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Fryar CD, Wambogo EA, Scanlon KS, Terry AL, Ogden CL. Trends in Food Consumption Among Children Aged 1-4 Years by Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children, United States, 2005-2018. J Nutr 2023; 153:839-847. [PMID: 36774232 PMCID: PMC11000027 DOI: 10.1016/j.tjnut.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/22/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND In 2009, the US Department of Agriculture Food and Nutrition Service's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages were revised to include more whole fruits, vegetables, whole grains, and lower-fat milk. OBJECTIVE The aim of this study was to describe trends over time in the consumption of fruits (total and whole), vegetables, whole grains, milk (whole, reduced fat, low-fat or nonfat (LFNF), and flavored), and added sugars, including breakfast cereals, by WIC participation status (current WIC recipient, WIC income-eligible nonrecipient, and WIC income-ineligible nonrecipient). METHODS Dietary intakes on a given day for 1- to 4-y-old children (n = 5568) from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed to examine trends in the percentage of individuals consuming and amounts consumed over time using linear regression adjusted for age, sex, and race and Hispanic origin. RESULTS From 2005 through 2018, the percentage of WIC recipients or WIC income-eligible nonrecipients consuming fruits and vegetables on a given day did not change, but the percentage of fruit consumed as whole fruit increased significantly among WIC recipients (36.4%-62.1%), but not among income-eligible nonrecipients. Among the WIC recipients, the percentage of consumption (5.5%-29.3%), the amount of LFNF milk servings consumed (0.1-0.4 cups), and the percentage of the total milk consumed as LFNF milk (4.8%-27%) significantly increased from 2005 to 2018. Conversely, the percentage of energy (12.3%-10.8%) and servings (11.4-10.6 teaspoons) from added sugars declined significantly. Among WIC-eligible nonrecipients, the servings of whole grains increased significantly, whereas servings and percentage of energy from added sugars declined significantly. CONCLUSIONS From 2005 through 2018, changes in dietary patterns for WIC recipients did not always mirror those of US children of the same age. The percentage of fruit consumed as whole fruit, and the percentage and quantity of milk consumed as LFNF milk increased significantly among WIC recipients, but not among income-eligible nonrecipients. J Nutr 20XX;xx:xx-xx.
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Affiliation(s)
- Cheryl D Fryar
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA.
| | - Edwina A Wambogo
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Kelley S Scanlon
- United States Department of Agriculture, Food and Nutrition Service, Alexandria, VA, USA
| | - Ana L Terry
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Cynthia L Ogden
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
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Zimmer M, Moshfegh AJ, Vernarelli JA, Barroso CS. Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children and Dietary Intake in Children: Associations With Race and Ethnicity. Am J Prev Med 2022; 62:578-585. [PMID: 34969606 DOI: 10.1016/j.amepre.2021.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Establishing healthy dietary intake in pediatric populations is important for prevention of chronic disease across the lifespan. Federal nutrition assistance programs can support the dietary intake of U.S. children. The objective of this study was to assess the relationship between Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation status and dietary intake within racial and ethnic groups. METHODS Dietary intake of children aged 2-4 years in the cross-sectional National Health and Nutrition Examination Survey 2011-2016 was analyzed in 2021. Multivariable linear regression was used to compare stratum-specific mean estimates for nutrient and food group intake of children participating in Special Supplemental Nutrition Program for Women, Infants, and Children (reference group) with those of nonparticipants who were income eligible and income ineligible (i.e., above income limits) for the WIC program. Significance was set to Bonferroni-corrected p-values. RESULTS Hispanic WIC participants consumed less added sugar (8.9 [SE=0.5] teaspoons) than their higher-income counterparts (14.6 [SE=1.5] teaspoons, p<0.001). Hispanic WIC participants also consumed more fiber (13.0 [SE=0.6] grams) than income-eligible (11.4 [SE=0.7] grams, p=0.032) and income-ineligible (i.e., higher-income, 9.4 [SE=1.3] grams, p=0.019) nonparticipants, but this was not significant at the Bonferroni-adjusted p-value of 0.01. No differences in dietary intake were observed by WIC participation status for non-Hispanic White and non-Hispanic Black children. CONCLUSIONS Participation in WIC was associated with healthier dietary outcomes among Hispanic children; however, dietary intake of White and Black children was comparable by WIC participation status. Federal nutrition assistance programs should support sound nutrition, an important factor in reducing the risk of chronic disease, in all groups.
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Affiliation(s)
- Meghan Zimmer
- Epidemiology and Genomics Research Program, National Cancer Institute, NIH, Rockville, Maryland; Department of Public Health, Colleg of Education, Health, and Human Sciences, The University of Tennessee Knoxville, Knoxville, Tennessee
| | - Alanna J Moshfegh
- Food Surveys Research Group, USDA Agricultural Research Service, Beltsville, Maryland
| | | | - Cristina S Barroso
- Department of Public Health, Colleg of Education, Health, and Human Sciences, The University of Tennessee Knoxville, Knoxville, Tennessee; College of Nursing, The University of Tennessee Knoxville, Knoxville, Tennessee.
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Czarnik M, Hamner HC, Moore LV. Food Preparation Practices for Infants Aged From 7 to 13 Months. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:28-35. [PMID: 34598893 PMCID: PMC10898497 DOI: 10.1016/j.jneb.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/10/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To examine infant food preparation practices at age 7, 9, 11, and 13 months overall and by sociodemographic characteristics. DESIGN Data from a longitudinal study from the US Department of Agriculture's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2) were used. PARTICIPANTS A sample of 1,904 infants (970 males and 934 females) enrolled in WIC who had been introduced to solid foods and were consuming food prepared at home. MAIN OUTCOME MEASURES Food preparation practices included pureeing, mashing, chopping/dicing, and prechewing. Estimates were provided overall and by sociodemographics. ANALYSIS Prevalence estimates were calculated for each survey month overall and by sociodemographics. Chi-square tests for independence were used to test for differences. RESULTS Food preparation practices changed as infants aged. Pureeing and mashing were common in month 7 (57.8% and 59.6%, respectively), but chopping/dicing were the most prevalent by month 13 (85.4%). Food preparation practices did not vary by education status, but statistical differences were consistently observed by race and ethnicity and inconsistently observed by maternal age at birth. CONCLUSIONS AND IMPLICATIONS Exposing children to a range of food textures at an appropriate age is important for developmental progress. Continued culturally relevant efforts by WIC educators and health care providers can emphasize the importance of early experiences with food textures.
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Affiliation(s)
- Michaila Czarnik
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Parnham J, Millett C, Chang K, Laverty AA, von Hinke S, Pearson-Stuttard J, Vamos EP. Is the healthy start scheme associated with increased food expenditure in low-income families with young children in the United Kingdom? BMC Public Health 2021; 21:2220. [PMID: 34915897 PMCID: PMC8680244 DOI: 10.1186/s12889-021-12222-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/11/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Healthy Start is a food assistance programme in the United Kingdom (UK) which aims to provide a nutritional safety-net and enable low-income families on welfare benefits to access a healthier diet through the provision of food vouchers. Healthy Start was launched in 2006 but remains under-evaluated. This study aims to determine whether participation in the Healthy Start scheme is associated with differences in food expenditure in a nationally representative sample of households in the UK. METHODS Cross-sectional analyses of the Living Costs and Food Survey dataset (2010-2017). All households with a child (0-3 years) or pregnant woman were included in the analysis (n = 4869). Multivariable quantile regression compared the expenditure and quantity of fruit and vegetables (FV), infant formula and total food purchases. Four exposure groups were defined based on eligibility, participation and income (Healthy Start Participating, Eligible Non-participating, Nearly Eligible low-income and Ineligible high-income households). RESULTS Of 876 eligible households, 54% participated in Healthy Start. No statistically significant differences were found in FV or total food purchases between participating and eligible non-participating households, but infant formula purchases were lower in Healthy Start participating households. Ineligible higher-income households had higher purchases of FV. CONCLUSION This study did not find evidence of an association between Healthy Start participation and FV expenditure. Moreover, inequalities in FV purchasing persist in the UK. Higher participation and increased voucher value may help to improve programme performance and counteract the harmful effects of poverty on diet.
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Affiliation(s)
- Jennie Parnham
- Department of Primary Care, Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus, St Dunstans Road, London, W6 8RP, UK.
| | - Christopher Millett
- Department of Primary Care, Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus, St Dunstans Road, London, W6 8RP, UK
| | - Kiara Chang
- Department of Primary Care, Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus, St Dunstans Road, London, W6 8RP, UK
| | - Anthony A Laverty
- Department of Primary Care, Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus, St Dunstans Road, London, W6 8RP, UK
| | - Stephanie von Hinke
- University of Bristol, Bristol, UK
- Erasmus University Rotterdam, Rotterdam, The Netherlands
- Institute for Fiscal Studies, London, UK
| | - Jonathan Pearson-Stuttard
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, Imperial College London, London, UK
- Northumbria Healthcare NHS Foundation Trust, London, UK
- Health Analytics, Lane Clark & Peacock LLP, London, UK
| | - Eszter P Vamos
- Department of Primary Care, Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, Charing Cross Campus, St Dunstans Road, London, W6 8RP, UK
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Zimmer MC, Beaird J, Steeves ETA. WIC Participants' Perspectives About Online Ordering and Technology in the WIC Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:602-607. [PMID: 33132035 DOI: 10.1016/j.jneb.2020.10.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/21/2020] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The objective of this study was to assess the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants' perceptions about ordering WIC groceries online. METHODS Qualitative semistructured interviews were conducted with 24 WIC participants in East Tennessee from May to October 2019. Interviews were transcribed verbatim and analyzed using a grounded theory approach. RESULTS Participants were interested in online ordering and spoke favorably about delivery and pickup options. Participants were willing to pay $2-5 to order online, though they were more willing to pay for a home or curbside delivery than an in-store pickup. Participants suggested additional ways to integrate technology into WIC food retail operations, such as providing benefit balances via text message and developing a mobile phone application for Tennessee WIC. CONCLUSIONS AND IMPLICATIONS Findings can inform pilot tests for WIC online ordering.
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Affiliation(s)
- Meghan C Zimmer
- Department of Nutrition, The University of Tennessee, Knoxville, TN; Department of Public Health, The University of Tennessee, Knoxville, TN
| | - Jacob Beaird
- Department of Nutrition, The University of Tennessee, Knoxville, TN
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Zimmer MC, Vernarelli JA. Select Food Group Intake of US Children Aged 2 to 4 Years by WIC Participation Status and Income. J Acad Nutr Diet 2021; 120:2032-2038.e1. [PMID: 33222884 DOI: 10.1016/j.jand.2020.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 07/07/2020] [Accepted: 07/27/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Food group and nutrient priorities for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Package IV for children aged 2 to 4 years were described in the 2017 review of the WIC Food Package. Research has evaluated priority nutrient intake, but priority food group intake remains unknown. OBJECTIVES To compare mean intake of priority food groups/subgroups of WIC children to WIC-eligible nonparticipants and higher income children. Further, we hoped to assess differences in percent contribution of food subgroups to total food group intake by WIC participation status and income. DESIGN Cross-sectional study conducted using data from the 2011-14 National Health and Nutrition Examination Survey. PARTICIPANTS/SETTING One thousand forty-seven children aged 2 to 4 years. MAIN OUTCOME MEASURES Mean intake reported in cup equivalents and ounce equivalents. We also looked at mean percent that food subgroups contributed to total intake within a food group. Analyses were performed for high and low priority food groups/subgroups: high = seafood, total vegetables, dark green vegetables, red/orange vegetables, whole grains, and nuts/seeds/soy; low = total starchy vegetables, other vegetables, legumes computed as vegetables, total dairy, and total protein foods. STATISTICAL ANALYSES PERFORMED Multivariable linear regression analysis was used evaluate the relationship between income/WIC participation and mean intake/percent food subgroups contributed to total food group intake. RESULTS Among low-income WIC-eligible children, participation in WIC was associated with greater mean intake of red/orange vegetables (0.18 ± 0.03 vs 0.01 ± 0.06 c equivalents; P < 0.05) and legumes (0.07 ± 0.01 vs 0.01 ± 0.02 c equivalents; P < 0.01). No differences in mean intake were observed between WIC children and higher income children. Grain intake of WIC children was composed of a higher percentage of whole grains (19.1% ± 1.6% vs 13.2% ± 1.5%; P < 0.01) compared with higher income children. The percent vegetable subgroups contributed to total vegetable intake varied by income; no differences were observed for dairy or protein subgroups. CONCLUSIONS Among low-income children, participation in WIC was associated with greater intake of certain vegetables. Participation in WIC may also help close the diet quality gap between low-income and higher income children for priority foods targeted by the WIC food package. Future research should explore socioeconomic disparities in intake of nutrient-poor foods.
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Hartline-Grafton H, Hassink SG. Food Insecurity and Health: Practices and Policies to Address Food Insecurity among Children. Acad Pediatr 2021; 21:205-210. [PMID: 32653691 PMCID: PMC7347342 DOI: 10.1016/j.acap.2020.07.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/01/2020] [Accepted: 07/05/2020] [Indexed: 11/23/2022]
Affiliation(s)
| | - Sandra G Hassink
- AAP Institute for Healthy Childhood Weight (SG Hassink), Itasca, Ill
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Zhang Q, Alsuliman MA, Wright M, Wang Y, Cheng X. Fruit and Vegetable Purchases and Consumption among WIC Participants after the 2009 WIC Food Package Revision: A Systematic Review. Adv Nutr 2020; 11:1646-1662. [PMID: 32452523 PMCID: PMC7666910 DOI: 10.1093/advances/nmaa060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 04/03/2020] [Accepted: 04/30/2020] [Indexed: 11/14/2022] Open
Abstract
To promote fruit and vegetable (FV) intake among participants, the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) implemented a comprehensive food package revision in 2009. However, to our knowledge, no studies have systematically explored the factors related to FV purchases and/or consumption among WIC participants in the post-2009 revision era. To fill this knowledge gap, we conducted a systematic literature review using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials, and Web of Science using key search terms. Studies published from January 1, 2007, through February 28, 2019, were included, since an interim rule for the WIC food package revision was issued in 2007. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format. The articles were grouped based on main themes or factors, settings, design, study years, and sample size. Thirty-nine articles met the inclusion criteria. Seven main themes or factors related to FV purchases and/or consumption in WIC participants were identified in these articles. The 2009 WIC food package revision was the most-studied factor (n = 9). National and state-level studies showed a consistently positive relation between the 2009 revision and FV purchases and/or consumption. However, some studies did not find a positive relation. State-level policy variations can be exploited as natural experiments to assess the causality of state-level factors in WIC participants' FV purchases or consumption. The majority of the included studies were limited in being local (n = 26, 66.7%), cross-sectional (n = 29, 74.4%), or having sample sizes <1000 (n = 25, 64.1%), which could explain the diverse results regarding the relation between FV purchases and/or consumption and various factors, including individual, store, and program characteristics.
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Affiliation(s)
- Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA
| | - Mohammed A Alsuliman
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA
| | - Mia Wright
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA
| | - Youfa Wang
- Fisher Institute of Health and Well-being, Department of Nutrition and Health Sciences, College of Health, Ball State University, Muncie, IN, USA
| | - Xinzhe Cheng
- Congressional Budget Office, Washington, DC, USA
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Moran AJ, Gu Y, Clynes S, Goheer A, Roberto CA, Palmer A. Associations between Governmental Policies to Improve the Nutritional Quality of Supermarket Purchases and Individual, Retailer, and Community Health Outcomes: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7493. [PMID: 33076280 PMCID: PMC7602424 DOI: 10.3390/ijerph17207493] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 01/19/2023]
Abstract
Supermarkets are natural and important settings for implementing environmental interventions to improve healthy eating, and governmental policies could help improve the nutritional quality of purchases in this setting. This review aimed to: (1) identify governmental policies in the United States (U.S.), including regulatory and legislative actions of federal, tribal, state, and local governments, designed to promote healthy choices in supermarkets; and (2) synthesize evidence of these policies' effects on retailers, consumers, and community health. We searched five policy databases and developed a list of seven policy actions that meet our inclusion criteria: calorie labeling of prepared foods in supermarkets; increasing U.S. Department of Agriculture (USDA) Supplemental Nutrition Assistance Program (SNAP) benefits; financial incentives for the purchase of fruit and vegetables; sweetened beverage taxes; revisions to the USDA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package; financial assistance for supermarkets to open in underserved areas; and allowing online purchases with SNAP. We searched PubMed, Econlit, PsycINFO, Web of Science, and Business Source Ultimate to identify peer-reviewed, academic, English-language literature published at any time until January 2020; 147 studies were included in the review. Sweetened beverage taxes, revisions to the WIC food package, and financial incentives for fruits and vegetables were associated with improvements in dietary behaviors (food purchases and/or consumption). Providing financial incentives to supermarkets to open in underserved areas and increases in SNAP benefits were not associated with changes in food purchasing or diet quality but may improve food security. More research is needed to understand the effects of calorie labeling in supermarkets and online SNAP purchasing.
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Affiliation(s)
- Alyssa J. Moran
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Yuxuan Gu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.G.); (S.C.)
| | - Sasha Clynes
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (Y.G.); (S.C.)
| | - Attia Goheer
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Christina A. Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Anne Palmer
- Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21202, USA
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Hamner HC, Moore LV. Dietary quality among children from 6 months to 4 years, NHANES 2011-2016. Am J Clin Nutr 2020; 111:61-69. [PMID: 31665202 PMCID: PMC8085715 DOI: 10.1093/ajcn/nqz261] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 09/23/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The US Dietary Guidelines for Americans provide dietary recommendations for individuals aged ≥2 y and metrics exist to assess alignment. Nonfederal feeding recommendations exist for children <2 y, but limited metrics and assessment of dietary quality are available. OBJECTIVE We aimed to assess dietary quality of children aged 6 mo-4 y using a modified Diet Quality Index Score (DQIS). METHODS NHANES 2011-2016 dietary data were used to estimate the dietary quality of children 6 mo-4 y old using a modified DQIS. Differences in mean modified DQIS by demographics were assessed using linear regression. RESULTS Mean modified DQIS ± SE was 22.4 ± 0.23 out of 45 possible points (50%) for children 6 mo-4 y of age on a given day. Modified DQIS scores on a given day decreased with age (27.7 ± 0.27 for 6- to 11-mo-olds, 23.9 ± 0.31 for 1-y-olds, 21.4 ± 0.26 for 2- to 3-y-olds, and 20.6 ± 0.49 for 4-y-olds; P < 0.0001 for trend). Children 6-11 mo old had 16% higher overall modified DQIS scores than 1-y-olds (P < 0.0001) and higher modified DQIS subcomponent scores for refined grains and protein, indicating higher age-appropriate intakes (P < 0.05). Similarly, children 6-11 mo old also had higher modified DQIS subcomponent scores, indicating no or limited intake, for 100% fruit juice, sugar-sweetened beverages, other added sugars, and salty snacks (P < 0.02). CONCLUSIONS Dietary quality declines with age and may begin as early as 1 y. The modified DQIS tool could help assess the dietary quality of young children. This may be important when identifying programmatic and policy efforts aimed at establishing and maintaining healthy dietary patterns beginning at an early age.
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Affiliation(s)
- Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA, USA
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA, USA
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Racial/Ethnic Disparities in Dietary Intake of U.S. Children Participating in WIC. Nutrients 2019; 11:nu11112607. [PMID: 31683601 PMCID: PMC6893478 DOI: 10.3390/nu11112607] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/24/2022] Open
Abstract
Recent studies have assessed diet quality of low-income U.S. children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but differences by race/ethnicity remain unknown. We assessed racial/ethnic disparities in nutrient intake from dietary sources (not supplements) among children participating in WIC, with a focus on priority nutrients and food groups for future WIC food package revisions, as described in a recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM). We used data from the 2011-2014 National Health and Nutrition Examination Surveys (NHANES) and multivariable linear regression analysis to evaluate relationships between race/ethnicity and nutrient/food group intake of children participating in WIC. All data were analyzed using SAS 9.4 survey procedures, accounting for the complex survey design of the NHANES. Compared to non-Hispanic White children, Hispanic children had diets with better nutrient distribution and lower dietary energy density, while non-Hispanic Black children had diets with poorer nutrient intake. Hispanic children had higher potassium and fiber intake, and consumed more legumes, while non-Hispanic Black children had lower calcium and vitamin D intake, higher sodium intake, and lower total dairy intake, compared to non-Hispanic White children. These findings can inform WIC nutrition education messages and future food package revisions.
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