Abstract P211: Diet Quality Declines and Differs by Race in Early Childhood

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Kelly Reynolds ◽  
Heidi Kalkwarf ◽  
Suzanne Summer ◽  
Philip Khoury ◽  
Marcia Gavin ◽  
...  

Introduction: Diet quality is an important determinant of health in children, but little is known about how diet quality progresses during early childhood. We hypothesized that overall diet quality, assessed by the 2010 Healthy Eating Index, would decline during early childhood. Methods: Three hundred seventy-two (372) healthy 3-year-old children were recruited from the Greater Cincinnati area and assessed every 4 months until age 7 at in-person clinical visits, for a total of 13 visits. Parents completed 3-day diet diaries at each visit which were analyzed for nutrient composition using the Nutrition Data Systems for Research system (NDSR). The 2010 Healthy Eating Index (HEI) total and food-group component scores were calculated and averaged by year of study. Longitudinal mixed modeling was used to evaluate longitudinal trends. Results: The population was 52% (195/372) male, 78% (290/372) white and 83% (308/372) completed the final visit. HEI total scores at age 3 were poor (mean±SE: 45.2±0.4) and declined significantly between ages 3-7 (p<0.0001). None of the participants had “good” quality diet (HEI>80) at any point in the study. HEI total scores differed by race, with white children having significantly higher scores (p=0.05, Figure). HEI component scores showed a mixed pattern, with some significantly improving (protein, vegetables and fatty acids), some significantly worsening (dairy, refined grains, sodium, whole fruit and total fruit); other component scores did not change. Differences by race also varied, with African-Americans having consistently better scores for vegetables, greens and beans, protein and fatty acids (all p<0.0001), while white children had better scores for dairy, sodium and refined grains (all p<0.0005). Conclusions: The average HEI scores for young children showed poor baseline diet quality at age 3 that became gradually worse throughout early childhood. The varying patterns in HEI component scores indicate specific areas of focus for early dietary intervention, which may differ by race.

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Veronique Gingras ◽  
Karen M Switkowski ◽  
Sheryl L Rifas-Shiman ◽  
Sabrina Faleschini ◽  
Emily Oken ◽  
...  

Introduction: Parental feeding behaviors have been found to be associated with dietary intakes and weight status in children, although the longitudinal associations of parental feeding behaviors in early life with diet later in childhood have been scarcely studied. Hypothesis: We hypothesized that parental feeding restriction, pressure to eat, and concerns about child’s weight would be associated with poorer diet quality throughout childhood. Methods: Among 1172 mother-child pairs from Project Viva, we examined associations of parental feeding behaviors at 2 years assessed via questions from the Child Feeding Questionnaire (behaviors dichotomized as yes vs. no) with diet quality in early (mean: 3.2, SD 0.2 years; n=1076) and mid-childhood (mean: 7.8, SD 0.7 years; n=993) assessed via food frequency questionnaires. We used linear regression models adjusted for socio-demographic characteristics, maternal and paternal body mass index, and maternal diet quality in pregnancy. Results: At 2 years postpartum, 47% of parents pressured/encouraged their child to eat more, 8% restricted their intakes, 15% were concerned about their child being overweight and 7% about their child being underweight. Parental pressure to eat at 2 years was associated with higher child intake of fruit juice (β 0.17 serving/day; 95% CI 0.01, 0.34) and snack foods (0.12 serving/day; 0.01, 0.22) in early childhood and with lower youth healthy eating index score (-1.32 points; -2.54, -0.10; score from 0 to 85 points) in mid-childhood. Parental feeding restriction at 2 years was associated with lower intake of sugar-sweetened beverages (-0.17 serving/day; -0.27, -0.06) in early childhood and with lower intake of dairy (-0.29 serving/day; -0.56, -0.02) in mid-childhood. Parental concerns about their child being underweight was associated with lower youth healthy eating index score (-2.18 points; -4.30, -0.05; score from 0 to 95 points) in early childhood while concerns about their child being overweight was associated with higher intakes of red and processed meat (0.14 serving/day; 0.04, 0.23) in early childhood and higher intake of baked products in mid-childhood (0.07 serving/day; 0.01, 0.13). Conclusions: We found that early parental feeding behaviors may have a modest contribution to dietary intakes throughout childhood. However, only a few associations persisted after adjusting for socio-economic and parental characteristics and effect sizes were modest. Strategies to improve diet quality in children might need to focus on the broader family and socio-economic context.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Heather Stanner ◽  
Diane Rigassio Radler ◽  
Joachim Sackey

Abstract Objectives The purpose of this study was to examine the association between diet quality (utilizing Healthy Eating Index-2010 [HEI-2010] total scores) and fasting blood glucose in people living with human immunodeficiency virus (PLHIV). The associations between refined grains and total fruit consumption (HEI-2010 component scores) and fasting blood glucose were also explored. Methods This was a cross-sectional analysis (N = 191) of an existing dataset from the Cardiovascular Assessment Risk Examination (CARE) study at Tufts Medical Center, Boston, MA between 2007 and 2013. It was hypothesized that there would be no association between diet quality and fasting blood glucose. Multiple linear regression was used to test the hypothesis adjusting for several a priori variables (age, race, sex, employment status, use of highly active antiretroviral therapy [HAART], living situation, body mass index, family history of type 2 diabetes [T2D] and year of enrollment). Results The mean age of the subjects was 41.1 years (SD = 7.1 years). Approximately half were white (50.8%, n = 97) and the majority were male (74.9%, n = 143). Subjects had a mean total HEI-2010 score of 49.3 out of 100 possible points with a range of 10–88 points. This is indicative of poor diet quality in this sample of PLHIV. Total protein foods and refined grains represented the component scores with the highest median scores (5.0 out of 5 possible points and 7.6 out of 10 possible points, respectively). Components with low median scores were total fruit (1.6 out of 5 possible points), whole fruit (1.4 out of 5 possible points), greens & beans (0.9 out of 5 possible points) and whole grains (1.5 out of 10 possible points). No significant associations were found between total HEI-2010 score and fasting blood glucose. No significant associations were found between the refined grains HEI-2010 component score or total fruit HEI-2010 component score and fasting blood glucose. Conclusions Overall diet quality was low in this study and the hypothesis of no association between diet quality and fasting blood glucose was supported. Additional studies are needed to determine the relationship between diet quality and fasting blood glucose in PLHIV and how to improve diet quality in this population. Funding Sources The CARE study was supported by the National Institutes of Health (R01HL065947).


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1105-1105
Author(s):  
Breanne Wright ◽  
Leah Lipsky ◽  
Anna Maria Siega-Riz ◽  
Aiyi Liu ◽  
Tonja Nansel

Abstract Objectives This study described diet quality across the perinatal continuum and investigated associations of sociodemographic characteristics with diet quality change from pregnancy to postpartum. Methods Pregnant women (n = 365) in a prospective cohort study completed a demographic questionnaire at recruitment and six 24-hour dietary recalls (one in each pregnancy trimester and 2, 6, and 12 months postpartum). Sample-level diet quality (Healthy Eating Index-2015, HEI total and component scores) at each of the six time points was quantified using the population ratio method and compared using bootstrapping and permutation tests. Individual-level HEI scores during the pregnancy (pooling 3 pregnancy recalls) and postpartum (pooling 3 postpartum recalls) periods were quantified using the by-person method and compared using paired t-tests. Multiple linear regression models examined independent associations of sociodemographic characteristics with change in HEI (postpartum subtracted from pregnancy score). Results Sample-level HEI total and component scores were generally consistent among time points within pregnancy and within postpartum but showed varied changes between periods. Within-person analyses indicated both positive (total protein, fatty acids, refined grains, saturated fat) and negative (total fruit, whole fruit, dairy) changes in HEI from pregnancy to postpartum. Greater improvements in HEI total score were observed in white non-Hispanic versus black non-Hispanic participants (β ± SEM: 6.7 ± 3.2), participants with at least a college degree versus less than a college degree (6.8 ± 2.7), and participants who were not working by choice versus working full time (7.0 ± 2.6). In addition to associations with change in HEI total score, race/ethnicity was associated with change in greens and beans, seafood and plant proteins, and added sugars component scores, education was associated with change in total fruit and refined grains scores, and employment was associated with change in refined grains score. Age, smoking status, and body mass index were also associated with changes in HEI component scores. Conclusions Perinatal decreases in fruit and dairy intake and sociodemographic disparities in dietary changes may represent critical intervention targets. Funding Sources This research was supported by the NICHD Intramural Research Program.


2020 ◽  
pp. 1-10
Author(s):  
Abrania Marrero ◽  
Martha Tamez ◽  
José F Rodríguez-Orengo ◽  
Josiemer Mattei

Abstract Objective: Diminished diet quality in the Caribbean and other island settings may be related to a dietary transition from local foods towards imported products. The current study aimed to characterise the association between intentionally purchasing local foods (IPLF) and diet quality in Puerto Rico (PR). Design: Cross-sectional study. Setting: Primary care clinics in the PR metropolitan area. Participants: Data were obtained from adult participants (30–75 years; n 243) of the Puerto Rico Assessment of Diet, Lifestyle, and Diseases. IPLF was probed by asking: ‘How often do you purposely purchase foods from PR (like fruits, vegetables, meat and other products that are produced on the island rather than being imported)?’ Dietary intake was measured using a FFQ, and diet quality was assessed by the Alternate Healthy Eating Index (range 0–110; higher scores indicating higher diet quality). Multivariate-adjusted generalised linear models tested the association between IPLF and Alternate Healthy Eating Index 2010 (AHEI) and its component scores. Results: A third (33·9 %) of participants reported seldom, 33·5 % reported often and 30·6 % reported always IPLF. Compared with seldom IPLF, fully adjusted mean AHEI scores were 3·6 (P = 0·038) points higher among those often IPLF and 9·3 (P < 0·0001) points higher among those always IPLF. Compared with seldom IPLF, those who always IPLF had significantly higher fully adjusted mean component scores for vegetables, fruits, whole grains, nuts and legumes, trans fat and n-3 fats. Conclusions: Adults in PR who intentionally purchase local foods had higher diet quality, especially for intake of plant-based foods and healthy fats, highlighting potential dietary benefits associated with improved local food availability in PR.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1850
Author(s):  
Hollie A. Raynor ◽  
Suzanne E. Mazzeo ◽  
Jessica Gokee LaRose ◽  
Elizabeth L. Adams ◽  
Laura M. Thornton ◽  
...  

Concerns remain about dietary changes during pediatric obesity treatment and eating pathology, which have not been investigated. This secondary data analysis from a randomized clinical trial examined associations between adolescents’ changes in energy intake and diet quality during obesity treatment with post-treatment eating pathology. Adolescents (N = 82: 13.7 ± 1.2 y, 34.9 ± 7.0 kg/m2, 63.4% female, 46.3% black) received TEENS+, a 4-month multicomponent intervention. TEENS+ provided individualized dietary goals (1200–1800 kcal/day; number of “Go” foods/day (low-energy, high-nutrient-dense foods)). At 0 and 4 months, 3-day food records assessed energy intake and diet quality (Healthy Eating Index 2015 (HEI-2015)). Two HEI-2015 subscores were created: components to increase (increase), and components to limit (decrease). The Eating Disorder Examination Questionnaire measured eating pathology (total score and subscales: restraint; and eating, weight, and shape concern). Corrected p-values are reported as q-values. Energy intake decreased (−292 ± 418 kcal/day; q < 0.001), while diet quality improved during treatment (total HEI-2015 (4.5 ± 15.1; q = 0.034) and increase (3.3 ± 9.4; q = 0.011)). Restraint increased (+0.6 ± 1.4; q < 0.001), whereas shape (−0.5 ± 1.3; q = 0.004) and weight (−0.5 ± 1.4; q = 0.015) concerns decreased. Greater decreases in energy intake were associated with greater restraint post-treatment (F = 17.69; q < 0.001). No other significant associations were observed. Changes in adolescents’ dietary intake during obesity treatment were unrelated to increased shape, weight, or eating concerns post-treatment.


2021 ◽  
pp. 1-29
Author(s):  
Zach Conrad ◽  
Sarah Reinhardt ◽  
Rebecca Boehm ◽  
Acree McDowell

Abstract Objectives: To evaluate the association between diet quality and cost for foods purchased for consumption at home and away from home. Design: Cross-sectional analysis. Multivariable linear regression models evaluated the association between diet quality and cost for all food, food at home, and food away from home. Setting: Daily food intake data from the National Health and Nutrition Examination Survey (2005-2016). Food prices were derived using data from multiple, publicly available databases. Diet quality was assessed using the Healthy Eating Index-2015 and the Alternative Healthy Eating Index-2010. Participants: 30,564 individuals ≥20 y with complete and reliable dietary data. Results: Mean per capita daily diet cost was $14.19 (95% CI: $13.91-14.48), including $6.92 ($6.73-7.10) for food consumed at home and $7.28 ($7.05-7.50) for food consumed away from home. Diet quality was higher for food at home compared to food away from home (P<0.001). Higher diet quality was associated with higher food costs overall, at home, and away from home (P<0.001 for all comparisons). Conclusions: These findings demonstrate that higher diet quality is associated with higher costs for all food, food consumed at home, and food consumed away from home. This research provides policymakers, public health professionals, and clinicians with information needed to support healthy eating habits. These findings are particularly relevant to contemporary health and economic concerns that have worsened because of the COVID-19 pandemic.


2009 ◽  
Vol 109 (4) ◽  
pp. 616-623 ◽  
Author(s):  
Yannis Manios ◽  
Georgia Kourlaba ◽  
Katerina Kondaki ◽  
Evangelia Grammatikaki ◽  
Manolis Birbilis ◽  
...  

2016 ◽  
Vol 29 (4) ◽  
pp. 555-565 ◽  
Author(s):  
Daniel dos SANTOS ◽  
Jacqueline Queiroz da SILVEIRA ◽  
Thais Borges CESAR

ABSTRACT Objective: To assess the dietary intake and overall diet quality of female soccer players before the competitive games. Methods: This descriptive and cross-sectional study included 21 women aged 20.8±4.5 years from a professional soccer team. Their nutritional status and dietary adequacy during the training period, before competition season, were assessed. Dietary intake was assessed by three 24-hour recalls, one food frequency questionnaire, and the Healthy Eating Index, an overall diet quality index based on food group intake. Results: The athletes have shown proper nutritional status, but a diet deficient in energy due largely to low carbohydrate intake. On the other hand, the intakes of protein, fatty acids, and sodium were above the recommended intakes, even for athletes. Diet quality assessment by the Healthy Eating Index - 2010 resulted in a mean score of 54.6 points of a maximum of 100, indicating a need of improving the overall diet quality. Conclusion: The study found that the dietary patterns of female football players were both quantitatively and qualitatively inappropriate. A nutritional intervention is indicated to improve diet quality, with the inclusion of various foods, such as whole grains, fruits, vegetables, dairy products, and better protein quality, along with a reduction in saturated fats, sodium, and added sugar.


2020 ◽  
Vol 11 (2) ◽  
pp. 96-102
Author(s):  
Krishna Mohandas ◽  
L. Prema

The food habits of global population has been evolving in such a way that makes unhealthy foods cheaper and widely available and healthy foods costly and less available. Being surrounded by such foods and living in an environment with lesser requirement for physical activity is the primary reason for the pandemic explosion in overweight and obesity. This study is an attempt to analyze the quality of diet with an aim to study the significance of Alternate Healthy Eating Index (AHEI) in predicting the quality of dietary intake. Methodology: The study was conducted in 66 respondents (44 females and 22 males) aged 18-65 years with BMI between 23 kg/m2 to 50 kg/m2. The respondent’s data were collected using a pretested standard questionnaire. The nutrient consumption was calculated from the 24 hour recall and the AHEI scores were derived from recall and food use frequency data. The data were analysed using SAS software. Results: The intake of Energy, protein, fat and carbohydrates were more than their requirement while intake of fibre was not meeting the requirement. The AHEI scores obtained ranged from 36 to 76 with a mean value of 55.6 ± 9.54. A positive linear association for AHEI with BMI (0.0362) and energy intake (0.13) was established through Pearson’s correlation while the association was negative with BMR (-0.14). Paired t test comparing AHEI against the difference between intake and requirement of macronutrients revealed that when the diet quality was good (as indicated by AHEI>51), the difference in intake exhibited a significant linear relationship with p values <0.001 while no relation was established when the diet quality was poor. Conclusion: AHEI encompasses all nutrients and food groups relevant to metabolic health and it can be used as a good tool to assess the quality of dietary habits of overweight and obese subjects.


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