Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Rollins School of Public Health, Emory University, Atlanta, Georgia.
Pediatrics. 2024 Dec 1;154(6). doi: 10.1542/peds.2024-067783.
Diet quality has improved over time for US adults and youth aged ≥2 years. Trends over time and disparities in the diet quality of toddlers 12 through 23 months old have not been documented. Our objective was to investigate the direction and magnitude of toddler diet quality trends from 1999 to 2018 overall and by household socioeconomic status.
This serial cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data was performed with 2541 toddlers from 10 NHANES cycles from 1999 to 2018. Dietary intake was measured by NHANES study staff using proxy-reported 24-hour recalls. Healthy Eating Index-Toddlers-2020 total scores (0-100 points, higher scores indicate healthier diets) and component scores were calculated from the 24-hour dietary recalls using the population ratio method. Multivariable linear regression was used to evaluate the association between time in years (measured as the midpoint of each NHANES cycle) and diet quality.
Toddler diet quality improved significantly from 1999 to 2018 (P < .001), from 63.7 points on average in 1999-2000 to 67.7 points in 2017-2018. A significant positive linear trend in total diet quality was observed for all socioeconomic status groups (P < .05). Several dietary component scores improved, as follows: Whole Fruits (P < .001), Whole Grains (P = .016), Fatty Acids (P = .002), Refined Grains (P = .009), and Added Sugars (P < .001). Scores did not significantly change for Total Fruit, Total Vegetables, Greens and Beans, Dairy, Total Protein Foods, Seafood and Plant Proteins, Sodium, or Saturated Fats.
From 1999 to 2018, toddler diet quality improved significantly, but mean scores still fell short of dietary guidance.
美国成年人和≥2 岁的青少年的饮食质量随着时间的推移而有所改善。然而，12 至 23 个月大的幼儿的饮食质量随时间的变化趋势和差异尚未得到记录。我们的目的是调查 1999 年至 2018 年期间幼儿饮食质量的变化方向和幅度，以及按家庭社会经济地位进行的调查。
这是一项对 1999 年至 2018 年期间 10 个 NHANES 周期中 2541 名幼儿进行的系列横断面分析。膳食摄入量由 NHANES 研究人员通过代理报告的 24 小时回忆进行测量。使用人群比法从 24 小时膳食回忆中计算出健康饮食指数-幼儿-2020 总分（0-100 分，得分越高表示饮食越健康）和成分得分。多变量线性回归用于评估时间（以每个 NHANES 周期的中点测量）与饮食质量之间的关系。
1999 年至 2018 年期间，幼儿饮食质量显著提高（P <.001），1999-2000 年平均得分 63.7 分，2017-2018 年得分 67.7 分。所有社会经济地位组均观察到总饮食质量的显著正线性趋势（P <.05）。以下几个饮食成分的得分有所提高：全水果（P <.001）、全谷物（P =.016）、脂肪酸（P =.002）、精制谷物（P =.009）和添加糖（P <.001）。全水果、总蔬菜、绿叶蔬菜和豆类、乳制品、总蛋白质食物、海鲜和植物蛋白质、钠或饱和脂肪的得分没有显著变化。
1999 年至 2018 年期间，幼儿饮食质量显著提高，但平均得分仍低于饮食指南。
