Mean Adequacy Ratio Scores Research Articles

Diet quality and snack preferences of Turkish adolescents in private and public schools.

Socioeconomic level is one of the important factors determining diet quality. Snack preferences are affected by socioeconomic level. The objective of this research was to determine the effect of socioeconomic levels on diet quality and snack preferences among adolescents from different socioeconomic backgrounds. The study involved 118 adolescents aged between 10-18 years residing in Istanbul. A questionnaire prepared by the researchers was used to obtain information on the adolescents' dietary habits, consumption of main meals and snacks, habits, and food consumption records. The participants' food consumption was assessed using the retrospective 24-hour recall method, and diet quality was evaluated using the calculated nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR). The mean age of the adolescents was 16.42±0.89 years. The number of snacks consumed in private schools was found to be higher than in public schools (p < 0.05). The NAR score for vitamin C consumption was significantly higher in private schools compared to public schools (p < 0.05). Although the MAR scores of adolescents in private schools were higher than those in public schools, this difference was not statistically significant. The majority of adolescents in private schools regularly consumed fresh fruit (67.2%), milk (60.3%), yogurt (60.3%), and nuts (56.9%) as snacks. In contrast, 45% of adolescents in public schools regularly consumed pastries (p < 0.05). It was observed that adolescents studying in public schools had a lower tendency to prefer healthy foods for snacks compared to those in private schools. Socioeconomic level was identified as an important factor influencing eating habits during adolescence. Considering that the level of income is significantly different between the adolescents studying at private and public schools, the higher consumption of snacks by the adolescents studying at private school may be associated with higher income.

Rise and shine for eating right: the link between healthy nutrition and chronotype among young adults.

Many studies have examined the relationship between chronotype and general health. Because healthy eating is the basis of health aim of this study is to evaluate the relationship between healthy nutrition attitudes and chronotype in young adults. Methods: This cross-sectional study was conducted with 1,400 young adults (936 females and 464 males). Chronotype was assessed by the Turkish version of the Morningness-Eveningness Questionnaire (MEQ) and the Attitude Scale for Healthy Nutrition (ASHN) was applied by face-to-face interview. Furthermore, 24-h dietary recall was collected. The scores of nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) were calculated. The anthropometric measurements including body weight and height were taken. The chronotype distribution of participants according to the MEQ score and MAR score were not significantly different between females and males (p > 0.05). The percentage of participants with high healthy eating attitude was lowest in the evening chronotype and highest in the morning chronotype (49.7, 37.7 and 25.4% in morning-, intermediate-, evening-types, respectively; p = 0.000 for all groups according to the reciprocal comparisons). There was a positive correlation of the MEQ scores with the scores of ASHN (r = 0.282, p < 0.01). ASHN score was shown to be a predictor for MEQ score (β = 0.280, p = 0.000). Moreover, the score of "poor eating habits" was shown to be highest in the evening chronotype and lowest in the morning chronotype (14.9 ± 3.0 and 13.1 ± 3.0, respectively; p < 0.01). The results of this study indicate that individuals with the evening chronotype are more deficient in terms of healthy nutrition attitudes. Further studies with larger populations will potentially guide the development of health promotion strategies to prevent and treat chronic diseases based on an individual's chronotype.

Diet Quality Trajectories over Adulthood in a Biracial Urban Sample from the Healthy Aging in Neighborhoods of Diversity across the Life Span Study.

Limited investigation has been done on diet quality trajectories over adulthood. The main study objectives were to determine the diet quality group trajectories (GTs) over time and to detect changes in a socio-economically and racially diverse middle-aged cohort. Data from three waves of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used to determine diet quality with group-based trajectory modeling (GBTM). Three quality indices-the Healthy Eating Index (HEI), the Dietary Inflammatory Index (DII), and the Mean Adequacy Ratio (MAR)-were explored. The rate of change in quality over time was determined by mixed-effects regression analysis. Three diet quality GTs, low, middle, and high quality, were identified for each index and confirmed with spaghetti plots. Within each GT, only small changes in diet quality scores were observed, with improvements for the HEI and DII indices and a slight decline in MAR scores. Weighted kappa values revealed that the DII had better agreement with the HEI-2010 and MAR indices compared with the agreement between the HEI-2010 and MAR. Bayesian estimates revealed that the annualized rate of change in diet quality per person across the GTs was similar. There was minimal change in diet quality over time, regardless of the diet quality index used.

Determining the relationship of diet quality with weight change, body mass index, and depression in women who had undergone sleeve gastrectomy: A cross-sectional descriptive study

Introduction: This study aims to determine the relationship of diet quality in women with weight change, body mass index (BMI), and depression one year after undergoing sleeve gastrectomy. Material and methods: This is a cross-sectional descriptive study with 62 women aged 18–65 years who underwent sleeve gastrectomy in a private hospital and completed their first postoperative year. The participants were asked to fill a questionnaire on 3-day food consumption record, sociodemographic characteristics, and nutritional status; Beck depression inventory (BDI) was applied. Mean adequacy ratio (MAR) was used to evaluate diet quality. Results:The mean age was 33.6 ± 9.5 years. The mean MAR score was 76.0 ± 31.8, and the mean BDI score was 8.2 ± 6.4. The excess weight loss rate was high in patients with good diet quality, and the BMI and depression scores were low (PEWL, BMI > 0.05, PBeck < 0.001). Diet quality was found to be negatively correlated with body weight, BMI and depression scores and positively correlated with excess weight loss. Conclusions: Enhancing the diet quality can help patients in overcoming postoperative depression and increasing the success of weight loss. Regular follow-up and guidance provided to the patients by specialized dietitians can further augment the success rates.

Nutrient Intake and Deficiency of Patients 1 Year After Bariatric Surgery: Tehran Obesity Treatment Study (TOTS)

PurposeThis study aimed at assessing nutrient adequacy after 1 year in patients who had undergone gastric bypass (GB) surgery or sleeve gastrectomy (SG) and to investigate the association of nutrient adequacy with anthropometric indices. MethodsA total of 180 severely obese patients (BMI ≥ 35 kg/m2) were selected among the participants of Tehran Obesity Treatment Study. Nutritional assessments were performed over 3 days of 24-h dietary recall. To evaluate the nutrient adequacy ratio (NAR), the subject’s nutrient intake was divided by the dietary reference intakes. The mean adequacy ratio (MAR) was also determined as the sum of NARs divided by the number of involved nutrients (n = 11). ResultsThe mean age of SG (67%) and GB (32%) patients was 39.2 ± 12 and 41.4 ± 10 years, respectively. SG patients had more postoperative fat-free mass (52.0 ± 12 kg) than GB patients (49.7 ± 8 kg) (P < 0.05). The most common postoperative serum nutrient deficiencies were related to vitamin B12 (30%), ferritin (19%), and 25-hydroxyvitamin D (16.2%). Moreover, high inadequacy of protein (> 80%) and total fat (> 70%) intake was reported. The MAR score showed that almost 45% of the patients had possibly adequate intakes of some nutrients. The adequacy of nutrients was positively associated with fat-free mass (β = 8.67, P < 0.05). ConclusionThese findings revealed that patients had inadequate nutrient intakes 1 year after bariatric surgery, which was accompanied by serum nutritional deficiencies. Compared to GB patients, SG patients had a better body composition. Overall, compliance of patients with dietary guidelines and supplementations needs to be carefully monitored in the postoperative period.

Sarcopenia in relation to nutrition and lifestyle factors among middle-aged and older Korean adults with obesity.

To examine the prevalence of sarcopenic obesity (SO) and its association with nutrition and lifestyle factors. Data from the 2008-2011 Korea National Health and Nutrition Examination Survey for 3937 Korean individuals aged 40years or older with obesity defined by the modified Asia-Pacific criteria (BMI ≥ 25kg/m2) were used. Sarcopenia was defined as an appendicular skeletal muscle mass divided by weight (%) of < 1 SD below the sex-specific mean for young adults. Logistic regression models were used for the associations controlling covariates. The prevalence of SO was 52.5%. The SO group had insufficient energy intake, protein, and antioxidant micronutrients, a lower overall dietary quality, a lower physical activity, and higher rates of negative psychological factors than the non-sarcopenic obesity group (p < 0.05). After controlling for covariates, having high mean adequacy ratio scores which was calculated by averaging the sum of the nutrient adequacy ratios had a 94% lower prevalence of SO in the older individuals. Low participation in aerobic exercises had a 74% higher prevalence of SO in the older aged group, and high participation in flexibility exercises had a 11% lower prevalence of SO in the middle-aged group. Interestingly, negative psychological factors were found only in the middle-aged adults with SO (p < 0.05). Sarcopenia was present in over half of the middle-aged and older Korean adults with obesity. Having high dietary quality, increased physical activity, and positive psychological health were associated with a low prevalence of SO.

Diet quality is associated with malnutrition and low calf circumference in Canadian long-term care residents

BackgroundOlder adults living in long-term care (LTC) are nutritionally vulnerable. The purpose of this study was to determine diet quality of Canadian LTC residents and its association with malnutrition and low calf circumference.MethodsA cross-sectional study was undertaken in 32 LTC homes across four Canadian provinces. Nutrient adequacy ratios (NARs) were calculated for seventeen nutrients; mean adequacy ratio (MAR) was calculated to describe overall diet quality. Malnutrition risk was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF) and diagnosis of protein/energy malnutrition with the Patient-Generated Subjective Global Assessment (PG-SGA). Calf circumference (CC) was also assessed. Linear and logistic regressions for these outcomes with diet quality as the predictor were conducted adjusting for covariates.ResultsAverage MNA-SF score was 10.7 ± 2.5. Residents (43.5%) had mild/moderate to severe malnutrition based on the PG-SGA and 32.6% had a CC of < 31 cm. Mean MAR score was 0.79 ± 0.09 with significant differences between those requiring eating assistance (0.77 ± 0.11) and those that did not require assistance (0.80 ± 0.07) (p < .05). MAR score was significantly associated with malnutrition in fully adjusted models: MNA-SF scores [β = 5.34, 95% Confidence interval (CI) (2.81, 7.85)] and PG-SGA [Odds ratio (OR) = 0.49, 95% CI (0.38, 0.64)]. Those who had better diet quality were more likely to be well nourished or not at risk. Although several individual nutrients were associated with low CC (< 31 cm), there was no association between overall diet quality (MAR) and low CC.ConclusionsDiet quality is associated with malnutrition and individual nutrients (NARs) with a low CC. In addition to calories and protein, nutrient dense diets that promote adequate micronutrient intake are required in LTC.

A Longitudinal Assessment of Diet Quality and Risks Associated with Malnutrition in Socioeconomic and Racially Diverse Adults.

Little is known about the effects of diet quality through adulthood and its association with malnutrition later in life. The first research objective was to evaluate diet quality assessed by Mean Adequacy Ratio (MAR) of United States African American and White adults (n = 2066), examined at baseline and two follow-up waves in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. The sample was split into cohorts by age at study baseline: Younger, <50, and older, ≥50 years. The second objective was to assess the association of MAR and risk for malnutrition in adults who were ≥60 years at wave 4 (n = 746). The Mini Nutritional Assessment was used to determine risk for malnutrition. At each of the three study waves, 17 micronutrients from two 24 h dietary recalls were used to calculate MAR. Over 13 years MAR changed minimally in the younger cohort as they aged from early to middle adulthood. In contrast, a statistically significant decline in MAR was observed for the older cohort between baseline (2004–2009) and wave 4 (2013–2017), with a greater degree of worsening at low energy levels. The risk for malnutrition was significantly associated with consuming a diet low in energy, lower protein as a percent of energy at baseline, as well as being food insecure, a current smoker, and having income <125% poverty. The risk for malnutrition was not associated with a change in protein intake in years prior to age 60, change in MAR scores across waves, MAR at wave 4, age, sex, race, or having hypertension or diabetes. These longitudinal study findings revealed that diet quality was not predictive of risk for malnutrition.

Use of Dietary Supplements Improved Diet Quality But Not Cardiovascular and Nutritional Biomarkers in Socioeconomically Diverse African American and White Adults

ABSTRACTKnowledge of the contribution of supplements to overall nutritional health is limited. The research objectives were to describe motivations for use of dietary supplements by African Americans and Whites examined in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study and to determine if supplements provided beneficial effects to micronutrient diet quality and nutritional and cardiovascular biomarkers. The majority of the HANDLS study population were smokers, overweight or obese, and self-reported their health as poor to good. The top two reasons for their supplement use were to supplement the diet and to improve overall health. Micronutrient intake was calculated from two 24-hour recalls and a supplement questionnaire. Diet quality was assessed by the Mean Adequacy Ratio (MAR) [Maximum score = 100] derived from the Nutrient Adequacy Ratio (NAR) for 17 micronutrients. The MAR score for nonusers was 73.12, for supplement users based on diet alone was 74.89, and for food and supplements was 86.61. Dietary supplements significantly increased each NAR score and MAR score. However, there were no significant differences between the population proportions with inadequate or excessive blood levels for any biomarkers examined. Nutrition education programs and intervention strategies addressing dietary supplement intake might lead to healthier food choices and may improve the health of this population.

Monetary Value of Diet Is Associated with Dietary Quality and Nutrient Adequacy among Urban Adults, Differentially by Sex, Race and Poverty Status.

ObjectiveThe association between monetary value of the diet (MVD, $/day) with dietary quality was examined using a large sample of urban US adults, differentially by socio-demographic factors.MethodsThis was a cross-sectional study of 2,111 participants, aged 30–64y, using data from the Healthy Aging in Neighborhoods of Diversity across the Life Span Study. Dietary quality indices included Healthy Eating Index–2010 (HEI–2010) and Mean Adequacy Ratio (MAR), (two 24-hr recalls). A national food price database was used to estimate MVD. Multiple linear/logistic regression analyses were conducted stratifying separately by sex, race and poverty status.ResultsWomen had significantly higher HEI-2010 scores than men (43.35 vs 41.57 out of 100, respectively), whereas MAR scores were higher for men (76.8 vs 69.9, out of 100), reflecting energy intake gender differentials. Importantly, a $3/day higher MVD (IQR: $3.70/d (Q1) to $6.62/d (Q4)) was associated with a 4.98±0.35 higher total HEI-2010 and a 3.88±0.37 higher MAR score, after energy-adjustment and control for key confounders. For HEI-2010 and MAR, stronger associations were observed among participants above poverty and among women, whilethe MVD vs. HEI-2010 association was additionally stronger among Whites. Sex and poverty status differentials were observed for many MAR and some HEI-2010 components.ConclusionsDespite positive associations between measures of dietary quality and MVD, particularly above poverty and among women, approaching compliance with the Dietary Guidelines (80 or more for HEI-2010) requires a substantially higher MVD. Thus, nutrition education may further improve people’s decision-making regarding food venues and dietary choices.

Does diet cost mediate the relation between socioeconomic position and diet quality?

Background/ObjectivesSocioeconomic disparities in diet quality are well established. This study tested the hypothesis that such disparities are mediated, in part, by diet cost.Subjects/MethodsThe Seattle Obesity Study (S.O.S.) was a cross sectional study based on a representative sample of 1266 adults of King County, WA conducted in 2008–09. Demographic and socioeconomic variables were obtained through telephone survey. Income and education were used as indicators of socioeconomic position (SEP). Dietary intake data were obtained using a food frequency questionnaire (FFQ). Diet cost was calculated based on retail prices for FFQ component foods. Energy density (KJ/g) and Mean Adequacy Ratio (MAR) were used as two indices of overall diet quality.ResultsHigher income and education were each associated with lower energy density and higher MAR scores, adjusting for covariates. Higher income and education were also associated with higher energy adjusted diet cost. Higher quality diets were in turn associated with higher diet costs. All these associations were significant (P<0.0001). In formal mediation analyses, diet cost significantly mediated the pathway between income and diet quality measures, adjusting for covariates (p <0.05 each). Further, income – diet cost – diet quality pathway was found to be moderated by education level.ConclusionsThe social gradient in diet quality may be explained by diet cost. Strategies to improve diet quality among lower socioeconomic strata may need to take food prices and diet cost along with nutrition education into account.

Patterns of Family Meals and Food and Nutrition Intake in Limited Resource Families

It was anticipated that the frequency of family meals would positively influence the food group intake patterns of limited resource families with children. The sample consisted of new enrollees (N = 108) in the Nebraska Nutrition Education Program. The data included demographic information, 24-hour food recalls, family mealtime patterns, and a food group frequency questionnaire. One of the measures was the Mean Adequacy Ratio (MAR), which compares the intake of individual nutrients to the Dietary Reference Intake. The 24-hour recalls showed that only 27.8% of the primary caregivers had a MAR < 75, which is considered to be adequate. For the total group of caregivers, the mean MAR score was 61. Chi-square tests revealed the following significant relationships between frequency of family meals and food consumption by the oldest school-aged child: increased frequency of family breakfast and the milk group; increased frequency of both family breakfast and lunch and 100% fruit juice; and increased frequency of family breakfast and fruit.

Effect of Race and Predictors of Socioeconomic Status on Diet Quality in the HANDLS Study Sample

PurposeTo examine effects of race and predictors of socioeconomic status (SES) on nutrient-based diet quality and their contribution to health disparities in an urban population of low SES. DesignData were analyzed from a sample of the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Study participants examining effects of age, sex, race, income, poverty income ratio, education, employment, and smoking status on nutrient-based diet quality as measured by a micronutrient composite index of nutrient adequacy ratios and a mean adequacy ratio. Regression models were used to examine associations and t tests were used to look at racial differences. SubjectsAfrican American and white adults ages 30 to 64 years residing in 12 predefined census tracts in Baltimore, Maryland. ResultsSex, age, education, poverty income ratio, and income were statistically significant predictors of diet quality for African Americans, while sex, education, and smoking status were statistically significant for whites. African Americans had lower mean adequacy ratio scores than whites (76.4 vs 79.1). Whites had significantly higher nutrient adequacy ratios scores for thiamin, riboflavin, folate, B12, vitamins A and E, magnesium, copper, zinc, and calcium, while African Americans had higher vitamin C scores. ConclusionEducation significantly impacted diet quality in the HANDLS sample, but race cannot be discounted. Whether the racial differences in diet quality are indicative of cultural differences in food preferences, selection, preparation, and availability, or disparities in socioeconomic status remains unclear.

Do Breakfast Skipping and Breakfast Type Affect Energy Intake, Nutrient Intake, Nutrient Adequacy, and Diet Quality in Young Adults? NHANES 1999–2002

Objective: To assess the impact of breakfast skipping and type of breakfast consumed on energy/nutrient intake, nutrient adequacy, and diet quality.Design: Cross-sectional.Setting: The National Health and Nutrition Examination Survey (NHANES), 1999–2002.Subjects: Young adults (20–39 years, n = 2615).Measures: A 24-hour dietary recall was used, with breakfast defined as self-reported. Covariate-adjusted sample-weighted means for the entire day's energy/nutrient intakes, mean adequacy ratio (MAR) for nutrient intakes, and diet quality (i.e., Healthy Eating Index [HEI]-2005) scores were compared using analysis of variance and Bonferroni's correction (p < 0.0167) among breakfast skippers (BS), ready-to-eat-cereal breakfast consumers (RTECC), and other breakfast consumers (OBC). Energy/nutrient intakes and food consumption at breakfast were also compared (p ≤ 0.05).Results: Twenty-five percent of young adults were BS, 16.5% were RTECC, and 58.4% were OBC. Intakes of total energy, percent energy from carbohydrate, and dietary fiber were higher in RTECC than in BS and OBC. Percent energy intake from added sugars was higher in BS than in RTECC and OBC. Compared with BS and RTECC, OBC consumed a lower percent energy from carbohydrates and total sugars, but consumed a higher percent energy from total fat and discretionary solid fats and had a higher cholesterol intake. Intakes of several micronutrients were higher in RTECC than in BS and OBC. Both MAR and total HEI scores were the highest in RTECC and higher in OBC than in BS. The HEI scores for intakes of whole fruits, total/whole grains, milk, and percent energy from solid fat/alcohol/added sugar were the highest in RTECC and higher in OBC than in BS. Compared with OBC, RTECC had a higher HEI score for the intake of saturated fat. At breakfast, RTECC consumed higher intakes of total fruits, whole grains, dairy products, carbohydrates and total sugars, dietary fiber, and several micronutrients than OBC, who consumed higher intakes of meat/poultry/fish, eggs, total fat, discretionary oils/solid fats, cholesterol, and sodium than RTECC.Conclusion: Thus, RTECC had more favorable nutrient intakes and better diet quality than BS and OBC.

The impact of dairy product consumption on nutrient adequacy and weight of Head Start mothers

To assess the relationship of dairy product consumption on diet quality and weight of low-income women. Head Start centres in Texas and Alabama, USA. Cross-sectional study. Women were divided into dairy consumption groups: < or =1, >1 to < or =2 and >2 servings/d. Nutrient intake/diet quality was determined by calculating the percentage meeting the Estimated Average Requirement, guidelines for fat and added sugar, and Mean Adequacy Ratio (MAR). Mean BMI was compared for the dairy consumption groups. Mothers with children in Head Start; 609 African-Americans (43 %), Hispanic-Americans (32 %) and European-Americans (24 %). Fifteen per cent of participants consumed >2 servings of dairy products and 57 % consumed < or =1 serving of dairy daily. Intakes of protein, vitamin D, riboflavin, P, Ca, K, Mg and Zn were significantly higher in those consuming >2 servings/d. Total SFA were higher and added sugars were lower in those consuming >2 servings of dairy products daily compared with those consuming < or =2 servings/d. Forty-one per cent of women consuming >2 servings of dairy daily had MAR scores under 85 compared with 94 % consuming < or =1 serving/d. Mean BMI was 30.36 kg/m2; there was no association between BMI and dairy product consumption. Consumption of dairy products was low and was not associated with BMI in this low-income population. Higher levels of dairy product consumption were associated with higher MAR scores and improved intakes of Ca, K and Mg, which have been identified as shortfall nutrients in the diets of adults.

Diet Quality Varies by Race/Ethnicity of Head Start Mothers

Background Despite the key role that women from limited income families play as family food providers and their high risk for diet-related chronic diseases, there is a paucity of data about their diet quality and how it might vary by race/ethnicity. Objective To compare nutrient and food intakes of multiethnic mothers with children in Head Start from Texas and Alabama. Design Cross-sectional, secondary data analysis. Methods The sample was 603 mothers, 33% Hispanic American from Texas; 19% African American from Texas; 24% African American from Alabama; and 24% white from Alabama who were interviewed from fall 2004 to spring 2005. Diet quality was evaluated by averaging 24-hour dietary recalls from 3 nonconsecutive days and calculating the percent meeting the Estimated Average Requirement, the Dietary Guidelines for fat and added sugar, and the mean adequacy ratio for eight nutrients. For multiple comparisons, the least square means statement was used for general linear model procedures, adjusted for age, body mass index, and energy intake. Results The average mean adequacy ratio scores for diet quality were low overall, but 44% of Hispanic Americans had mean adequacy ratio scores <85, whereas 96% to 97% of other groups did. Most mothers exceeded 35% of energy from fat, with Hispanic Americans having the lowest percentage. Overall, 15% of mothers exceeded 25% of energy from added sugars, with Hispanic Americans having 5% with excess intakes. Energy intakes were highest for Hispanic Americans (2,017 kcal) and lowest for African Americans (1,340 kcal). The Hispanic Americans surveyed averaged 4.6 c fruit and vegetables per day compared to 3.2, 2.3, and 2.9 c/day among African Americans from Texas, African Americans from Alabama, and whites from Alabama, respectively. Conclusions Despite limited food resources, Hispanic-American mothers consumed adequate amounts of fruit and vegetables. There was considerable variation in diet quality among race/ethnic groups on a low income budget.

Predictors of Nutritional Adequacy in Mother–Toddler Dyads from Rural Families with Limited Incomes

Objective To predict the mean adequacy ratio (MAR) scores of mothers and toddlers from intakes of fruits, vegetables, and dairy group foods and being seated during mealtimes. Design/subjects This was a regression analysis of cross-sectional data of the diet quality and being seated during mealtimes of 100 rural mother–toddler dyads from limited-income families using two 24-hour dietary recalls. Children were 11 to 25 months of age and at or below 100% of the poverty index. Measures of outcome Dietary quality for mothers and toddlers was assessed using a MAR score for eight different nutrients (vitamin A, vitamin C, vitamin D, folate, calcium, zinc, iron, and magnesium), and a score of 85 or above was considered nutritionally adequate. The main food groups of interest were servings from the fruits, vegetables, and dairy group foods. Mealtime sitting behavior was the percentage of times the toddler remained seated while eating. Results Servings of fruits, vegetables, and dairy foods predicted 0.62 of the variance in the mother’s MAR score, whereas vegetable and dairy intakes along with being seated while eating indicated nutritional adequacy for toddlers. Mothers with low MAR scores were most likely to have toddlers with poor diets, although few toddlers had poor diet quality. Conclusions Adequate intakes of dairy, vegetables, and whole fruits along with being seated while eating could be quick assessment tools to screen toddlers for nutritional risk. Mothers with poor diet quality were likely to have toddlers with poor diets; low intakes of fruits, vegetables, and dairy foods were markers for poor diet quality in mothers.

A comparison of food group variety between toddlers with and without cystic fibrosis

To compare the food group variety and nutritional adequacy of the diet between toddlers with cystic fibrosis (CF) and age-matched controls. Subjects A clinical sample of 22 toddlers with CF (mean age=21.3 +/- 7.2 months) matched to a community sample of 22 healthy peers. The variety index for toddlers (VIT) and the mean adequacy ratio (MAR). Fruit group scores were highest for children with CF (0.95 +/- 0.13; possible range 0.00-1.00), and dairy group scores were highest for controls (0.90 +/- 0.18). All children earned the lowest scores for vegetables (CF: 0.15 +/- 0.12; controls: 0.26 +/- 0.22). No significant differences were found when comparing VIT and MAR scores by sample (P >0.05). A moderate positive relationship was found between total VIT scores and MAR scores for all children (r=0.38, P <0.05). Toddlers with CF did not achieve the 120-150% of Recommended Dietary Allowance (RDA) for energy. Toddlers with CF are consuming diets that are varied and nutritionally adequate for a healthy child. To optimize nutritional status and growth, current recommendations for toddlers with CF to eat a well-balanced diet and to exceed daily RDA for energy requirements remain key dietary issues.

A Food Variety Index for Toddlers (VIT): Development and Application

Objective To develop a variety index based on the Food Guide Pyramid that is specific to toddlers and is indicative of dietary adequacy. Design Subjects’ mothers were assigned randomly to two in-home interviews with a registered dietitian at four possible collection periods: 24, 28, 32, or 36 months. Three days of dietary information were collected at each period. A Variety Index for Toddlers (VIT) was developed to assess variety within and among food groups based on the number of servings from the food groups in the Food Guide Pyramid. Subjects White children aged 24 to 36 months (n=124) and their mothers who were participants in an ongoing longitudinal study. Statistical analyses Descriptive statistical procedures were performed on VIT scores. Mean adequacy ratio (MAR) scores were calculated for all subjects and compared with VIT scores. Results Bread group scores were consistently the highest of the individual food groups (mean score=0.94 to 0.96 on the 0.0 to 1.0 scale); the vegetable and meat groups were generally the lowest (mean score=0.68 to 0.73 and 0.73 to 0.76, respectively). Mean VIT scores (an average of the five food group scores) over the four collection periods ranged from 0.79±0.14 to 0.81±0.15; a score of 1.00 represented intake of at least the minimum number of recommended servings from each food group. VIT scores were strongly correlated to the MAR score of nutrient adequacy ( r=+.74, P<.01). Applications The VIT can provide a numeric description of dietary variety specific to toddlers. VIT scores can be compared with other characteristics of children, and this index has the potential to be adapted for use with other age groups and populations. J Am Diet Assoc. 1997;97: 1382-1386.

Dietary Quality in Girls Who Report Dieting

LEARNING OUTCOME: To determine whether dieting and weight concerns influence nutrient intake in females 8–17 years of age. A cross-section of young females (n=230) 8–17 years of age from a rural community in Nebraska were surveyed to determine whether dieting and weight behaviors impacts nutrient intake. Research has indicated that dieting behaviors emerge during these years. A previously validated 13-item questionnaire was used to assess frequency of thoughts and practices which involve weight and dieting concerns. Three day diet diaries were analyzed for nutrients and compared with the Recommended Dietary Allowances (RDA) using Food Processor Plus II software. Using the diet record, a Mean Adequacy Ratio (MAR) score was determined, based on the intake of 9 nutrients divided by the RDA for the nutrient. These values are then totaled and divided by the number of nutrients studied. Results indicated that 78% of all the girls who answered they “sometimes” or “very often” wished they were thinner, had significantly lower MAR scores (P = 0.0001) then those girls who did not wish they were thinner. Dieting “sometimes” or “very often” was reported by 47% of all girls and they were found to have significantly lower MAR scores (P = 0.0002) than those who did not diet. MAR scores for all girls reporting dieting was 76.4 ± 12.9%. Nutrient inadequacies included: calcium, iron, zinc, vitamin A, and vitamin C. When analysis of variance was completed on groups by age (8–10, 11–14, and 15–17 yrs) significantly lower MAR scores were only associated with both the desire to be thinner (P=0.04) and reported dieting (P=0.0001) in the 11–14 yr olds. From this study, we conclude there is an association between dieting and weight concerns, and dietary intake in girls 11–14 yrs. This study also suggests that some girls are not meeting minimal nutritional needs which may have a cumulative negative effect on growth and development.