Topical Area: Nutritional Epidemiology
Objectives : To use the Healthy Eating Index-2015 (HEI-2015) to describe the diet quality of children in the United States by race/ethnicity within categories of body mass index (BMI) using a nationally representative sample.
Methods : Dietary datasets from three cycles of the National Health and Nutrition Examination Survey (2009-2014) were used to calculate HEI-2015 total and component scores using the population ratio method for children 2-18 years of age (N=8,894). Diet quality scores were computed by race/ethnicity (non-Hispanic black, non-Hispanic white, Mexican American, other Hispanic, and other race) within BMI category (normal weight, overweight, and obese). Means and 95% confidence intervals were computed for HEI-2015 total and component scores.
Results : Significant differences in HEI-2015 mean total scores were present in children with normal weight and overweight, but not obesity. For children with normal weight, the mean total score was significantly higher for Mexican Americans vs non-Hispanic blacks (57.1 vs 53 out of 100 points). For children with overweight, mean total scores were higher for Mexican Americans and other races vs non-Hispanic blacks (59.0 and 60.4 vs 50.3). For children with normal weight, racial/ethnic differences in mean scores were present for all 13 components except for total vegetables. For children with overweight, racial/ethnic differences in mean scores were present for seven components – total fruits, whole fruits, greens and beans, dairy, fatty acids, added sugars, and saturated fats. For children with obesity, racial/ethnic differences were present for two components – refined grains and added sugars. Due to small samples sizes resulting in unreliable estimates, results were not included for the underweight category.
Conclusions : Although significant diet quality differences were found among races/ethnicities within BMI categories, total diet quality scores were low for all populations of children in this study. These results suggest that efforts are still needed to improve the diet quality of children in the United States, regardless of BMI status.
Funding Sources : US Department of Agriculture, Agricultural Research Service.