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Diet quality in European pre-schoolers: evaluation based on diet quality indices and association with gender, socio-economic status and overweight, the ToyBox-study

  • An-Sofie Pinket (a1), Marieke De Craemer (a2), Inge Huybrechts (a3), Ilse De Bourdeaudhuij (a2), Benedicte Deforche (a1) (a4), Greet Cardon (a2), Odysseas Androutsos (a5), Berthold Koletzko (a6), Luis Moreno (a7), Piotr Socha (a8), Violeta Iotova (a9), Yannis Manios (a5) and Wendy Van Lippevelde (a1)...

Abstract

Objective

To study diet quality among pre-schoolers using the Diet Quality Index (DQI) and to investigate differences according to gender, socio-economic status (SES) and overweight/obesity status.

Design

Kindergarten-based cross-sectional survey within the ToyBox-study. A standardized protocol was used and parents/caregivers self-reported sociodemographic data and a semi-quantitative FFQ. A total DQI and its four subcomponents (diversity, quality, equilibrium and meal index) were calculated based on this FFQ. High total DQI scores indicate better diet quality than low scores. Results of the total DQI and the subcomponents were reported as percentages of maximum scores (100 %).

Setting

Kindergartens in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain).

Subjects

European pre-schoolers (aged 3·5–5·5 years) and their parents/caregivers (n 7063).

Results

The mean total DQI score was 68·3 %. Mean scores of the subcomponents were 61·7 % for diversity, 56·5 % for quality, 65·4 % for equilibrium and 89·7 % for the meal index. Pre-schoolers of lower-SES backgrounds had lower scores on the total DQI and all its subcomponents. No clear differences were found by gender and overweight status. Results differed slightly according to country.

Conclusions

Pre-schoolers scored low on the total DQI and especially on dietary quality, as energy-dense, low-nutritious food items were more often consumed than highly nutritious food items. Furthermore, already in pre-schoolers lower-SES mothers were less likely to provide a good diet quality and this was consistent for all four subcomponents of the total DQI. Food intake in pre-schoolers should be enhanced, especially in pre-schoolers of lower-SES backgrounds.

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Copyright

Corresponding author

* Corresponding author: Email ansofie.pinket@ugent.be

References

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1. Huybrechts, I & De Henauw, S (2007) Energy and nutrient intake by pre-school children in Flanders-Belgium. Br J Nutr 98, 600610.
2. Craigie, AM, Lake, AA, Kelly, SA et al. (2011) Tracking of obesity-related behaviours from childhood to adulthood: a systematic review. Maturitas 70, 266284.
3. Huybrechts, I, Matthys, C, Vereecken, C et al. (2008) Food intakes by preschool children in Flanders compared with dietary guidelines. Int J Environ Res Public Health 5, 243257.
4. Manios, Y, Kourlaba, G, Kondaki, K et al. (2009) Diet quality of preschoolers in Greece based on the Healthy Eating Index: the GENESIS study. J Am Diet Assoc 109, 616623.
5. Royo-Bordonada, MA, Gorgojo, L, Martín-Moreno, JM et al. (2003) Spanish children’s diet: compliance with nutrient and food intake guidelines. Eur J Clin Nutr 57, 930939.
6. Kersting, M, Alexy, U, Kroke, A et al. (2004) Nutrition of children and adolescents. Results of the DONALD Study. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 57, 213218.
7. Huybrechts, I, Vereecken, C, De Bacquer, D et al. (2010) Reproducibility and validity of a diet quality index for children assessed using a FFQ. Br J Nutr 104, 135144.
8. Huybrechts, I, Vereecken, C, Vyncke, K et al. (2013) The ‘Diet Quality Index’ and its applications. In Diet Quality: An Evidence-Based Approach, vol. 2, pp. 301314 [VR Preedy, L-A Hunter and VB Patel, editors]. New York: Springer.
9. Nicklaus, S (2009) Development of food variety in children. Appetite 52, 253255.
10. Krebs-Smith, SM, Smiciklas-Wright, H, Guthrie, HA et al. (1987) The effects of variety in food choices on dietary quality. J Am Diet Assoc 87, 897903.
11. McConahy, KL, Smiciklas-Wright, H, Mitchell, DC et al. (2004) Portion size of common foods predicts energy intake among preschool-aged children. J Am Diet Assoc 104, 975979.
12. Barlow SE & Expert Committee (2007) Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 120, 164192.
13. Koletzko, B & Toschke, AM (2010) Meal patterns and frequencies: do they affect body weight in children and adolescents? Crit Rev Food Sci Nutr 50, 100105.
14. Patterson, RE, Haines, PS & Popkin, BM (1994) Diet quality index: capturing a multidimensional behavior. J Am Diet Assoc 94, 5764.
15. Batty, GD & Leon, DA (2002) Socio-economic position and coronary heart disease risk factors in children and young people. Evidence from UK epidemiological studies. Eur J Public Health 12, 263272.
16. Fernández-Alvira, JM, Mouratidou, T, Bammann, K et al. (2013) Parental education and frequency of food consumption in European children: the IDEFICS study. Public Health Nutr 16, 487498.
17. Brug, J, van Stralen, MM, te Velde, SJ et al. (2012) Differences in weight status and energy-balance related behaviors among schoolchildren across Europe: the ENERGY-project. PLoS One 7, E34742.
18. Szajewska, H & Ruszczynski, M (2010) Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Crit Rev Food Sci Nutr 50, 113119.
19. Martin, HP (1973) Nutrition: its relationship to children’s physical, mental, and emotional development. Am J Clin Nutr 26, 766775.
20. Manios, Y, Androutsos, O, Katsarou, C et al. (2014) Designing and implementing a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study. Obes Rev 15, 513.
21. Manios, Y, Grammatikaki, E, Androutsos, O et al. (2012) A systematic approach for the development of a kindergarten-based intervention for the prevention of obesity in preschool age children: the ToyBox-study. Obes Rev 13, 312.
22. Huybrechts, I, De Backer, G, De Bacquer, D et al. (2009) Relative validity and reproducibility of a food-frequency questionnaire for estimating food intakes among Flemish preschoolers. Int J Environ Res Public Health 6, 382399.
23. Vanhauwaert, E (2012) De actieve voedingsdriehoek. Leuven: Acco.
24. European Food Information Council (2009) Food-based dietary guidelines in Europe . http://www.eufic.org/article/en/expid/food-based-dietary-guidelines-in-europe/ (accessed April 2015).
25. Winkleby, MA, Jatulis, DE, Frank, E et al. (1992) Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health 82, 816820.
26. De Miguel-Etayo, P, Mesana, MI, Cardon, G et al. (2014) Reliability of anthropometric measurements in European preschool children: the ToyBox-study. Obes Rev 15, 6773.
27. Cole, TJ & Lobstein, T (2012) Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes 7, 284294.
28. Mouratidou, T, Miguel, ML, Androutsos, O et al. (2014) Tools, harmonization and standardization procedures of the impact and outcome evaluation indices obtained during a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study. Obes Rev 15, 5360.
29. Vereecken, CA, Keukelier, E & Maes, L (2004) Influence of mother’s educational level on food parenting practices and food habits of young children. Appetite 45, 93103.
30. O’Malley, AS, Kerner, JF & Johnson, L (1999) Are we getting the message out to all? Health information sources and ethnicity. Am J Prev Med 17, 198202.
31. Kant, AK & Graubard, BI (2013) Family income and education were related with 30-year time trends in dietary and meal behaviors of American children and adolescents. J Nutr 143, 690700.
32. Tooze, JA, Subar, AF, Thompson, FE et al. (2004) Psychosocial predictors of energy underreporting in a large doubly labeled water study. Am J Clin Nutr 79, 795804.
33. González-Gil, EM, Mouratidou, T, Cardon, G et al. (2014) Reliability of primary caregivers reports on lifestyle behaviours of European pre-school children: the ToyBox-study. Obes Rev 15, 6166.
34. De Coen, V, Vansteelandt, S, Maes, L et al. (2012) Parental socioeconomic status and soft drink consumption of the child. The mediating proportion of parenting practices. Appetite 59, 7680.
35. Williams, SK & Kelly, FD (2005) Relationships among involvement, attachment, and behavioral problems in adolescence: examining father’s influence. J Early Adolesc 25, 168196.
36. De Coen, V, De Bourdeaudhuij, I, Verbestel, V et al. (2014) Risk factors for childhood overweight: a 30-month longitudinal study of 3- to 6-year-old children. Public Health Nutr 17, 19932000.
37. Moreno, LA, De Henauw, S, González-Gross, M et al. (2008) Design and implementation of the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study. Int J Obes (Lond) 32, 511.
38. van Stralen, MM, te Velde, SJ, Singh, AS et al. (2011) EuropeaN Energy balance Research to prevent excessive weight Gain among Youth (ENERGY) project: design and methodology of the ENERGY cross-sectional survey. BMC Public Health 11, 65.

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