Baseline diet quality of predominantly minority children and adolescents from households characterized by low socioeconomic status in the Childhood Obesity Prevention and Treatment Research (COPTR) Consortium

Abstract

Background: The Healthy Eating Index (HEI-2010) is a measure of diet quality that examines conformance with the Dietary Guidelines for Americans. The objectives of this study were to estimate baseline diet quality of predominantly low-income minority children using the HEI-2010 and to identify the most important HEI components to target for dietary intervention. Methods: Two or three baseline 24 h dietary recalls were collected in-person or over telephone between May 2012 and June 2014 from 1,745 children and adolescents from four randomized clinical trials in the Childhood Obesity Prevention and Treatment Research (COPTR) Consortium. Nine adequacy and three moderation food components were calculated and averaged to determine overall HEI scores. The overall HEI-2010 scores were categorized as ≥81, 51-80, or ≤ 50 based on the HEI-2005 classification. For each study, mean overall and component HEI scores were estimated using linear regression models. Results: Mean (95% CI) overall HEI scores ranged from 47.9 (46.8, 49.0) to 64.5 (63.6, 65.4). Only 0.3 to 8.1% of children and adolescents had HEI-2010 score ≥ 81. The average component score for green and beans was less than 30% of maximum score for all trials. In contrast, the average component score for protein, dairy (except for IMPACT), and empty calories (except forIMPACT) was more than 80% of maximum score. Conclusions: Based on HEI-2010 scores, few children and adolescents consumed high quality diets. Dietary interventions for children and adolescents should focus on improving intakes of green vegetables and beans.

Examination of the ‘5-2-1-0’ Recommendations in Racially Diverse Young Children Exposed to Tobacco Smoke

“…17 -20 Prior research indicates that children who are racial/ethnic minorities and who have low-income have poor attainment of the ‘5-2-1-0’ recommendations. 21 -25 Although TSE is associated with obesity, 7 -10 ‘5-2-1-0’ attainment has not been evaluated or used as a tool to provide anticipatory guidance to parents of children with TSE. Thus, we sought to assess the rates of overweight, obesity, TSE, and attainment of the ‘5-2-1-0’ recommendations among a racially/ethnically diverse sample of children whose parents smoked and thus were exposed to varying levels of TSE.…”

Dietary patterns and associations with BMI in low-income, ethnic minority youth in the USA according to baseline data from four randomised controlled trials

“…This methodology allows for the detection of dietary patterns unique to each population and does not rely on previously validated scores or indices (14) . This type of approach is especially useful in populations like the COPTR cohorts in which the distributions of a priori scores like HEI-2010 are narrow (6) . Another strength is the diversity in age and in race/ethnicity in the COPTR populations with multiple 24-h recalls collected per child.…”

“…Dietary patterns can be operationalised with various dietary quality indices and scores. For example, children's diet quality has been examined using the Healthy Eating Index-2010 (HEI-2010) (6) , Dietary Approaches to Stop Hypertension scores (7) and the Mediterranean Diet Quality Index for children and adolescents (8,9) . These scores are based on recommended 'healthy' dietary patterns that have been defined a priori.…”

“…For example, in the four randomised controlled trials within the Childhood Obesity Prevention and Treatment Research (COPTR) Consortium (10) which examined predominantly low-income, racial/ethnic minority youth aged 2-5 or 7-13 years -HEI-2010 scores in each study were narrowly distributed. Specifically, out of a possible score of 100, the mean and 95 % CI for each study were: 63•7 (95 % CI 62•8, 64•7), 64•5 (95 % CI 63•6, 65•4), 47•9 (95 % CI 46•8, 49•0) and 61•7 (95 % CI 60•3, 63•2) (6) . Further, an HEI-2010 score ≥81 indicated good dietary quality (6) , but only 0•3-8•1 % of participants met this criterion across the four COPTR studies.…”

“…Specifically, out of a possible score of 100, the mean and 95 % CI for each study were: 63•7 (95 % CI 62•8, 64•7), 64•5 (95 % CI 63•6, 65•4), 47•9 (95 % CI 46•8, 49•0) and 61•7 (95 % CI 60•3, 63•2) (6) . Further, an HEI-2010 score ≥81 indicated good dietary quality (6) , but only 0•3-8•1 % of participants met this criterion across the four COPTR studies. Such a narrow range of scores does not allow for accurate examination of associations between HEI-2010 scores and outcomes like BMI.…”