Racial/Ethnic Disparities in Meeting 5-2-1-0 Recommendations among Children and Adolescents in the United States

Abstract

Objective To evaluate racial/ethnic disparities among children and adolescents in meeting the 4 daily 5-2-1-0 nutrition and activity targets in a nationally representative sample. The 5-2-1-0 message summarizes 4 target daily behaviors for obesity prevention: consuming ≥5 servings of fruit and vegetables, engaging in ≤2 hours of screen time, engaging in ≥1 hour of physical activity, and consuming 0 sugar-sweetened beverages daily. Study design The National Health and Nutrition Examination Survey (2011–2012) data were used. The study sample included Hispanic (n = 608), non-Hispanic black (n = 609), Asian (n = 253), and non-Hispanic white (n = 484) youth 6–19 years old. The 5-2-1-0 targets were assessed using 24-hour dietary recalls, the Global Physical Activity Questionnaire, and sedentary behavior items. Outcomes included meeting all targets, no targets, and individual targets. Multivariable logistic regression models accounting for the complex sampling design were used to evaluate the association of race/ethnicity with each outcome among children and adolescents separately. Results None of the adolescents and <1% of children met all 4 of the 5-2-1-0 targets, and 19% and 33%, of children and adolescents, respectively, met zero targets. No racial/ethnic differences in meeting zero targets were observed among children. Hispanic (aOR, 1.76 [95% CI, 1.04–2.98]), non-Hispanic black (aOR, 1.82 [95% CI, 1.04–3.17]), and Asian (aOR, 1.48 [95% CI, 1.08–2.04]) adolescents had greater odds of meeting zero targets compared with non-Hispanic whites. Racial/ethnic differences in meeting individual targets were observed among children and adolescents. Conclusions Despite national initiatives, youth in the US are far from meeting 5-2-1-0 targets. Racial/ethnic disparities exist, particularly among adolescents.

Asian American Dietary Sources of Sodium and Salt Behaviors Compared with Other Racial/Ethnic Groups, NHANES, 2011-2012

“…First, the primary sources of sodium consumed in Asian Americans appear to be salt added during cooking, not from packaged and restaurant foods; 13,31,32 and second, Asian Americans may retain traditional dietary practices postmigration to America. 33,34 Examination of Asian American demographics in NHANES reveals that NHANES appears to have recruited one portion of this population: highly educated, high-income earners 35,36 -with these individuals likely being more acculturated, 37 meaning they have adopted more US cultural practices.…”

“…41 Sodium added at the table and from supplements and medicines are not included, which may result in underestimations of consumption. 42 Lastly, it is unclear whether the Asian Americans sampled in NHANES are representative of all Asian Americans; NHANES recruited highly educated, high income earners 37 -though a stark bimodal income distribution exists for Asian Americans. 35 By potentially missing less acculturated individuals, sodium intakes may not be generalizable to all Asian Americans.…”

Dietary Disparities of Urban Chinese American Children in New York City: Results from a Pilot Study

“…[2] Analyses of dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 2011-12 wave -the first to include an oversample of Asian Americans documented lower consumption of sugary drinks. [3] Lower consumption of sugary drinks and unhealthy items (i.e., fried potatoes, fruit juice, fast food) in children were corroborated in another analysis, though patterns tended to differ by Asian subgroup (e.g., Chinese, Indian)highlighting the necessity for disaggregated analyses by Asian subgroup. [4] Beyond these examples, understanding of the diets in Asian American children, let alone specific Asian American subgroups is extremely limited.…”

Latino adolescent-father discrepancies in reporting activity parenting practices and associations with adolescents’ physical activity and screen time

“…Accelerometer data showed that a representative sample of Latino youth aged 8-16 in the United States, on average, had 35 min of moderate to vigorous physical activity (MVPA) per day, which was below the recommendation of 60 min [16]. In addition, more than three-quarters of Latino adolescents aged 12-19 in the United States had more than two hours of daily screen time [17].…”