Adherence to a healthy eating index from pre-school to school age and its associations with sociodemographic and early life factors

Abstract

Childhood is considered an important period for the development of healthy eating behaviours. This study aimed to evaluate the influence of early life factors and sociodemographic characteristics, including early diet quality, on diet quality at 7 years. The sample includes 5013 children evaluated at the ages of 4 and 7 years from the Portuguese birth cohort Generation XXI with complete information on FFQ. A healthy eating index was developed at both ages to assess adherence to the WHO’s dietary recommendations, including eight food groups. Consumption quartiles were obtained for each group at 4 years and assigned a score between 1 and 4. A higher score represents a higher adherence to a better diet (range: 8 to 32). The associations between early life factors and sociodemographic characteristics and the score of the healthy eating index at 7 years were evaluated through linear regression models. The healthy eating index had an average score of 21⋅4 ± 3⋅53 (range: 12 to 32) at 4 years and 20⋅3 ± 3⋅36 (range: 11 to 31) at 7 years. After adjustment for confounders, a positive association was found between the healthy eating index at 4 and 7 years (β = 0⋅384, 95 % CI 0⋅356, 0⋅441). Maternal years of education (β = 0⋅094, 95 % CI 0⋅071, 0⋅116) and dietary score (β = 0⋅182, 95 % CI 0⋅155, 0⋅209) were positively associated with increasing dietary quality from 4 to 7 years. A healthier diet at preschool age, higher maternal education and a healthier diet increase the likelihood of maintaining a high healthy eating index score at school age.

The role of socio-economic factors in food consumption of Portuguese children and adolescents: results from the National Food, Nutrition and Physical Activity Survey 2015–2016

“…A healthy eating index, previously used in Portuguese children (28,29) and based on the WHO's dietary recommendations (30) , was developed in the present study to evaluate the participants' adherence to a healthier eating pattern. The index included the nine food groups previously described.…”

Correlations between diet quality and early childhood caries among 2- to 5-year-old Chinese children：A cross-sectional study

“…Dietary imbalance will lead to malnutrition with varying degrees, which in turn will result in the hypofunction of salivary glands, and the variation in saliva composition and the decline in buffering ability of saliva, increasing the risk of ECC [31,32]. The diet quality of preschool children will affect their diet quality both at the school age and adulthood [33], and is associated with the incidence of chronic diseases and even death at the adulthood and old age [34,35]. Thus, the dietary imbalance problems of preschool children deserves great attention globally.…”

Interaction effects of socio-economic position in the association between eating location and diet quality in Portuguese children and adolescents: results from the National Food, Nutrition and Physical Activity Survey 2015–2016

“…The diet quality was assessed as a higher adherence to a healthy eating pattern previously developed for children and adolescents (30) . Briefly, nine food groups were defined and included in the index based on the WHO dietary recommendations (31) and previously validated against nutrient status (32) . Higher scores in the index were positively correlated with protein and fibre intake and negatively with total energy, total fat and saturated fat intake.…”