US Department of Health and Human Services, National Cancer Institute, Bethesda, MD.
US Department of Agriculture, Food and Nutrition Services, Alexandria, VA.
J Acad Nutr Diet. 2023 Sep;123(9):1307-1319. doi: 10.1016/j.jand.2023.05.014. Epub 2023 May 16.
With the addition of new guidance for children from birth to 24 months in the Dietary Guidelines for Americans, 2020-2025 (DGA), a Healthy Eating Index (HEI) was developed for toddlers.
To evaluate the psychometric properties of the HEI-Toddlers-2020, 5 analyses relevant to construct and concurrent validity and 2 related to reliability were examined.
Twenty-four-hour diet recall data from the cross-sectional National Health and Nutrition Examination Survey (2011-2018) were used. In addition, exemplary menus were analyzed.
PARTICIPANTS/SETTING: The main analytic sample included toddlers aged 12 through 23 months (n = 838), with additional analyses of toddlers aged 12 through 35 months (n = 1,717) from the United States. Included participants had valid diet recalls and available weight-for-age data.
Outcomes measures included HEI-Toddlers-2020 total and component scores on menus, population distributions, and correlations.
HEI total and component scores were calculated using menus from the American Academy of Pediatrics and Healthy Eating Research. Score means and distributions were estimated using a Markov Chain Monte Carlo approach with National Health and Nutrition Examination Survey data (2011-2018). Principal component analysis explored dimensions and Pearson correlations examined components, energy, and Cronbach α. In addition, HEI-Toddlers-2020 and HEI-2020 scores were compared for identical intakes at age 24 months.
For validity, exemplary menus received high scores with the HEI-Toddlers-2020. The mean ± SE total HEI-Toddlers-2020 score for toddlers aged 12 through 23 months was 62.9 ± 0.78 and ranged from 40.1 to 84.4 (1 to 99 percentile). Correlation between diet quality and diet quantity was low (-0.15); the scree plot revealed multiple factors. In addition, total scores for identical intakes were approximately 1.5 points higher for HEI-Toddlers-2020 compared with HEI-2020 (difference range for component scores, -4.97 to 4.89). For reliability, most of the intercorrelations among components were low to moderate (0 to 0.49), with a few exceptions among related components. Cronbach α was .48. These results indicate that the index is multidimensional, with no single component driving the total score, and no unnecessary components that are highly correlated with another component.
The results demonstrated evidence supportive of validity and reliability. The HEI-Toddlers-2020 can be used to assess alignment with the DGA for toddlers.
随着《美国人的膳食指南，2020-2025》（DGA）中为出生至 24 个月的儿童新增了指导内容，为幼儿制定了一个健康饮食指数（HEI）。
评估 2020 年幼儿健康饮食指数（HEI-Toddlers-2020）的心理测量学特性，共进行了 5 项与结构和同时效度相关的分析以及 2 项与信度相关的分析。
使用了来自横断面全国健康和营养检查调查（2011-2018 年）的 24 小时饮食回忆数据。此外，还分析了示范菜单。
参与者/设置：主要分析样本包括 12 至 23 个月大的幼儿（n=838），对于来自美国的 12 至 35 个月大的幼儿（n=1717）进行了额外的分析。纳入的参与者有有效的饮食回忆和可用的体重与年龄数据。
观察指标包括菜单上的 HEI-Toddlers-2020 总分和成分评分、人口分布和相关性。
使用美国儿科学会和健康饮食研究的菜单计算 HEI 总分和成分得分。使用国家健康和营养检查调查数据（2011-2018 年）的马尔可夫链蒙特卡罗方法估计得分均值和分布。主成分分析探索了维度，皮尔逊相关分析考察了成分、能量和克朗巴赫 α。此外，还比较了 24 个月龄时相同摄入量的 HEI-Toddlers-2020 和 HEI-2020 评分。
在有效性方面，示范菜单的 HEI-Toddlers-2020 得分较高。12 至 23 个月大的幼儿的平均±标准误总 HEI-Toddlers-2020 评分为 62.9±0.78，范围为 40.1 至 84.4（1 至 99 百分位）。饮食质量与饮食数量之间的相关性较低（-0.15）；散点图显示存在多个因素。此外，对于相同的摄入量，HEI-Toddlers-2020 的总分比 HEI-2020 高出约 1.5 分（成分得分的差值范围为-4.97 至 4.89）。在可靠性方面，各成分之间的大部分相互关联度较低到中等（0 到 0.49），只有少数相关成分之间的相互关联度较高。克朗巴赫 α 为.48。这些结果表明，该指数是多维的，没有一个单一的成分可以驱动总分，也没有与另一个成分高度相关的不必要的成分。
研究结果表明，该指数具有有效性和可靠性的证据支持。HEI-Toddlers-2020 可用于评估与 DGA 对幼儿的一致性。
