Department of Pediatrics, Duke University, Durham, NC, USA.
Department of Nutrition, Gillings School of Global Public Health and Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.
J Nutr. 2023 Jan;153(1):215-224. doi: 10.1016/j.tjnut.2022.11.016. Epub 2022 Dec 21.
Accurate assessment of toddler diet quality is essential for understanding current intakes and evaluating the effect of interventions and programs to promote healthy eating and prevent chronic disease.
The goal of this article was to assess the diet quality among toddlers using two different indices appropriate for 24-mo-old toddlers and compare differences in scoring between the measures by race and Hispanic origin.
We used cross-sectional data from 24-mo-old toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a national study that includes 24-hour dietary recall information from children enrolled in WIC at birth. The main outcome measure was diet quality using both the toddler diet quality index (TDQI) and the healthy eating index (HEI)-2015. We derived mean scores for overall diet quality and for each component. We examined associations between the distribution of diet quality scores across terciles and by race and Hispanic origin using Rao-Scott chi-square tests of association.
Nearly half of the mothers and caregivers self-identified as Hispanic (49%). Diet quality scores were higher when using the HEI-2015 compared with the TDQI (56.4 vs. 49.9, respectively). The difference in component scores was largest for refined grains, followed by sodium, added sugars, and dairy. Toddlers from Hispanic mothers and caregivers had significantly higher component scores for greens and beans and dairy but had lower scores for whole grains (P < 0.05) than those for the other racial and ethnic subgroups assessed.
We found noteworthy differences in toddler diet quality depending on whether the HEI-2015 or TDQI is used, and children of different racial and ethnic subgroups may be differentially classified as having high or low diet quality depending on which index is used. This may have important implications for understanding which populations are at risk of future diet-related diseases.
准确评估幼儿的饮食质量对于了解当前的摄入量以及评估促进健康饮食和预防慢性病的干预措施和计划的效果至关重要。
本文旨在使用适用于 24 个月大幼儿的两种不同指数评估幼儿的饮食质量，并比较这些措施在种族和西班牙裔来源方面评分的差异。
我们使用了参与特殊补充营养计划妇女、婴儿和儿童（WIC）婴儿和幼儿喂养实践研究-2（ITFPS-2）的 24 个月大幼儿的横断面数据，这是一项全国性研究，包括在 WIC 出生时注册的儿童的 24 小时饮食回忆信息。主要结果测量指标是使用幼儿饮食质量指数（TDQI）和健康饮食指数（HEI）-2015 评估的饮食质量。我们得出了整体饮食质量和每个组成部分的平均得分。我们使用 Rao-Scott 关联检验检查了饮食质量得分在三分位数之间以及按种族和西班牙裔来源的分布之间的关联。
近一半的母亲和照顾者自我认同为西班牙裔（49%）。与 TDQI 相比，使用 HEI-2015 时饮食质量评分更高（分别为 56.4 和 49.9）。在精制谷物之后，钠、添加糖和乳制品的成分得分差异最大。来自西班牙裔母亲和照顾者的幼儿在绿色蔬菜和豆类以及乳制品方面的成分得分明显更高，但在全谷物方面的得分较低（P < 0.05），与其他评估的种族和族裔亚组相比。
我们发现，根据使用的是 HEI-2015 还是 TDQI，幼儿的饮食质量存在显著差异，并且根据使用的指数，不同种族和族裔亚组的儿童可能被不同地归类为具有高或低的饮食质量。这对于了解哪些人群面临未来与饮食相关的疾病的风险具有重要意义。
