US Children’s Diet Quality Still Low, But Improving

24 Nov 2016 --- The diet of US children has improved between 1999 and 2012, according to the authors of a new study that examined diet quality data from more than 38,000 kids. However, the researchers stress that overall diet still remains poor and that disparities remain among key subgroups.

The study, published in the American Journal of Clinical Nutrition, used the 100-point Healthy Eating Index (HEI-2010) score, and researchers analyzed data gathered from 38,487 children aged 2 to 18 in the National Health and Nutrition Examination Survey (NHANES).

Over the study period the average HEI-2010 rose to 50.9 from 42.5 as children ate more healthy foods, such as whole fruit, and became increasingly likely to avoid “empty calories,” such as sugary drinks.

The improvement in “empty calories” explained about a third of the total improvement.

“I am encouraged by the gains,” says study lead author Xiao Gu, a master's student in epidemiology in the Brown University School of Public Health.

“Although we showed several components still need to be improved, our paper provides evidence that we are on the correct track,” Gu adds.

Many of the components that make up the overall HEI-2010 score improved significantly, such as empty calories; whole grains; dairy; whole fruit; total fruit; seafood and plant proteins, greens and beans, and fatty acids; total protein foods; and refined grains. Sodium consumption worsened slightly.

However, in many cases the component scores improved from very poor levels, suggesting that nutrition among U.S. children needs to improve even further.

“The average score for whole grains is only 2, which is far below its maximum of 10, even though we observed a significant increasing trend,” Gu says.

“For whole fruit the optimal is 5 but the average we observed is 2.1. I think the increasing trend is encouraging but the current dietary quality level is disappointing.”

Although every demographic subgroup of children showed an improvement, the pace varied and the disparities between them remain.

The score among non-Hispanic black children improved to 48.4 in 2012 from 39.6 in 1999, but over the same period the score for non-Hispanic whites rose to 50.2 from 42.1.

While the gap narrowed somewhat, a clear disparity persists. Gu and Tucker also looked at economic correlates of nutrition. They found that as household wealth increased, so did the degree of gains.

The authors also analyzed diet quality among children in federal nutrition assistance programs.

Over the course of the study period, the HEI-2010 scores of children in families receiving Supplemental Nutrition Assistance Program (SNAP) benefits began to lag those of children not receiving such benefits, while children benefitting from the Women Infants and Children (WIC) program pulled further ahead of children not receiving that assistance.

That difference might in part relate to how the two programs are structured, Gu says. In SNAP, because consumers can buy almost any food they might buy less healthy ones if they are less expensive.

WIC, on the other hand, limits food choices to ones that adhere to dietary guidelines.

Overall, the researchers believe that the policy changes over recent years play a huge role in the overall improvement.

“Over the same period researchers, policymakers and non-governmental organizations have worked well together, for example, to improve nutritional guidelines. Ballot initiatives may have helped further,” Gu says, “by passing soda taxes in several cities that could further discourage empty calorie consumption. “

“We should continue improving our policies and programs along with doing more research because that has really made Americans healthier,” Gu concludes.