Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
University of Cincinnati College of Medicine, Cincinnati, OH.
J Acad Nutr Diet. 2021 Jul;121(7):1273-1283. doi: 10.1016/j.jand.2020.08.084. Epub 2020 Oct 24.
There is little information about how diet quality evolves in early childhood, whether children exhibit varying diet quality trajectories, or which components of diet quality should be targeted for intervention.
The goal of this study was to identify and evaluate trajectories of dietary quality in young children.
This was a secondary analysis of an observational, longitudinal cohort study of non-Hispanic African American or White children and their parents from racially concordant households with 4 years of follow-up (up to 13 study visits). Data on mother, infant feeding, and body mass index were assessed at baseline. Diet was evaluated using 3-day diaries at each visit.
PARTICIPANTS/SETTING: Of 372 children enrolled, 349 children had at least 3 study visits with dietary data for this analysis. Participants were enrolled at age 3 years between March 2001 and August 2002 in Cincinnati, OH. Final study visits were conducted between February 2005 and June 2006.
The main outcome measure was the total Healthy Eating Index 2005 (HEI-2005) score and HEI-2005 component scores.
Diet quality trajectories were modeled using group-based modeling techniques.
The total HEI-2005 score was low at age 3 years (mean ± standard error = 55.1 ± 0.4 of maximum 100 points) and remained stable to age 7 years (mean ± standard error = 54.0 ± 0.6; P = 0.08 for trend). Five HEI-2005 trajectory groups were identified, of which 1 declined and 1 improved over time. HEI-2005 component scores, except milk intake and meat/beans scores, differed significantly (all, P ≤ 0.02) among trajectory groups at age 3 years, and most differences were maintained at age 7 years. Total vegetables, dark green and orange vegetables and legumes, and whole grains component scores were low for all trajectory groups. Whole fruit; total fruit; saturated fat; and calories from solid fats, alcoholic beverages, and added sugars (SoFAAS) were highly variable among trajectory groups. Children in the lowest diet quality trajectory group were less likely to be breastfed and more likely to have been regular consumers of soft drinks (e.g., powdered drink mixes, sport drinks, or soda pop) before age 3 years.
Young childhood diet quality was low at age 3 years and remained stable to age 7 years. Improving intake of vegetables and whole grains is needed for all children. Focused attention regarding increasing fruit intake and reducing SoFAAS may be needed for families at increased risk for low overall diet quality.
关于儿童早期饮食质量的变化情况、儿童是否表现出不同的饮食质量轨迹，以及应该针对哪些饮食质量成分进行干预，目前相关信息有限。
本研究旨在确定并评估幼儿饮食质量的轨迹。
这是一项针对非西班牙裔非洲裔美国或白人儿童及其父母的观察性、纵向队列研究的二次分析，研究对象来自种族一致的家庭，随访时间为 4 年（最多 13 次研究访问）。在基线时评估母亲、婴儿喂养和体重指数的数据。每次访问时使用 3 天的饮食日记来评估饮食情况。
参与者/设置：在 372 名入组的儿童中，有 349 名儿童至少有 3 次研究访问并提供了可用于本分析的饮食数据。参与者于 2001 年 3 月至 2002 年 8 月期间在俄亥俄州辛辛那提市入组，最后一次研究访问于 2005 年 2 月至 2006 年 6 月进行。
主要结局指标是总健康饮食指数 2005（HEI-2005）评分和 HEI-2005 成分评分。
使用基于群组的建模技术对饮食质量轨迹进行建模。
3 岁时的总 HEI-2005 评分较低（平均±标准误差=55.1±0.4 分，最高 100 分），到 7 岁时保持稳定（平均±标准误差=54.0±0.6 分；P=0.08 趋势）。确定了 5 个 HEI-2005 轨迹组，其中 1 个组随时间下降，1 个组随时间改善。3 岁时，除了牛奶摄入量和肉类/豆类评分外，HEI-2005 成分评分在所有轨迹组之间差异显著（均 P≤0.02），大多数差异在 7 岁时仍保持不变。所有轨迹组的总蔬菜、深绿色和橙色蔬菜和豆类以及全谷物成分评分均较低。全水果；总水果；饱和脂肪；以及来自固体脂肪、含酒精饮料和添加糖（SoFAAS）的卡路里的摄入量在轨迹组之间差异很大。处于最低饮食质量轨迹组的儿童母乳喂养的可能性较低，并且在 3 岁之前更有可能经常饮用软饮料（例如，粉末饮料混合剂、运动饮料或苏打水）。
3 岁时幼儿饮食质量较低，到 7 岁时保持稳定。所有儿童都需要增加蔬菜和全谷物的摄入量。对于整体饮食质量较高风险的家庭，可能需要更加关注增加水果摄入量和减少 SoFAAS。
