Nutrient adequacy and diet quality in non-overweight and overweight Hispanic children of low socioeconomic status: The Viva La Familia Study

Authors: WILSON, THERESA - Children'S Nutrition Research Center (CNRC); ADOLPH, ANNE - Children'S Nutrition Research Center (CNRC); BUTTE, NANCY - Children'S Nutrition Research Center (CNRC)

Submitted to: Journal Of The American Dietetic Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/21/2008
Publication Date: 6/1/2009
Citation: Wilson, T.A., Adolph, A.L., Butte, N.F. 2009. Nutrient adequacy and diet quality in non-overweight and overweight Hispanic children of low socioeconomic status: The Viva La Familia Study. Journal Of The American Dietetic Association. 109:1012-1021.

Interpretive Summary: The role of diet quality and nutrient adequacy in the etiology of childhood obesity was explored. Non-overweight and overweight siblings in the VIVA LA FAMILIA Study were asked to recall their complete dietary intake on two random, weekday occasions. Diet quality was evaluated against the US Dietary Guidelines. Nutrient adequacy was assessed against estimated requirements. On average, diet quality did not comply with the US dietary guidelines in terms of fat, cholesterol, saturated fatty acids, fiber, added sugar, and sodium. Although energy intake was higher in overweight children, food sources, diet quality, macro- and micronutrient composition were similar between non-overweight and overweight siblings. Average nutrient intakes were adequate, except possibly for vitamins D and E, pantothenic acid, calcium, and potassium. While the diets of these low socioeconomic status Hispanic children were adequate in most essential nutrients, dietary quality was suboptimal. Knowledge of the diets of high-risk Hispanic children will inform nutritional interventions and policy.

Technical Abstract: The role of diet quality and nutrient adequacy in the etiology of childhood obesity is poorly understood. The specific aims of these analyses were to assess overall diet quality and nutrient adequacy, and test for association between weight status and diet in children from low socioeconomic status (SES) Hispanic families at high risk for obesity. A cross-sectional study design was used to assess dietary intake in low-SES Hispanic children with and without overweight who were enrolled in the Viva la Familia Study. Multiple-pass 24-hour dietary recalls were recorded on two random, weekday occasions. Diet quality was evaluated according to the Dietary Guidelines for Americans. Nutrient adequacy was assessed using z scores based on estimated average requirement or adequate intake. The study included 1,030 Hispanic children and adolescents, aged 4 to 19 years, in Houston, TX, who participated between November 2000 and August 2004. STATA software (version 9.1, 2006, STATA Corp, College Station, TX) was used for generalized estimating equations and random effects regression. Diet quality did not adhere to the Dietary Guidelines for Americans for fat, cholesterol, saturated fatty acids, fiber, added sugar, and sodium. Although energy intake was significantly higher in children with overweight, food sources, diet quality, macro- and micronutrient composition were similar between non-overweight and overweight children. Relative to estimated average requirements or adequate intake levels, mean nutrient intakes were adequate (70% to 98% probability) in the children without and with overweight, except for vitamins D and E, pantothenic acid, calcium, and potassium, for which z scores cannot be interpreted given the uncertainty of their adequate intake levels. Whereas the diets of low-SES Hispanic children with and without overweight were adequate in most essential nutrients, other components of a healthful diet, which promote long-term health, were suboptimal. Knowledge of the diets of high-risk Hispanic children will inform nutritional interventions and policy.