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Title: Poor adherence to US Dietary Guidelines for children and adolescents in the National Health and Nutrition Examination Survey population

Author
item BANFIELD, EMILYN - MD ANDERSON CANCER CENTER
item LIU, YAN - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item DAVIS, JENNIFER - MD ANDERSON CANCER CENTER
item CHANG, SHINE - MD ANDERSON CANCER CENTER
item FRAZIER-WOOD, ALEXIS - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/4/2015
Publication Date: 1/1/2016
Citation: Banfield, E.C., Liu, Y., Davis, J.S., Chang, S., Frazier-Wood, A.C. 2016. Poor adherence to US Dietary Guidelines for children and adolescents in the National Health and Nutrition Examination Survey population. Journal of the Academy of Nutrition and Dietetics. 116(1):21-27.

Interpretive Summary: Poor diet quality in childhood and adolescence is associated with adverse health outcomes throughout life, and much effort is spent devising prevention and intervention program to improve dietary quality acorss this important time. The problem that the dietary habits of American children and how they change across childhood and adolescence are unknown, making it hard to tailor these interventions so that they are as effective as possible. Therefore, this study sought to describe diet quality among children and adolescents by assessing adherence to the 2010 Dietary Guidelines for Americans (DGA) and to determine whether any differences in adherence occurred across childhood. The study found that younger children had the highest overall diet quality due to a higher intake of total fruit, whole fruit, dairy, and whole grain compared to older children. Young children also ate less sodium, refined grains, and empty calories, which are parts of the diet considered to reflect a poor dietary quality. This study presented important data showing that children and adolescents are failing to meet the DGA and may be at an increased risk of chronic diseases throughout life. By showing that there are differences in dietary intakes of specific components of a healthy diet in different age groups, this study provides data that can inform the development of dietary interventions to promote specific food groups targeting specific ages and improve diet quality among children and adolescents.

Technical Abstract: Poor diet quality in childhood and adolescence is associated with adverse health outcomes throughout life, yet the dietary habits of American children and how they change across childhood and adolescence are unknown. This study sought to describe diet quality among children and adolescents by assessing adherence to the 2010 Dietary Guidelines for Americans (DGA) and to determine whether any differences in adherence occurred across childhood. We employed a cross-sectional design using data from the National Health and Nutrition Examination Survey (NHANES). Of 9,280 children aged 4 to 18 years who participated in NHANES from 2005 to 2010, those with insufficient data on dietary recall (n=852) or who were pregnant or lactating during the time of interview (n=38) were excluded from the final study sample (n=8,390). We measured adherence to the DGA using the Healthy Eating Index 2010 (HEI-2010) and stratified participants into three age groups (4 to 8, 9 to 13, and 14 to 18 years of age). We analyzed each of 12 HEI-2010 components and total HEI-2010 score. The youngest children had the highest overall diet quality due to significantly greater scores for total fruit, whole fruit, dairy, and whole grains. These children also had the highest scores for sodium, refined grains, and empty calories. Total HEI-2010 scores ranged from 43.59 to 52.11 out of 100, much lower than the minimum score of 80 that is thought to indicate a diet associated with good health. Overall, children and adolescents are failing to meet the DGA and may be at an increased risk of chronic diseases throughout life. By analyzing which food groups show differences between age groups, we provide data that can inform the development of dietary interventions to promote specific food groups targeting specific ages and improve diet quality among children and adolescents.