Abstract
PurposeWe aimed to evaluate diet quality of 8-year-old children in the Netherlands, to identify sociodemographic and lifestyle correlates of child diet quality, and to examine tracking of diet quality from early to mid-childhood.MethodsFor 4733 children participating in a population-based cohort, we assessed dietary intake using a validated food-frequency questionnaire at a median age of 8.1 years (interquartile range 8.0–8.2) (2011–2014). Based on dietary guidelines, we developed and validated a food-based diet quality score for children consisting of ten components (score 0–10): sufficient intake of vegetables; fruit; whole grains; fish; legumes; nuts; dairy; oils and soft fats; and low intake of sugar-containing-beverages; and high-fat and processed meat.ResultsWe observed a mean (± SD) diet quality score of 4.5 (± 1.2) out of a maximum of 10. On average, intake of legumes, nuts, and oils or soft fats was below recommendations, whereas intake of sugar-containing beverages and high-fat or processed meat was higher than recommended. The main factors associated with higher diet quality were higher maternal educational level (β = 0.29, 95% CI 0.21, 0.37 versus low education), higher household income (β = 0.15, 95% CI 0.05, 0.25 versus low income), no maternal smoking (β = 0.13, 95% CI 0.02, 0.25 versus current smoking), and less screen time (β = 0.31, 95% CI 0.24, 0.38)—all independent of each other. For children with available dietary data at age 1 year (n = 2608), we observed only weak tracking of diet quality from early to mid-childhood (Pearson’s r = 0.19, k = 0.11 for extreme quartiles).ConclusionOverall diet quality of 8-year-old children did not conform to dietary guidelines, especially for children having more screen time, children of lower educated or smoking mothers, or from lower-income households.
Highlights
A healthy diet during childhood is important for healthy growth and development [1], and may contribute to the prevention of obesity and chronic diseases later in life [2, 3]
We aimed to evaluate overall diet quality of 8-year-old children participating in a large population-based cohort in the Netherlands. For this aim we developed a new food-based diet quality score based on current Dutch dietary guidelines [15], and we assessed the construct validity of this new diet quality score
We developed and validated a food-based diet quality score based on Dutch dietary guidelines to estimate overall diet quality of children
Summary
A healthy diet during childhood is important for healthy growth and development [1], and may contribute to the prevention of obesity and chronic diseases later in life [2, 3]. Dietary habits in childhood have been shown to track over time and are an important predictor of diet quality in adulthood [4]. Because dietary habits and guidelines may differ between countries and cultures, it is important to use a diet quality score that assesses recommendations specific for the study population [12]. Previous studies reported tracking of diet from mid-childhood or adolescence to adulthood [2, 14], but information on changes in diet quality from early childhood to mid-childhood is scarce. This information is needed in order to establish whether dietary interventions could be efficient early in life [2]
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