ARS | Publication request: Childhood Obesity and Association with Lower Diet Quality in US Children

Submitted to: Pediatric Academic Society
Publication Type: Abstract Only
Publication Acceptance Date: February 1, 2008
Publication Date: May 1, 2008
Citation: Mendoza, J.A., Shetty, P., Nicklas, T., Liu, H., Chang, S. 2008. Childhood obesity and association with lower diet quality in US children [abstract]. Pediatric Academic Societies. Abstract No. 4474.37. Available: http://www.abstracts2view.com/pas/view.php?nu=PAS08L1_2073&terms=.

Technical Abstract: While overweight children consume adequate calories, little is known regarding the quality of their diets. We sought to compare the diet quality of children in the US by their weight status and identify other correlates of dietary inadequacy. We conducted a cross-sectional analysis on a nationally representative sample of participants aged 2-19 years from NHANES, 2003-2004 (n=3321). Dietary data were collected using two 24-hour dietary recalls. For six key micronutrients, we calculated a Nutrient Adequacy Ratio (NAR=nutrient intake/Estimated Average Requirement). From the NARs, we calculated an overall Mean Adequacy Ratio (MAR). Children were classified as (1) normal weight (>=5th % to <85th % BMI) or (2) at risk for overweight or overweight (>=85th % BMI). We used multivariate logistic regression analyses, with gender, age, race/ethnicity, and income as covariates, to test the independent association between weight status and inadequate MAR (< 85%) or NAR (<100%) scores. Among overweight and at risk for overweight children, the risk of inadequate MAR increased 0.8% for every age versus children of the same age and of normal weight status (OR=1.008, 95% CI (1.001, 1.015)). Boys, increasing age, lower incomes, non-Hispanic blacks (vs. whites), and other race, were significantly associated with inadequate MARs (P<0.05, R(2)=0.224). Being overweight or at risk for overweight was associated with inadequate NARs for calcium (OR=1.09, 95% CI (1.010, 1.168)), iron (OR=1.02, 95% CI (1.001, 1.035)), and folate (OR=1.04, 95% CI (1.013, 1.076)). Increasing age was associated with inadequate intake of Vitamins A (OR=1.05, 95% CI (1.038, 1.105)) and C (OR=1.04, 95% CI (1.029, 1.044)), calcium (OR=1.03, 95% CI (1.024, 1.040)), iron (OR=1.003, 95% CI (1.001, 1.005)), and folate (OR=1.01, 95% CI (1.007, 1.015)). Compared to non-Hispanic whites, non-Hispanic black children were more likely to have inadequate intakes of Vitamin A (OR=1.15, 95 % CI (1.050, 1.266)) and calcium (OR=1.28, 95% CI (1.086, 1.507)). In US children, being overweight or at risk for overweight was associated with nutritional inadequacy of several key nutrients. Older children and non-Hispanic black children were also at higher risk of poor diet quality. Health care providers, policy-makers, and the food industry should provide programs, resources, and products to improve diet quality for children at risk.