The Development and Evaluation of a Diet Quality Index for Asian Toddlers and Its Perinatal Correlates: The GUSTO Cohort Study

Abstract

Early childhood diet may have lifelong influences on health outcomes, yet development of indices to assess diet quality is scarce in toddlers, especially in Asian countries. We aimed to develop and evaluate a Diet Quality Index (DQI) in a multi-ethnic Asian mother–offspring cohort and identify perinatal correlates of early childhood diet. Based primarily on the Singapore dietary guidelines, the DQI includes seven food components: rice, bread and alternatives; fruit; vegetables; meat and alternatives; milk and dairy products; whole grains; and foods high in sugar. The DQI was developed using parental report of Food Frequency Questionnaires (FFQ) data for 18-month-old toddlers (n = 561). The mean ± SD of DQI for the study toddlers was 44.2 ± 8.9 (theoretical range: 0–65). A higher DQI (better diet quality) was associated with higher intakes of several nutrients and food groups (e.g., vegetables, dietary fibre, and beta-carotene; all p < 0.001). Further construct validity was demonstrated by substantial agreement between the FFQ-DQI and 24-hour-recall-DQI (Intraclass-correlation-coefficient: 0.70). Independent predictors of lower DQI included higher maternal pre-pregnancy BMI [β(95% CI): −0.23(−0.39, −0.07)], Malay ethnicity [−1.88(−3.67, −0.09)], lower household income [−1.97(−3.91, −0.03)], lower education level [−2.57(−4.85, −0.28)] and never breastfeeding [−6.17(−11.06, −1.28)]. We developed a valid DQI for assessing the overall quality of the diets of Asian toddlers.

The Adherence of Singaporean Students in Different Educational Institutions to National Food-Based Dietary Guidelines

“…The HEI-SGA scores across the cohort suggested that dietary intake was frequently divergent from dietary guidelines in this cohort, with the median score of the current sample (48.5 out of 100) appearing lower than similar estimates of diet quality in Singaporean pre-teen (median 65.4 out of 100) and infants (mean 44.2 out of 65) noted in recent studies [ 34 , 35 ].…”

“…Such approaches may also be less prone to confounding factors than an evaluation of intake of single or multiple nutrients and food groups [ 33 ]. While approaches to estimate overall dietary quality have been published for Singaporean infants and children [ 34 , 35 ], the authors believe that no such method has currently been defined for late adolescents and young adults.…”

Edukasi Gizi Dan Pembuatan Menu Program Makan Bersama Pada Ibu Siswa/I Pendidikan Anak Usia Dini

“…Anak Usia Dini memiliki Indeks Makan Sehat rata-rata hanya 60 %, dimana AUD jarang mengkonsumsi sayuran dan kacang-kacangan hijau serta tinggi konsumsi makanan lemak jenuh PAUD (Murphey et al 2011). Chen et al (2019) juga menemukan kebiasaan AUD mengonsumsi makanan jenis karbohidrat per-hari mencapai 58,1 %, makanan gula tinggi 94,8 %, sedangkan sayur hanya 9,8%, dan buah hanya 28 %.…”

As a mother, I prefer to give a healthy snack, however... : Mothers’ considerations and value conflicts while providing snacks to their 2-7-year-old children

“…Gevers et al (2016) found that 7-12-year-old children of mothers with a lower educational level consumed more energy-dense snacks, compared to children of higher educated mothers. Likewise, studies of Durão et al (2017), Chen et al (2019), van der Velde et al (2019), and Gutiérrez-Camacho et al (2019) confirm the relation between higher maternal education and a healthier dietary pattern of their children. Whether maternal educational attainment influences mothers' snack choices for their 2-7-year-old children and the possible value conflicts experienced is studied in this thesis.…”

“…Parents influence the food intake of their children through their interaction with their children, as well as by the availability of foods at home (Horst and Sleddens, 2017). In addition, the educational level of the mother is of influence on their food choice for their children (Craig et al, 2010;Chen et al, 2019;van der Velde et al, 2019;Damen t al., 2019b). Also the family structure, including the presence of siblings has been shown to influcence eating habits of children (Haines et al, 2019, Damen et al, 2020b.…”