Perinatal & Pediatric
Toddler diet quality: a factor associated with childhood growth? Xuanxuan Zhu* Edwina Yeung Xuanxuan Zhu Diane Putnick Priscilla Clayton Tzu-Chun Lin Edwina Yeung
Background. Childhood growth is crucial for long-term overall health and well-being. Diet quality is an essential component of nutritional status reflecting dietary patterns and nutrient intake. While research in adults has shown that higher diet quality is associated with a lower risk of obesity, its association with childhood growth has remained unclear. This study aims to evaluate the association between diet quality among toddlers and their growth in middle childhood.
Methods. Mothers from Upstate KIDS, a prospective cohort study, reported numbers of servings/day for specific foods fed to toddlers at 30 and 36 months of age such as dairy, fruit, vegetables, and meat. Accordingly, the Youth Healthy Eating Index (YHEI) was calculated to measure toddler diet quality (range 0-80) with higher scores indicating better diet quality. Children’s height, weight, and waist circumference were reported up to three times when they were 7-9 years old, and corresponding height-for-age (HAZ), weight-for-age (WAZ), body mass index-for-age (BMIZ) z-scores and overweight status were calculated. Mixed effects models were used to estimate associations, adjusting for maternal age at delivery, race/ethnicity, education, private insurance, WIC participation, pre-pregnancy BMI, etc.
Results. Among 1,116 children (51.79% male, 86.74% non-Hispanic white), the mean YHEI score at 30/36 months of age was 44.578.54. A one-point increase in YHEI score would increase HAZ by 0.01 (adjusted =0.01, 95% CI: 0.0004, 0.02) and reduce waist circumference by 0.02 (adjusted =-0.02, 95% CI: -0.04, -0.002). YHEI scores were negatively associated with the risk of overweight (adjusted OR=0.96, 95% CI: 0.93, 0.99). YHEI scores were not associated with WAZ and BMIZ.
Conclusion. Higher toddler diet quality is associated with linear growth and reduced central adiposity and overweight in middle childhood. Interventions aimed at improving early diet quality are needed to promote healthy growth in childhood.