The quality of girls' diets declines and tracks across middle childhood

BACKGROUND: Food group intakes by US children are below recommendations and micronutrient inadequacies have been reported. There are few longitudinal data that focus on developmental changes in food and nutrient intake from early to middle childhood. We examined changes in nutrient and food group intakes over time and the tracking of intakes across middle childhood in a longitudinal sample of girls. METHODS: Three multiple-pass 24-hour diet recalls were conducted in a sample of 181 non-Hispanic White girls at ages 5, 7, and 9 years. Food and nutrient data were averaged across 3 days. Analyses of time effects were conducted using repeated measures analysis of variance and tracking of intakes was assessed via rank analysis. RESULTS: We found significant decreases in nutrient densities (intakes per 1000 kcal) of vitamins C and D, calcium, phosphorus, magnesium and zinc at age 9. Girls maintained their relative quartile positions for these micronutrients from ages 5–9. Analysis of food group data showed similar trends. At age 9, significantly fewer girls were meeting the recommendations for dairy, fruit and vegetable servings than at age 5 and girls also tended to remain in their respective quartiles over time, especially for fruit and dairy intakes. CONCLUSIONS: These results highlight the importance of developing healthy eating practices during early childhood when caretakers have considerable control over children's food intake

Girls’ Dairy Intake, Energy Intake, and Weight Status

We explored the relationships among girls’ weight status, dairy servings, and total energy intake. The hypothesis that consuming dairy could reduce risk for overweight was evaluated by comparing energy intake and weight status of girls who met or consumed less than the recommended three servings of dairy per day. Participants included 172 11-year-old non-Hispanic white girls, assessed cross-sectionally. Intakes of dairy, calcium, and energy were measured using three 24-hour recalls. Body mass index and body fat measures from dual-energy x-ray absorptiometry were obtained. Because preliminary analyses suggested systematic underreporting of energy intake, the relationships among dairy servings and measures of weight status were examined for the total sample and for subsamples of under-, plausible, and overreporters. Data for the total sample provided support for the hypothesized relationship among weight status, dairy servings, and energy intake. Thirty-nine percent of girls reported consuming the recommended ≥3 servings of dairy per day; these girls also reported higher energy intake but had lower body mass index z scores and body fat than the girls who consumed fewer than three dairy servings each day. Among plausible reporters, no relationship between dairy intake and weight status was noted. This discrepancy may be attributable to a high percentage (45%) of overweight underreporters in the total sample. Our findings reveal that reporting bias, resulting from the presence of a substantial proportion of underreporters of higher weight status, can contribute to obtaining spurious associations between dairy intake and weight status. These findings underscore the need for randomly controlled trials to assess the role of dairy in weight management. The prevalence of pediatric obesity has been rising for more than 20 years (1). There is evidence that increased intake of dairy foods and calcium may play a significant role in maintaining a healthful weight and moderating body fat (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15). However, results across studies have been inconsistent (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 and 28), and this may be attributable to major challenges in using self-reported dietary intake data. Self-reported intakes tend to be subject to underreporting bias and the underreporting of energy intake tends to be positively related to weight status. Underreporters also tend to weigh more (29 and 30). Doubly labeled water techniques assessing energy expenditure suggest underreporting results in a 10% to 50% underestimation of actual energy intake and is a significant problem in older children (31). Doubly labeled water techniques are expensive and not feasible for large samples; thus, several methods have been developed that use estimated energy requirements to assess reporting bias (29 and 32). Therefore, in this study the method suggested by Huang and colleagues (29) was used to classify children as under-, plausible, or overreporters. The objective of this study was to assess the relationship among girls’ weight status, dairy servings, and total energy intake. The hypothesis that consuming dairy could reduce risk for overweight was evaluated by comparing energy intake and weight status of girls who met or consumed less than the recommended three servings of dairy per day. To explore the effect of reporting bias on this relationship, the hypothesis was evaluated using the total sample, and subgroups of girls identified as plausible, under-, or overreporters

Consumption of recommended food groups among children from medically underserved communities

This cross-sectional study of 2 to 12 year olds living in medically underserved areas examined the proportion of children meeting the food group intake recommendations for fruits, vegetables, total grains, dairy, and meat/meat alternatives by age group and body weight status. Based on 24-hour recalls collected between July 2004 and March of 2005, mean food group intake and deviation from the recommended intake amount were determined (actual intake minus recommended intake). Measured weight and height were used to calculate body mass index z-scores using the Centers for Disease Control and Prevention (CDC) growth charts. Analyses were conducted for two age groups (2 to 5 and 6 to 12 year olds) (n=214), by weight status categories (underweight or healthy weight ( 95th percentile)), and repeated for the subset of children with biologically plausible reports. The majority of children lived in lowincome households. More 2 to 5 year olds met intake recommendations compared to 6 to 12 year olds. Overall, the proportion of children meeting the food group intake recommendations was low with the exception of the meat group, which was met by 52% to 93% of children. There was a positive association between the proportion of younger children meeting the fruits or total grains recommendation and increasing body weight. The data support the importance of community-level nutrition intervention programs to improve children's diet quality in low income, medically underserved areas and suggest that such interventions may help reduce the risk of obesity. Originally published Journal of the American Dietetic Association, Vol. 109, No. 4, Apr 200