Diet quality in a nationally representative sample of American children by sociodemographic characteristics

Authors: Thomson, Jessica; TUSSING-HUMPHREYS, LISA - University Of Illinois; Goodman, Melissa; LANDRY, ALICIA - University Of Central Arkansas

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/19/2018
Publication Date: 2/5/2019
Publication URL: https://handle.nal.usda.gov/10113/6471057
Citation: Thomson, J.L., Tussing-Humphreys, L.M., Goodman, M.H., Landry, A.S. 2019. Diet quality in a nationally representative sample of American children by sociodemographic characteristics. American Journal of Clinical Nutrition. 109/127-138. https://doi.org/10.1093/ajcn/nqy284.
DOI: https://doi.org/10.1093/ajcn/nqy284

Interpretive Summary: Proper nutrition is vitally important for health and quality of life. Hence it is essential that the nutritional status of the nation’s various populations is reported on a timely basis. Tracking the diets of children may be of particular importance not only because of developmental issues, but also because of adverse conditions associated with improper dietary intake, such as prediabetes. Therefore, the purpose of this research was to use the most recent version of an index that aligns with the Dietary Guidelines for Americans to describe the diet quality of American children overall and within various sociodemographic populations. Data from What We Eat in America, the dietary component of the National Health and Nutrition Examination Survey (2009-2014) were used to calculate total and component diet quality scores for children 2-18 years of age. Diet quality scores were computed overall and by age group (2-5, 6-11, and 12-18 years), gender, race/ethnicity, and family poverty to income ratio (below and at/above poverty threshold). The total diet quality score for children overall was 54.9 (on a scale of 0-100). As age group increased diet quality decreased; the total score was significantly higher for children in the youngest versus the two older age groups (60.1 vs. 53.9 vs. 52.0). Diet quality was significantly lower for non-Hispanic black children versus Mexican American children, other Hispanic children, and children of other races (52.6 vs. 57.0, 56.8, and 57.1). Diet quality also was significantly lower for non-Hispanic white children versus Mexican American children (54.2 vs. 57.0). No differences in diet quality were apparent between boys and girls nor between poverty threshold classes. Diet quality for cross-classified sociodemographic characteristics generally followed the same patterns observed for single characteristics with the most notable differences occurring within age and race/ethnicity classes. The diet quality of American children remains low overall with continued disparities across some sociodemographic populations, notably age and race/ethnicity. Diet quality estimates reported in this paper can be used by researchers, practitioners and other stakeholders to guide intervention efforts, practices, and policy settings for child nutrition/dietary intake.

Technical Abstract: Background: To date, Healthy Eating Index 2015 (HEI-2015) scores have not been published in the peer-reviewed literature for nationally representative samples of American children. Objective: The aim of this study was to use the HEI-2015 to describe the diet quality of American children overall and within various sociodemographic populations. Methods: We used 3 cycles of NHANES dietary data sets (2009-2010, 2011-2012, and 2013-2014) to calculate HEI-2015 total and component scores by use of the population ratio method for children 2-18 y (n = 9000). Diet-quality scores were computed overall and by age (2-5, 6-11, and 12-18 y), gender, race or ethnicity (non-Hispanic black, non-Hispanic white, Mexican American, other Hispanic, and other race), and family poverty-to-income ratio (below or at or above the poverty threshold). HEI-2015 mean total and component scores were computed along with 95% CIs. Results: The HEI-2015 total mean score for children overall was 54.9 (range: 0-100). As the age group increased, the total scores decreased; the total mean score was significantly higher for children in the youngest age group compared with the 2 older age groups (60.1 compared with 53.9 compared with 52.0, respectively). The total mean score was significantly lower for non-Hispanic black children compared with Mexican American children, other Hispanic children, and children of other races (52.6 compared with 57.0, 56.8, and 57.1, respectively). The total mean score was significantly lower for non-Hispanic white children compared with Mexican American children (54.2 compared with 57.0). No differences in total mean scores were apparent between boys and girls or between poverty threshold classes. The total mean scores for cross-classified sociodemographic characteristics generally followed the same patterns observed for single characteristics, with notable differences occurring within age and race or ethnicity classes. Conclusions: The diet quality of American children remains low overall, with continued disparities across some sociodemographic populations, notably age and race or ethnicity. The results of these analyses can help guide the efforts of child nutrition researchers, practitioners and other stakeholders.