1. Children who consumed a greater variety of foods and those more adherent to recommended diets for their age (dietary diversity) were found to have larger, inappropriate increases in body mass index (BMI) scores each year than children who ate a more limited selection of food.
2. Older children and girls were more likely to eat a wide variety of fruits, vegetables, and healthy foods, as well as to consume a higher proportion of servings within the recommended dietary guidelines.
Evidence Rating Level: 2 (Good)
Study Rundown: With a significant amount of preschool children in the United States being overweight, dietary interventions are common targets for treatment. Previous studies have shown that increasing healthy dietary variety in adults is associated with a decrease in obesity; however, results in children and adolescents have been inconclusive. The authors of the current study sought to determine if there was an association between these dietary measures and the BMI scores of preschool aged children. Results indicated that contrary to popular belief and current medical practices, children who consumed a higher variety of foods and were more adherent to dietary recommendations actually had greater yearly increases in BMI scores than children with more limited diets. Girls and older children were more likely to eat a wide variety of fruits, vegetables, and healthy foods. They also had higher dietary diversity scores than younger children and boys. The results may not be generalizable outside of the study area and data was limited by self-reporting of dietary intake. However, results of this study should encourage providers to reevaluate their recommendations for increased dietary variety in order to prevent and control obesity in children.
Relevant Reading: Dietary recommendations for children and adolescents
In-Depth [prospective cohort]: A total of 340 children (50.6% girls, 69.4% Caucasian) from Michigan were included from the federally-funded preschool program for low-income families, Head Start. Participants were weighed and measured and BMI scores were calculated; follow-up was initiated at an average of 20.6 months. Parents completed the Harvard Service Food Frequency Questionnaire to document children’s dietary intake. Scores for fruit/vegetable, healthy foods, and moderation foods variety were calculated for each child by assigning 1 point for each food that met the criterion of ≥1 serving per week. Dietary diversity scores were computed for each child in order to understand their concordance with dietary guidelines for each food group. Results demonstrated an association between older age and higher scores in all areas of dietary variety [fruit/vegetable, healthy foods, moderation foods, and overall variety (p<.001 for all)] as well as dietary diversity (p =.03). Girls also had significantly higher scores than boys in the fruit/vegetable variety (p=.03), healthy foods variety (p =.02), and dietary diversity (p =.04) categories. Overall, scores higher in healthy variety (p =.04), overall variety (p =.02), and dietary diversity (p =.02) were associated with larger increases in annual BMI scores.
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