measures is scarce. We therefore investigated the relationship between a recently developed food-based dietary index and change in measured BMI and waist circumference (WC) in Australian adults (1992–2007). We used data from the Australian population-based Nambour Skin Cancer Study comprising 1231 adults aged 25–75 years at baseline (1992). We applied generalised estimating equations (GEE) to examine the association between diet quality and change in anthropometric measures. Dietary intake was assessed by an FFQ in 1992, 1996 and 2007. Diet quality was estimated using the dietary guideline index (DGI), developed to reflect the dietary guidelines for Australian adults; a higher score indicating increased compliance. Multivariable models, stratified by sex, were adjusted for sociodemographic and lifestyle characteristics. We show that men with higher diet quality had a lower gain in BMI as compared to those with low diet quality during the 15-year follow-up. In a multivariable adjusted model, as compared to men in quartile 1 (reference), those in the highest quartile had the lowest gain in BMI (mean (95 % CI): 0·05 (0·00, 0·09) v. 0·11 (0·06, 0·16) kg/m2 per year, P =0·01). Diet quality was inversely, but non-significantly associated with change in WC. In women, DGI score was unrelated to change in any body measure. Energy underreporting did not explain the lack of association. We conclude that adherence to a high-quality diet according to Australian dietary guidelines leads to lower gain in BMI and WC in middle-aged men, but not in women.

scholarly journals Adherence to the Healthy Eating Index–2015 and Other Dietary Patterns May Reduce Risk of Cardiovascular Disease, Cardiovascular Mortality, and All-Cause Mortality

2019 ◽  
Vol 150 (2) ◽  
pp. 312-321 ◽  
Author(s):  
Emily A Hu ◽  
Lyn M Steffen ◽  
Josef Coresh ◽  
Lawrence J Appel ◽  
Casey M Rebholz
Keyword(s):  
Cardiovascular Disease ◽  
Healthy Eating ◽  
Lower Risk ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Mortality Data ◽  
Dietary Intakes ◽  
All Cause Mortality ◽  
Dietary Guidelines For Americans ◽  
Cvd Mortality

ABSTRACT Background The Healthy Eating Index–2015 (HEI-2015) score measures adherence to recommendations from the 2015–2020 Dietary Guidelines for Americans. The HEI-2015 was altered from the HEI-2010 by reclassifying sources of dietary protein and replacing the empty calories component with 2 new components: saturated fats and added sugars. Objectives Our aim was to assess whether the HEI-2015 score, along with 3 other previously defined indices, were associated with incident cardiovascular disease (CVD), CVD mortality, and all-cause mortality. Methods We conducted a prospective analysis of 12,413 participants aged 45–64 y (56% women) from the Atherosclerosis Risk in Communities (ARIC) Study. The HEI-2015, Alternative Healthy Eating Index–2010 (AHEI-2010), alternate Mediterranean (aMed) diet, and Dietary Approaches to Stop Hypertension Trial (DASH) scores were computed using the average dietary intakes of Visits 1 (1987–1989) and 3 (1993–1995). Incident CVD, CVD mortality, and all-cause mortality data were ascertained from baseline through 31 December, 2017. We used Cox proportional hazards models to estimate HRs and 95% CIs. Results There were 4509 cases of incident CVD, 1722 cases of CVD mortality, and 5747 cases of all-cause mortality over a median of 24–25 y of follow-up. Compared with participants in the lowest quintile of HEI-2015, participants in the highest quintile had a 16% lower risk of incident CVD (HR: 0.84; 95% CI: 0.76–0.93; P-trend &lt; 0.001), 32% lower risk of CVD mortality (HR: 0.68; 95% CI: 0.58–0.80; P-trend &lt; 0.001), and 18% lower risk of all-cause mortality (HR: 0.82; 95% CI: 0.75–0.89; P-trend &lt; 0.001) after adjusting for demographic and lifestyle covariates. There were similar protective associations for AHEI-2010, aMed, and DASH scores, and no significant interactions by race. Conclusions Higher adherence to the 2015–2020 Dietary Guidelines for Americans was associated with lower risks of incident CVD, CVD mortality, and all-cause mortality among US adults.

scholarly journals Diet Quality Indices Used in Australian and New Zealand Adults: A Systematic Review and Critical Appraisal

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3777
Author(s):  
Hlaing Hlaing-Hlaing ◽  
Kristine Pezdirc ◽  
Meredith Tavener ◽  
Erica L. James ◽  
Alexis Hure
Keyword(s):  
New Zealand ◽  
Diet Quality ◽  
Critical Appraisal ◽  
Assessment Method ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Nutritional Epidemiology ◽  
Food Groups ◽  
Quality Indices ◽  
Dietary Guideline

Distilling the complexity of overall diet into a simple measure or summative score by data reduction methods has become a common practice in nutritional epidemiology. Recent reviews on diet quality indices (DQI) have highlighted the importance of sound construction criteria and validation. The aim of this current review was to identify and critically appraise all DQI used within Australian and New Zealand adult populations. Twenty-five existing DQI were identified by electronic searching in Medline and hand searching of reference lists. DQI were constructed based on the respective national dietary guidelines and condition-specific recommendations. For preferable features of DQI, six captured the dimensions of adequacy, moderation and balance; five had a nested structure; 12 consisted of foods, food groups and nutrients; 11 used metric scoring systems and most of those with metric scales used normative cutoff points. Food frequency questionnaires, either alone or with other methods, were the most common dietary assessment method used in 20 DQI. For evaluation of DQI, construct validity and relative validity are reported. Based on our critical appraisal, Dietary Guideline Index (DGI), Dietary Guideline Index-2013 (DGI-2013), Total Diet Score (TDS), Healthy Eating Index for Australian Adults-2013 (HEIFA-2013), and Aussie-Diet Quality Index (Aussie-DQI) were the preferred DQI used in Australian adults according to dimension, indicator selection, scoring criteria and evaluation. Further work is needed to enhance the construction of all Australian and New Zealand DQI, especially in terms of dimension and structure, for alignment with recommended construction criteria.

Abstract P355: Development and Validation of a Nutrient Density Score That Includes Foods Groups

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jessica D Smith ◽  
Victor Fulgoni ◽  
Adam Drewnowski
Keyword(s):  
Diet Quality ◽  
Saturated Fat ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Food Groups ◽  
Unsaturated Fat ◽  
Nutrient Density ◽  
Density Score ◽  
Considerable Work ◽  
Development And Validation

Introduction: There has been considerable work performed on nutrient profiling to assess the nutritional contribution of a food to a healthy dietary pattern. Most profiling approaches have focused on nutrients to limit and nutrients to encourage. A few profiling approaches have also included certain food groups in the profiling algorithm. Objectives: The objective of this study was to develop a nutrient density score, based on the Nutrient Rich Food Index (NRF) 6.3, that includes food groups and validate the score against a gold-standard marker of diet quality, the Healthy Eating Index (HEI) 2015. Methods: Stepwise regression was used to develop a nutrient density score based on the day 1 total dietary intake of the U.S. population 2 years and older (excluding pregnant and lactating women) from the National Health and Nutrition Examination Survey (NHANES) 2011-2016 (n=23,743). Intake of food groups was taken from the Food Patterns Equivalent Database (FPED) 2011-2016. Sixteen nutrients (as a percent of the Daily Value) as well as five food groups (as a percentage of recommended intake in 2015-2020 Dietary Guidelines) were considered in the score. Results: When only the 16 nutrients were included in the score, 66% of the variability in the HEI 2015 could be accounted for (R 2 = 0.66). When only the five food groups were considered, the maximum R 2 with the HEI 2015 was 0.50. However, when both nutrients and foods groups were considered, the model explained 74% of the variability in the HEI 2015 (Table). The increase in the R 2 begins to plateau after the inclusion of 10 elements: 3 nutrients to encourage (fiber, potassium and unsaturated fat), 4 food groups (dairy, fruit, whole grains, and nuts and seeds) and 3 nutrients to limit (added sugar, saturated fat, sodium). Conclusion: A nutrient density score that includes both nutrients and foods groups best predicts diet quality as measured by the HEI 2015.

Diet quality and all-cause mortality among US adults, estimated from National Health and Nutrition Examination Survey (NHANES), 2003–2008

2021 ◽  
pp. 1-11
Author(s):  
Selma Gicevic ◽  
Emin Tahirovic ◽  
Sabri Bromage ◽  
Walter Willett
Keyword(s):  
National Health ◽  
Diet Quality ◽  
Total Mortality ◽  
Healthy Eating Index ◽  
Cox Proportional Hazards ◽  
Mortality Data ◽  
Nutrition Examination Survey ◽  
Health And Nutrition ◽  
The Us ◽  
All Cause Mortality

Abstract Objective: We assessed the ability of the Prime Diet Quality Score (PDQS) to predict mortality in the US population and compared its predictiveness with that of the Healthy Eating Index-2015 (HEI-2015). Design: PDQS and HEI-2015 scores were derived using two 24-h recalls and converted to quintiles. Mortality data were obtained from the 2015 Public-Use Linked Mortality File. Associations between diet quality and all-cause mortality were evaluated using multivariable Cox proportional hazards models, and predictive performance of the two metrics was compared using a Wald test of equality of coefficients with both scores in a single model. Finally, we evaluated associations between individual metric components and mortality. Setting: A prospective analysis of the US National Health and Nutrition Examination Survey (NHANES) data. Participants: Five-thousand five hundred and twenty-five participants from three survey cycles (2003–2008) in the NHANES aged 40 years and over. Results: Over the 51 248 person-years of follow-up (mean: 9·2 years), 767 deaths were recorded. In multivariable models, hazard ratios between the highest and lowest quintiles of diet quality scores were 0·70 (95 % CI 0·51, 0·96, Ptrend = 0·03) for the PDQS and 0·77 (95 % CI 0·57, 1·03, Ptrend = 0·20) for the HEI-2015. The PDQS and HEI-2015 were similarly good predictors of total mortality (Pdifference = 0·88). Conclusion: Among US adults, better diet quality measured by the PDQS was associated with reduced risk of all-cause mortality. Given that the PDQS is simpler to calculate than the HEI-2015, it should be evaluated further for use as a diet quality metric globally.

scholarly journals Diet quality in middle-aged and older women with and without body weight dissatisfaction: results from a population-based national nutrition survey in Switzerland

2021 ◽  
Vol 10 ◽  
Author(s):  
Angéline Chatelan ◽  
Isabelle Carrard
Keyword(s):  
Body Weight ◽  
Older Women ◽  
Diet Quality ◽  
Population Based ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Middle Aged ◽  
Nutrition Survey ◽  
National Nutrition Survey ◽  
Body Weight Dissatisfaction

Abstract Body weight dissatisfaction is associated with unhealthy dietary behaviours in young adults, but data are scarce regarding how this relationship evolves with age. The objectives of the present study were to assess the prevalence of body weight dissatisfaction and the association between body weight dissatisfaction, nutrient intake and diet quality in middle-aged and older women. We used data of a population-based sample of 468 middle-aged (50–64 y/o) and older (65–75 y/o) women, extracted from the cross-sectional 2014–15 Swiss National Nutrition Survey. Body weight dissatisfaction was assessed by questionnaire. Dietitians assessed dietary intakes using two non-consecutive computer-assisted multi-pass 24-h dietary recalls and performed anthropometric measurements. Nutrient intakes were calculated and compared with national dietary guidelines, and diet quality scored with the 2010 Alternate Healthy Eating Index (2010-AHEI). 41⋅1 % of women reported body weight dissatisfaction, and 49⋅8 % wanted to lose weight. Body weight dissatisfaction was associated with weight loss desire and a higher body mass index (BMI; P < 0⋅001). Women with body weight dissatisfaction consumed significantly less carbohydrates and dietary fibres, even when BMI was controlled for (P < 0⋅05). They also fell short of national dietary guidelines for magnesium and iron. Body weight dissatisfied women obtained lower 2010-AHEI scores than satisfied women (β −4⋅36, 95 % CI −6⋅78, −1⋅93). However, this association disappeared when the BMI was introduced in the equation. This highlights the importance of targeting both body dissatisfaction and unhealthy eating in obesity prevention and treatment at all ages.

scholarly journals Associations of Maternal Sociodemographic Characteristics and Eating Behaviors with Infant Feeding Behaviors

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1046-1046
Author(s):  
Tonja Nansel ◽  
Leah Lipsky ◽  
Carolina Schwedhelm ◽  
Breanne Wright ◽  
Chelsie Temmen ◽  
...  
Keyword(s):  
Infant Feeding ◽  
Diet Quality ◽  
Maternal Education ◽  
Healthy Eating Index ◽  
Fruit And Vegetables ◽  
Infant Food ◽  
Food Groups ◽  
Feeding Behaviors ◽  
White Race ◽  
Maternal Characteristics

Abstract Objectives This study examines associations of maternal characteristics with infant feeding of discretionary and health-promoting foods. Methods Mothers in PEAS, a prospective cohort study, reported maternal and child dietary intake, demographics, and eating competence (EC). Maternal diet quality (Healthy Eating Index-2015, HEI) was calculated combining 24-hour diet recalls at 6 weeks, 6, and 12 months postpartum (n = 209). Infant food frequency questionnaires were completed at 6, 9, and 12 months, assessing age of introduction and intake frequency of food groups. T-tests examined bivariate associations of demographics with feeding of discretionary sweets, discretionary savory foods, fruit, and vegetables. Linear regressions examined associations of maternal EC and HEI with infant feeding controlling for demographics. Results Fruit, vegetables, discretionary sweet, and discretionary savory foods were introduced at 5.8 ± 1.7, 5.9 ± 1.7, 8.0 ± 2.0, and 8.8 ± 1.8 months, respectively. Earlier introduction of fruit and vegetables was associated with higher maternal education, white race, and nulliparity; earlier introduction of vegetables was also associated with higher income. Age of introduction of discretionary sweet and savory foods was not associated with maternal demographics, HEI, or EC. At age 12 months, greater infant intake frequency of fruit and vegetables was associated with higher education and income, white race, and breastfeeding, while greater intake frequency of discretionary sweet and savory foods was associated with lower maternal education and minority race. Greater intake frequency of sweets was also associated with multiparity and greater intake frequency of discretionary savory foods was associated with lower income. Maternal HEI was positively associated with infant intake frequency of fruit, vegetables, and discretionary sweet and savory foods. Maternal EC was positively associated with infant intake frequency of fruit and vegetables. Conclusions Demographic differences in infant feeding behaviors indicates these behaviors as critical intervention targets to address disparities in child diet quality. Associations of maternal HEI and EC with infant feeding behaviors suggest potential pathways of maternal influence on infant diet. Funding Sources This research was supported by the NICHD Intramural Research Program.

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