Use of the Infant Diet Quality Index Score (DQIS) for the Identification of Targets for Nutritional Intervention Among Infants of 4 to 6 Months at Risk of Childhood Obesity

Abstract

ObjectivesHealthcare providers have been called to intervene during the first 1000 days of life to reduce childhood obesity. Screening instruments that facilitate the identification of targets for intervention are not currently available. A Diet Quality Index Score (DQIS) was created and measured for its validity in predicting excessive weight gain in a sample of Latino infants. Evidence that infants with BMI percentiles ≥85th at 2 months developed early childhood obesity demands strategies to detect targets for intervention in a systems-based approach. MethodsSecondary database analysis using data sourced from a lifestyle intervention project implemented among WIC participants. Assessments were completed on baseline while the infant was 0–2 months of age and follow up at 4–6 months. Socio-demographic and anthropometric characteristics of infants and their caregivers were evaluated. DQIS was calculated using an infant food frequency questionnaire. Descriptive analysis of the variables of interest was conducted. Correlation analysis between the numeric DQIS and categorical assessment of the scale was performed to determine the degree of association of values or risk category associated with a BMI z score percentile at or above 85th according to the age and gender appropriate WHO growth standards. Results169 dyads were included in this study (Puerto Rico 54.4%), mean caregiver age was 27 y (4.94). 41.4% had achieved an educational level high school or less. In infants: 52% received care in health centers, 82.2% where up to date on vaccinations, 99.4% had an excellent DQIS score at baseline. At follow up 19.5% were found in good and 8.9% needs improvement to poor range. Mean BMI z scores increased from -0.52 (1.35) at birth to 0.9 (1.46) at follow up. ConclusionsThe infant DQIS used between 4 to 6 months of life as a screening tool could assist non nutritional healthcare providers in the identification of intervention targets while a more detailed assessment is completed. Funding SourcesThis study was supported by the National Institute of Minority Health and Health Disparities (NIMHD), of the NIH, award number U54MD008149. Infrastructure support also provided by the National Institute on Minority Health and Health Disparities RCMI Grant: 8G12MD007600. This research was also supported by grant U54MD007584 (RMATRIX) from the NIMHD of the NIH.