Children's Diet Quality Research Articles

Dietary intake, diet quality and nutritional status of homeless children: A cross-sectional study

Dietary intake, diet quality and nutritional status of homeless children: A cross-sectional study

Food insecurity impacts diet quality and adherence to the gluten-free diet in youth with celiac disease.

Celiac disease (CD) is an autoimmune gastrointestinal disorder that requires a strict lifelong gluten-free diet (GFD). Gluten-free (GF) foods are more expensive and less readily accessible than gluten-containing foods, contributing to an increased risk for food insecurity (FI). The study aimed to determine associations between GF-FI, sociodemographic risk factors and child dietary adherence and diet quality (DQ). A 26-item, cross-country online survey was administered through social media to parents of children with CD on the GFD. The survey elicited household and CD child sociodemographic and clinical characteristics (e.g., duration of CD), measures of household FI, child DQ and GFD adherence, and parents' concerns related to GF food. Household GF-FI was evaluated using the validated Hunger Vital Sign™ and the US Department of Agriculture Six-Item Short Form Household Food Security Survey Module. GF-FI occurred in 47% of households with children with CD with >30% reporting low to very low food security. Sociodemographic risk factors identified included lower income, renters, rural residency, single-parental households, and having children with additional dietary restrictions (p < 0.001). Regardless of FI status, a majority of households reported experiencing significantly higher GF food expenditure. GF-FI was associated with reduced adherence to the GFD, increased consumption of processed GF food, and lower intakes of fresh fruits and vegetables and GF grains among children with CD (p < 0.05). GF-FI is prevalent in this multiethnic cohort of households with CD children and is associated with worsening DQ and GFD adherence. Policy interventions are urgently needed to address GF-FI.

The development and testing of a single-arm feasibility and acceptability study of a whole foods diet intervention for adults with prediabetes and their offspring

BackgroundDiet is considered a first-line treatment option for prediabetes, a condition that affects 96 million United States (U.S.) adults. Diet patterns that prioritize whole foods (e.g., Mediterranean) are currently recommended to treat prediabetes. However, no studies have tested whether a U.S.-style diet pattern that prioritizes whole foods can be used to treat prediabetes. The purpose of this study was to assess the feasibility and acceptability of a whole foods diet for adults with prediabetes and their offspring prior to conducting a larger clinical trial.MethodsA 2-week single-arm pre-post experimental controlled-feeding intervention of a 2020–2025 Dietary Guidelines for Americans adapted whole foods diet (e.g., primarily focused on foods that have undergone limited processing or refinement) was conducted in adults (25–59 years) with prediabetes and their biological offspring (6–17 years). Families received 2 weeks of menus and grocery delivery and weekly counseling by a registered dietitian. Families were invited to attend an optional focus group session. Feasibility was based on having a ≥ 50% family completion rate with ≥ 80% completion of study outcomes. Measures included adult–child anthropometrics (weight [kg], body mass index [BMI] including BMI% and Z-scores for offspring, waist circumference [cm]) and child diet quality estimated using the 2015 Healthy Eating Index (HEI) from a single random food record. Wilcoxon signed rank was used to compare differences between baseline and 2-week anthropometrics measures and offspring total HEI scores. Qualitative data were analyzed using thematic analysis to understand factors attributed to diet adherence and acceptability.ResultsEight families enrolled (n = 8 adults, n = 12 offspring), with 7 families completing the study (12% attrition) and completing 100% of study outcome measures. Adults experienced a median weight loss of − 1.0 kg from baseline to 2 weeks (79.5 kg to 78.5 kg). Offspring had a 24-point increase in total 2015 HEI scores (median difference 50 to 74). Focus group participants (n = 4 adults) reported being satisfied with the program and expressed a willingness to continue the diet despite identified barriers.ConclusionsA whole foods diet that provides dietary support was found to be feasible and acceptable for families at risk for T2D. Future studies are needed to test the effects of the diet on prediabetes outcomes, diet quality, and diet adherence in adults and families.Trial registrationNCT05483972 at ClinicalTrials.gov. Registered July 25, 2022. https://clinicaltrials.gov/study/NCT05483972?cond=prediabetes&term=whole%20foods%20&rank=1

Maternal diet in pregnancy and the risk of inflammatory bowel disease in the offspring: a prospective cohort study

BackgroundDiet has been hypothesized as a risk factor for development of inflammatory bowel disease (IBD). ObjectiveTo explore associations between maternal diet diversity and quality in pregnancy and the offspring’s risk of IBD. MethodsWe used data from a nationwide cohort study on 85,129 Norwegian children followed from birth (1999–2009) with information on maternal diet in pregnancy from validated food frequency questionnaires. Hazard ratios (aHRs) for IBD, Crohn’s disease (CD), and ulcerative colitis (UC) by maternal diet diversity, quality and intake amounts of individual food groups were adjusted for maternal body mass index, parental IBD, and socio-demographic factors. Sensitivity analyses adjusted for the child's early-life diet quality and antibiotic treatment. Dietary exposures were classified into tertiles, comparing low (reference) to medium, and high levels. ResultsDuring a mean follow-up time of 16.1 years (1,367,837 person-years of follow-up), 268 children developed IBD (CD, n=119; UC, n=76; IBD-unclassified, n=73). High compared with low diet diversity in pregnancy was associated with a lower risk of UC in the offspring (aHR 0.46, 95% confidence interval 0.25-0.87), with consistent findings after further adjustment for the child's early-life diet quality and antibiotic treatment. High compared with low diet diversity in pregnancy yielded aHRs of 0.81 for CD (0.51-1.28) and 0.75 for any IBD (0.55-1.02) in the offspring. A high compared with low diet quality in pregnancy or intakes of specific food groups were not associated with the offspring’s risk of IBD or its subtypes. ConclusionsOur findings suggest that a higher maternal diet diversity in pregnancy may be associated with a lower risk of UC in the offspring.

Maternal pregnancy diet quality, night eating, and offspring metabolic health: the GUSTO study.

We investigated the understudied influence of maternal diet quality, food timing, and their interactions during pregnancy on offspring metabolic health. Maternal diet at 26-28 weeks' gestation was assessed using a 24-h recall and adherence to the modified-healthy-eating-index (HEI-SGP) reflects diet quality. Predominant night-eating (PNE) was defined as consuming >50% of total daily energy intake from 19:00 to 06:59. Outcomes were offspring composite metabolic syndrome score and its components measured at age 6 years. Multivariable linear regressions adjusted for relevant maternal and child covariates assessed associations of diet quality and PNE with these outcomes. Up to 758 mother-child pairs were included. The mean(SD) maternal HEI-SGP score was 52.3(13.7) points (theoretical range: 0-100) and 15% of the mothers demonstrated PNE. Maternal diet quality showed inverse relationship with offspring HomeostaticModel AssessmentforInsulinResistance (HOMA-IR) [β(95% CI): -0.08(-0.15, -0.02) per-10-point HEI-SGP increment; P = 0.012]. Maternal PNE was associated with a higher offspring HOMA-IR [0.28(0.06, 0.50); P = 0.012], with similar estimates after adjustment for children's BMI and diet quality; the association was stronger for boys (P-interaction<0.001) and among mothers with lower diet quality (<median HEI-SGP) (P-interaction = 0.062). Maternal PNE and low dietary quality were associated with a higher level of insulin resistance in early childhood, especially among boys. We demonstrated that maternal predominant night-eating behavior and low-quality diet are associated with higher offspring insulin resistance. Maternal low-quality diet and predominant night-eating behavior synergistically interact to influence offspring insulin resistance, particularly among boys. While maternal diet quality and food timing impact the mother's health, their influence on offspring long-term health outcomes through developmental programming is not well understood. Our findings highlight the significance of maternal food timing and calls for further studies on its influence on child health through developmental programming. Targeting both dietary quality and food timing during pregnancy could be a promising intervention strategy.

The effects of age on associations between pre-school children's eating behaviour traits and diet quality

Child eating behaviour traits are associated with several aspects of dietary intake of pre-school children, however the associations between child eating behaviour traits and overall dietary quality in pre-school children has not been examined. Additionally, it is unknown how these relationships vary by age. This study examines the associations between child eating behaviour traits and pre-school children's dietary quality and whether children's age moderates these associations. This study utilises cross-sectional online survey data collected from mothers (n = 1367) of pre-school aged children (2–5 years) from across Australia. The survey included a validated measure of four child eating behaviour traits and a validated measure of diet quality. Multiple linear regression assessed associations between child eating behaviour traits and dietary quality, including interactions between child eating behaviour traits and child age. The average age of the children was 3.3 years, with 50.2% reported as males. Enjoyment of food was positively associated with dietary quality (B coefficient: 2.51, p < 0.001). Food fussiness and satiety responsiveness were inversely associated with dietary quality (B coefficients: 2.59 and −2.25, respectively, p < 0.001), while food responsiveness was not related to diet quality. Child age moderated associations between food fussiness and dietary quality (B coefficient: 0.38, p = 0.025). The difference in dietary quality between lower and higher food fussiness is most pronounced among 5-year-old children. In conclusion, this study demonstrates that it is important for future interventions aiming to improve dietary quality of pre-school children to target children with lower food enjoyment, higher food fussiness or satiety responsiveness as possible ways to improve child dietary quality. Future interventions should also have a particular focus on strategies to reduce food fussiness for older preschoolers.

The relationship between nutritional problems, eating behaviors, and diet quality in children with autism

Objectives This study aimed to determine the current nutritional problems, eating behaviors, and diet quality of children with autism and to examine the relationship between eating behavior and diet quality. Methods This descriptive study was conducted with 52 children aged 8–14 years with Autism Spectrum Disorder. Data were collected by using a questionnaire consisting of five sections (descriptive information form, anthropometric measurements, Screening Tool for Nutritional Problems (STEP), Mediterranean Diet Quality Index for Children and Adolescents (KIDMED), and Child Three-Factor Eating Questionnaire (CTFEQ)). The significance level of statistical tests was accepted as p < 0.05. Results The mean age of children was 11.52 ± 2.73 years, 84.6% were male, and 21.2% were obese. Current nutritional issues were primarily behavioral disorders and nutritional skills-related. The highest score on the Three-Factor Eating Scale was in the uncontrolled eating sub-dimension (15.02 ± 3.63). The mean score for children with autism was 5.79 ± 1.87, with the majority (69.2%) moderately adhering to the Mediterranean diet. In the low adherence group, total Three-Factor Eating Scale score and uncontrolled eating sub-scale score were significantly higher than the moderate-high adherence group (p < 0.05). Although adherence to the Mediterranean diet increased as the frequency and severity of nutritional problems decreased according to the STEP, this difference was not statistically significant (p > 0.05). Conclusions Our results show that children with autism are at risk for obesity. Identifying current nutritional problems, improving diet quality, and detecting and preventing unhealthy eating behaviors such as uncontrolled eating are important for the health of children with autism.

Isotemporal Substitution Effects of Daily Time Use on Cardiorespiratory Fitness of Children in the OptiChild Study: A Mediation Analysis with Diet Quality.

(1) Background: Although daily time-use is associated with diet quality and cardiorespiratory fitness (CRF) in children, their interdependence remains unexplored. This study first examined the associations between reallocating daily movement time and diet quality and CRF, and second the mediating role of diet quality in the relationship between daily time-use and CRF. (2) Methods: This study included 1131 Chinese children (aged 8 to 10 years; median [interquartile range]: 8.5 [8.3, 8.8]) at baseline (September 2022) and 1268 children at the 9-month follow-up (June 2023) from the OptiChild study. Daily durations of moderate-to-vigorous physical activity (MVPA), sleep, and sedentary behavior (e.g., screen time) were self-reported or proxy-reported by parents. Diet quality was assessed via the Diet Quality Questionnaire (DQQ), which uses a 24 h dietary recall and is categorized according to the Global Dietary Recommendations (GDR) score and Food Group Diversity Score (FGDS). The CRF was measured using VO2max after the 20 m shuttle run test. Longitudinal associations between daily time-use, diet quality, and CRF were calculated using isotemporal substitution models. Mediation analyses were used to determine whether diet quality mediated the associations between daily time-use and CRF. (3) Results: Reallocation of 30 min from screen time to MVPA resulted in significant improvements in the GDR score (β baseline = 0.11, p = 0.024; β follow-up = 0.26, p < 0.001), FGDS (β baseline = 0.11, p = 0.006; β follow-up = 0.19, p < 0.001), and CRF (β baseline = 0.40, p < 0.001; β follow-up = 0.26, p = 0.001). Diet quality partially mediated the associations between MVPA, screen time, and CRF. Substituting 30 min of screen time for MVPA led to diet quality mediating a proportion of the association with CRF (GDR score: 11.4%, FGDS: 6.6%). (4) Conclusions: These findings underscore the importance of optimizing daily time-use of MVPA and screen time and improving diet quality to promote physical fitness in school-aged children.

Associations between child eating behaviors with eating patterns and diet quality in preschool-aged children

Childhood eating behaviors are associated with weight status and laboratory assessments of dietary intake. However, little is known about how eating behaviors relate to the eating patterns and diet quality of children from marginalized populations when assessed in their natural environments. Therefore, we examined the association of food avoidant (e.g., food fussiness and satiety responsiveness) and food approach (e.g., food responsiveness and enjoyment of food) eating behaviors with children's meal size, eating frequency, and diet quality. We analyzed data from 61 predominately low-income Hispanic/Latinx preschool-aged children. Caregivers completed the Childhood Eating Behavior Questionnaire and two 24-h dietary recalls. From the recalls, we calculated meal size, eating frequency, and modified Diet Quality Index Scores (DQIS), and evaluated associations with eating behaviors using multivariable linear models. We also explored the relationship between eating behaviors and DQIS components. Food-avoidant subscales were associated with smaller meals and satiety responsiveness were associated with decreased snack frequency. Food approach subscales were not associated with meal size or eating frequency. Both food-avoidant and food-approach behaviors were associated with components of diet quality and caloric beverages outside of meal and snacks. These findings can inform future research on the relationship between child eating behaviors and dietary intake so that we can develop more tailored and effective interventions to promote healthy eating habits for low-income, Hispanic/Latinx preschool-aged children.

Cognitive Interviewing to Improve Infant and Young Child Dietary Assessments in the Nepal Demographic and Health Survey

BackgroundThe Demographic and Health Survey (DHS) is the primary source of nationally representative nutrition data for many countries and is important in shaping national nutrition policy, advocacy, and research. Without careful testing and adaptation to local contexts, findings are at risk of inaccurately representing respondents’ behaviors and key nutritional indicators. ObjectivesThis study used a cognitive interviewing approach to assess mothers’ comprehension, retrieval, judgment, and response to the infant and young child feeding (IYCF) dietary assessment module questions in the Nepal DHS-8 Woman’s Questionnaire. MethodsA cross-sectional qualitative study was conducted in December 2021, using semistructured cognitive interviews, among 54 mothers of children 6–23 mo of age across 3 regions of Nepal. Interviews were analyzed to identify issues in participant understanding of questions, as well as cognitive challenges or benefits of a longer introduction to the IYCF dietary assessment module, as compared with the original shorter introduction and challenges or benefits to using closed-ended compared with open-ended questions. ResultsCognitive challenges were identified, including issues with judgment of certain food categories resulting in misclassification, comprehension of certain concepts, and comprehension of certain instructions for the dietary assessment that resulted in the variability of food and liquids recalled by mothers. ConclusionsThese findings carry substantial implications for the measurement of the diet quality of infants and young children (IYC) in Nepal, and similar cognitive challenges may exist in other contexts. Although this current study is not able to answer the exact extent to which the accuracy and precision of IYCF indicators are affected by these cognitive challenges, these findings indicate that current measurements may be subject to over or underestimation and there is a need for further research in this area to understand the degree of measurement error related to these challenges.

Diet Quality Among Mothers and Children in India: Roles of Social and Behavior Change Communication and Nutrition-Sensitive Social Protection Programs

BackgroundLimited evidence exists on determinants of maternal and child diet quality. ObjectivesThis study examined the role of social and behavior change communication (SBCC) and nutrition-sensitive social protection (NSSP) programs on maternal and child diet quality. MethodsData were from cross-sectional phone survey on 6627 Indian mothers that took place in late 2021. The Diet Quality Questionnaire (DQQ) was used to measure maternal and child diet quality, including minimum dietary diversity (MDD), dietary diversity scores (DDSs), noncommunicable disease (NCD)-protect and NCD-risk scores, adherence to dietary guidelines (All-5 and India-All-6), and unhealthy child feeding. Multivariate regression models were used to explore the association between diet indicators and coverage of SBCC and NSSP programs. ResultsMaternal and child diet quality was suboptimal, with more mothers (57%) achieving MDD than children (23%). SBCC was positively associated with healthy food consumption in children (odds ratio [OR]: 2.14 for MDD; β: 0.60 for DDS and 0.54 for NCD-protect) and mothers (β: 0.38 for DDS and 0.43 for NCD-protect). Cash transfers were associated with healthier diets in mothers (OR: 1.45 for MDD, 1.86 for All-5, and 2.14 for India-All-6; β: 0.43 for DDS and 0.26 for NCD-protect), but less associations noted for children (β: 0.14 for NCD-protect). Receiving food was associated not only with healthier diets in mothers (OR: 1.47 for MDD; β: 0.27 for DDS and 0.33 for NCD-protect) and children (β: 0.19 for DDS and 0.15 for NCD-protect) but also with unhealthy food in children (OR: 1.34). Exposure to multiple programs showed stronger associations with diet quality. ConclusionsSBCC has greater positive impact on child feeding than food and cash transfers, while cash has a stronger association with improved maternal diets. Food and cash are also associated with unhealthy food consumption. Our study underscores the importance of interventions that combine education, resource provision, and targeted support to promote maternal and child diet quality.

Diet Quality of Children 6 to 24 Months Old in Low-Income Households in the US: Commendations and Concerns

Diet Quality of Children 6 to 24 Months Old in Low-Income Households in the US: Commendations and Concerns

Regional Causal Loop Diagram With Action Ideas for Improving Child Diet Quality and Weight Status in the Children’s Healthy Living Food Systems (CHLFS) Program

Regional Causal Loop Diagram With Action Ideas for Improving Child Diet Quality and Weight Status in the Children’s Healthy Living Food Systems (CHLFS) Program

Is Parent Diet Quality Related to Child Diet Quality? A Cross-Sectional Pilot Study Among Low-Income Families From Indiana

Is Parent Diet Quality Related to Child Diet Quality? A Cross-Sectional Pilot Study Among Low-Income Families From Indiana

Evaluation of the Improved Feeding Practices for the First 1000 Days Project in Ghana

BackgroundSub-optimal nutrition during the first 1000 days of life can impair the physical andcognitive development of children, as well as limit their health and wellbeing. Theimproved feeding practices for the first 1,000 days (IFP) project aimed to improve thedietary practices of women of reproductive age (pregnant and lactating) and children belowages two years in three selected districts (Kassena-Nankana West [KNW], Sekyere East[SE],and Kintampo South[KS]) in Ghana. This integrated project combined interventions onmicronutrient powder (MNP) distribution, social behaviour-change communication, andnutrition-sensitive agriculture to catalyse enhanced awareness and consumption ofnutrient-rich foods in selected communities.ObjectiveThis paper evaluates the IFP project based on measures associated with relevance,effectiveness, impact, and sustainability.MethodsUsing a mixed-methods design, data from in-depth interviews of project beneficiaries, andkey community-based actors involved in the project’s implementation were triangulatedwith routine project monitoring data, and documentation to answer the evaluationquestions. The evaluation questions and our analyses were guided by the DevelopmentAssistance Committee evaluation criteria. Interviews with key stakeholders wereconducted in June 2023. Key project data were compared between baseline and endlineassessments to ascertain the extent to which the project met its intended objectives andtargets.ResultsThe project demonstrated high relevance of the proposed project among the target groups;for example, nearly half the children were eating low quality, non-diverse diets (49% inKNW, 46% in KS and 35 in SE). The project enabled almost 14,000 children to be reachedwith MNP. While 96,000 eggs were produced, &lt;10% was consumed at home. About 35,000kilograms of orange-fleshed sweet potatoes (OFSP) were produced, resulting in improvedaccess to the nutrient-rich foods produced. Nutrition messages were disseminated widelyand were reported to have contributed to improved awareness of nutrition amongcaregivers. Data-based and reported evidence both indicated there was improved childdietary diversity between baseline and endline of the project; in KNW, 90% of children metminimum dietary diversity at endline compared to 75% at baseline. In KS and SE, theendline estimates of dietary diversity were 71% and 70%, up from 65% in both districts atbaseline, respectively. Multiple strategies aiming to support project sustainability thatwere built into the project design were implemented. Additional sustainability strategiesevolved during the project’s lifetime, including crossbreeding of project chickens withhardier local breeds, continued multiplication of OFSP vines, and transfer of VillageSavings and Loans Association funds accumulated from MNP sale to Village-BasedEntrepreneurs to sustain MNP supply.ConclusionsIFP project delivered interventions successfully, leading to improved awareness andpractices related to diets of women in reproductive age and young children, in projectcommunities. These strategies can be extended to women and children living in similarsettings to improve the diet quality of women and children.

Intuitive eating, diet quality, and nutritional status of vulnerable children living separated from their families: A pilot study

AbstractNutritional problems can be seen in children living separated from their families. This cross-sectional pilot study aimed to evaluate intuitive eating, diet quality, and nutritional status of children living separated from their families. A total of 55 adolescent girls aged 12–18 years participated in the study. Anthropometric measurements, biochemical data, and 24-h dietary recall data were collected. The Intuitive Eating Scale-2 (IES-2) and the Turkish version of the Healthy Lifestyle-Diet (HLD-TR) index were used. Participants were divided into two groups according to their scores on the diet quality index using the 50th percentile. Group 1 consisted of participants with a score of 25 points or less, and Group 2 consisted of participants with a score above 25 points. Waist circumference (72.0 (66–83), 65.0 (60–77)) was significantly higher in Group 1 (P &lt; 0.05). IES–2 score (3.05 (2.85–3.40), 3.30 (3.12–3.90)) and two sub–factors; reliance in hunger and satiety cues (2.80 (1.80–3.40), 4.00 (2.60–4.60)) and body–food choice congruence (2.50 (2.00–3.50), 3.50 (3.00–4.50)) were higher in Group 2 (P &lt; 0.05). After adjustment for body mass index, age, and energy intake, there was a significant positive correlation between IES-2 and HLD-TR scores (P = 0.029). In conclusion, it may be advantageous to resort to strategies that promote intuitive eating to reduce obesity and associated problems in this vulnerable group.

Association between modified youth healthy eating index and nutritional status among Iranian children in Zabol city: a cross-sectional study

Diet quality in childhood and adolescence can affect health outcomes such as physical and cognitive growth and preventing chronic diseases in adulthood. This study aimed to evaluate the relationship between diet quality using the modified youth healthy eating index (MYHEI) with socioeconomic factors and nutrition status in 7–12-year-old children in Iran. This descriptive-cross-sectional study was performed on 580 students in Zabol, Iran, selected through multistage cluster sampling. The diet was assessed through the 168-item food frequency questionnaire (FFQ) and eating behaviors. Then, the MYHEI scoring system was used to calculate the diet quality. In addition, we used the WHO growth indices, such as weight to age, height to age, and body mass index (BMI) to age ratios, to evaluate nutrition status. The mean total MYHEI score in children was 56.3 ± 11.2. Among children with the highest MYHEI score quartile, the number of girls was significantly higher than boys (p = 0.001). The prevalence of underweight, stunting, and wasting was 25.3%, 17.4%, and 21.7%, respectively. The prevalence of underweight (OR: 2.2; 95% CI 1.26, 3.90, p = 0.001) and stunting (OR: 3.2; 95% CI 1.65, 6.14, p = 0.006) were significantly lower in the higher MYHEI score quartile compared to the lower quartile. The overall diet quality of most children should be modified. Therefore, to improve the children’s health and nutrition status, it is necessary to perform nutritional interventions such as training and promotional programs, especially in schools.

Socioeconomic Characteristics and the Home Food Environment Are Associated With Feeding Healthful and Discretionary Foods During the First Year of Life in the Pregnancy Eating Attributes Study

BackgroundFeeding of nutrient-poor foods begins in infancy and may adversely influence long-term food preferences. ObjectiveTo examine associations of socioeconomic characteristics, childbearing parent eating behaviors, and home food environment with infant feeding characteristics. DesignSecondary analysis of a prospective cohort study from first trimester of pregnancy through 12 months postpartum. Participants/settingParticipants with uncomplicated singleton pregnancies and no major chronic illness were enrolled from November 2014 through October 2016 from 2 university-based obstetrics clinics in Chapel Hill, NC. Of 458 enrolled, 321 were retained through 12 months postpartum. Main outcome measuresParticipants completed infant food frequency questionnaires indicating age at introduction and frequency of consuming multiple food groups. Exposures included childbearing parent socioeconomic characteristics, hedonic hunger, addictive-like eating, Healthy Eating Index 2015 calculated from three 24-hour diet recalls, and home food environment fruit/vegetable and obesogenic scores. Statistical analyses performedMultiple imputation using Heckman selection model; linear and logistic regressions examining associations with infant feeding characteristics. ResultsLower education and income were associated with later infant age at introduction to, and lower frequency of consuming fruits and vegetables at age 12 months. Socioeconomic characteristics were not associated with age at introduction to discretionary solid foods; however, lower education and income were associated with greater infant frequency of intake of discretionary foods and greater odds of introducing fruit juice and sweetened beverages by age 12 months. Childbearing parent Healthy Eating Index 2015, hedonic hunger, and addictive-like eating were not consistently associated with infant feeding characteristics. A more obesogenic food environment was associated with greater frequency of intake of discretionary foods, lower frequency of intake of fruit, and greater odds of fruit juice introduction by age 12 months. ConclusionsInfant feeding characteristics may be important intervention targets for addressing socioeconomic disparities in child diet quality. Efforts to reduce routine feeding of discretionary foods across socioeconomic groups are needed; modifying the home food environment may promote healthful infant feeding.

The Longitudinal Relationship Between Diet Quality and Executive Functioning Development of Hispanic Preschoolers in Houston, Texas

BackgroundDiet quality has been found to be related to cognitive health in school-aged children. However, this relationship remains understudied among Hispanic preschool-aged children, who are vulnerable to poor dietary habits and low cognitive development due to socioeconomic, cultural, and structural disparities. ObjectiveThis longitudinal study evaluated whether the diet quality of preschool-aged children would be associated with executive functions (EFs) in later childhood. DesignThis is a secondary analysis of a longitudinal study of Hispanic preschool-aged children (age 4 and 5 years) at baseline (Time 1) and 18 months (Time 2). Participants and settingThis study included 185 mother-child dyads with complete data at Time 1, recruited through Head Start centers in Houston, TX, beginning in 2011. Main outcome measuresMothers reported on their child’s dietary intake via 3 24-hour recalls, which was used to calculate Healthy Eating Index (HEI)-2010 component and total scores. Laboratory tasks assessed cold EFs (tapping and Flexible Item Selection Tasks) and hot EFs (delay of gratification and gift-wrapping tasks). Whereas higher scores on tapping, Flexible Item Selection Task, and delay of gratification tasks represent a high EF, higher scores in gift-wrapping task represent a low EF. Statistical analyses performedHierarchical linear regression analyses assessed the relationship between diet quality, as measured by HEI-2010 total and component scores, at Time 1 (independent variables) and EF outcomes (dependent variables) at Time 2, controlling for child sex, age, body mass index z score, and EF at Time 1. ResultsHEI-2010 component score for fatty acids (b = –.13; P = .04) and seafood and plant proteins (b = .09; P = .05), were respectively related to later cold and hot EFs of Hispanic preschool-aged children. Other HEI components or the overall score did not predict EFs. ConclusionsThis study shows that specific HEI components support cold and hot EFs development among Hispanic preschool-aged children, but total HEI-2010 score does not. Experimental research is needed to assess the influence of dietary interventions on cognitive development of Hispanic preschool-aged children.

Evaluation of the Prime Diet Quality Score from Early Childhood Through Mid-Adolescence

BackgroundFew diet quality indices have been developed and validated for use among children and adolescents. Additionally, many available indices require completion of burdensome dietary assessments. ObjectivesWe aimed to calculate and evaluate the performance of a modified version of the food-based Prime Diet Quality Score (PDQS) derived from different diet assessment methods conducted at 4 time points in a single study population from childhood through adolescence. MethodsAmong 1460 child participants in the Project Viva cohort, we calculated the PDQS in early and mid-childhood and early and mid-adolescence using dietary data obtained from food frequency questionnaire (early childhood: parent report), PrimeScreen (mid-childhood: parent report; early adolescence: self-report) and 24-h recall (mid-adolescence: self-report). We evaluated construct and relative validity and internal reliability of the score in each life stage. ResultsThe PDQS showed a range of scores at all life stages and higher scores were associated with intake of many health-promoting macronutrients and micronutrients (e.g., protein, fiber, and vitamins) in early childhood and mid-adolescence. The PDQS performed similarly to the Youth Healthy Eating Index/Healthy Eating Index (Spearman r = 0.63–0.85) in various assessments. Higher PDQS was associated with expected characteristics including more frequent breakfast eating, family dinners, and vigorous physical activity; with less frequent TV viewing and fast food intake; and with more sleep and higher maternal diet scores during pregnancy. Cross-sectional associations of the PDQS with various anthropometric measurements and biomarkers were inconsistent but generally in the expected directions (e.g., higher PDQS associated with lower triglycerides and insulin and higher HDL cholesterol). Internal reliability was consistent with what has been found for other diet quality indices. ConclusionsThe PDQS can be calculated from data collected using different and brief dietary assessment methods and appears to be a valid and useful measure of overall diet quality in children and adolescents.Project Viva was registered at clinicaltrials.gov as NCT02820402.