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To construct and evaluate an independent Children’s Index of Diet Quality (CIDQ).
Design
A food consumption questionnaire, which contained twenty-five multiple-item questions on eating and food intake, was formulated and evaluated against 7 d food records. Key questions that best reflected a healthy diet, defined in criteria set by the nutrient recommendations, were searched and validated by correlation and analyses of receiver-operating characteristic curves.
Settings
A cohort of a young population of South-West Finland.
Subjects
Participants (n 400) were 2–6-year-old children.
Results
Fifteen questions were identified to best depict the children’s diet quality in reference to the recommendations. These questions were scored, summarized and further constructed into a three-class index (good, moderate and poor dietary quality) where higher scores depicted better diet quality. The CIDQ cut-off score of 14 points for good dietary quality had a sensitivity of 0·59 and a specificity of 0·82 and the cut-off score of 10 points, for at least moderate dietary quality, had a sensitivity of 0·77 and a specificity of 0·69. Higher index scores were related to higher dietary intakes of several vitamins, lower dietary intakes of SFA and cholesterol, and further with lower serum cholesterol and higher serum vitamin C concentrations.
Conclusions
The three-class food index was found to represent diet quality as defined in recommendations and evaluated against nutrient intakes from food diaries and biochemical markers. This self-standing index could provide an effective and low-burden method to obtain information about diet quality and guide future recommendations.
In New Zealand (NZ), Fe deficiency (ID) is present in 14 % of children aged <2 years. Prevalence varies with ethnicity (NZ European 7 %, Pacific 17 %, Maori 20 %). We describe dietary Fe intake, how this varies with ethnicity and whether intake predicts Fe status.
Design
A random sample of children aged 6–23 months. Usual Fe intake and dietary sources were estimated from 2 d weighed food records. Associations were determined between adequacy of Fe intake, as measured by the Estimated Average Requirement (EAR), and ID.
Subjects
Sampling was stratified by ethnicity. Dietary and blood analysis data were available for 247 children.
Results
The median daily Fe intake was 8·3 mg (age 6–11 months) and 6·3 mg (age 12–23 months). Breast milk and milk formulas (median 58 %; age 6–11 months), and cereals (41 %) and fruit and vegetables (17 %; age 12–23 months), were the predominant dietary sources of Fe. Fe intake was below the EAR for 25 % of the children. Not meeting the EAR increased the risk of ID for children aged 6–11 months (relative risk = 18·45, 95 % CI 3·24, 100·00) and 12–23 months (relative risk = 4·95, 95 % CI 1·59, 15·41). In comparison with NZ European, Pacific children had a greater daily Fe intake (P = 0·04) and obtained a larger proportion of Fe from meat and meat dishes (P = 0·02).
Conclusions
A significant proportion of young NZ children have inadequate dietary Fe intake. This inadequate intake increases the risk of ID. Ethnic differences in Fe intake do not explain the increased risk of ID for Pacific children.
To investigate the maternal factors associated with poor diet among disadvantaged children.
Design
Survey of 300 mothers of 2-year-old children from areas of high deprivation in Scotland (response rate 81 %). A diet quality score was derived from reported consumption of carbohydrates, protein, fruit and vegetables, dairy products and restriction of sugary fatty foods.
Results
Most children (85 %) were classified as having a poor quality diet (low diet quality score). Mothers’ general knowledge about healthy eating was high, but did not predict the quality of the children’s diet. Lower frequencies of food preparation and serving, such as cooking with raw ingredients, providing breakfast daily and the family eating together, were also associated with a poorer diet. Regression modelling identified five significant factors. An increased risk of a poor diet was associated with mothers being unlikely to restrict sweets (OR = 21·63, 95 % CI 2·70, 173·30) or finding it difficult to provide 2–3 portions of fruit daily (OR = 2·94, 95 % CI 1·09, 7·95). Concern that the child did not eat enough increased the risk of a poor diet (OR = 2·37, 95 % CI 1·09, 5·16). Believing a healthy diet would help the child eat more reduced the risk of having a poor diet (OR = 0·28, 95 % CI 0·11, 0·74), as did providing breakfast daily (OR = 0·22, 95 % CI 0·05, 0·99).
Conclusions
Interventions to improve children’s diet could promote more positive intentions about preparing and serving of foods, particularly of specific meals at which the family eats together. The benefits of these behaviours to the child (improved diet, weight control) should be emphasised.
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