Interrelationships of More Healthful and Less Healthful Aspects of Diet Quality in a Low-Income Community Sample of Preschool-Aged Children

To investigate whether higher intake of "healthy" foods was associated with lower intake of "unhealthy" foods among a sample of low-income preschool-aged children, and if associations differed for younger (2-3 years) and older (4-5 years) children. Between May 2012 and May 2013, we studied 298 parents/guardians of 357 preschool-aged children living in a low-income area of a large Midwestern city in the United States. Parents reported on children's past week frequency of intake of juice, fruits, vegetables, milk, sugar-sweetened beverages, fast food, sweets, and salty snacks with seven response options (coded 0-6) ranging from none to a parts per thousand yen4 times/day. We combined fruits, vegetables, and milk to create a healthy diet score, and denoted a healthy diet behavior if frequency of intake of these foods was a parts per thousand yen2 times/day. Sugar-sweetened beverages, fast food, sweets, and salty snacks were considered unhealthy aspects of children's diets. Juice was examined separately. The number of healthy diet behaviors was not related to the number of unhealthy diet behaviors or the unhealthy diet score. This was true overall and by age group (P trend values ranged from 0.26 to 0.90), and the pattern did not differ by age (P interaction > 0.3). Correlations between healthy and unhealthy diet scores overall and for younger and older preschool-aged children were not statistically significant (Spearman correlation coefficients = 0.05, -0.01 and 0.11 respectively). Healthy and unhealthy aspects of children's diets may be independent of one another. Additional research in heterogeneous populations is needed.