Looking at diets in early childhood

The diet in the early years of a child’s life is seen as an important way to intervene and promote high-quality nutrition. However, there is little data on the evolution of nutritional quality in early childhood, nor is there much data on the variation in nutritional quality trajectories. A report in the Journal of the Academy of Nutrition and Dietetics attempted to identify and evaluate these pathways

The researchers conducted a secondary analysis of an observational, longitudinal cohort study that involved both non-Hispanic black and white children and their parents from racially-matched families, along with a 4-year follow-up, which could mean as many as 13 study visits. for the child, with a minimum of 3 visits required for admission. At baseline, body mass index, infant feeding habits, and maternal data were collected. A child’s diet was evaluated at each visit by means of a three-day diary. The main outcome measures were the component scores of the Healthy Eating Index 2005 (HEI-2005) and the total score of the HEI-2005.

They found that overall HEI score was generally low when a child was 3 years old (mean ± standard error = 55.1 ± 0.4 of up to 100 points) and remained stable until (?) when the child was 7 years old. was (mean ± standard error = 55.1 ± 0.4 of up to 100 points). ± standard error = 54.0 ± 0.6; P = 0.08 for trend). 5 HEI-2005 trajectory groups were noted, of which 1 decreased over time and 1 improved over time. The HEI-2005 component scores, excluding meat/beans and milk intake, varied significantly (all, PP 0.02) between the trajectory groups at 3 years of age and these differences were maintained at 7 years of age. All trajectory groups saw low component scores in total vegetables, whole grains, and dark green and orange vegetables and legumes. High variability was noted in whole fruit; total fruit; saturated fats; and calories from solid fats, alcoholic beverages and added sugars. Children who were in the lowest diet group were more likely to drink soda regularly before their third birthday and were also less likely to breastfeed.

The researchers concluded that children had low nutritional quality at age 3, and this remained stable until age 7. All children’s diets can be improved by consuming more vegetables and whole grains. In families at risk for overall low nutritional quality, there should be a concentrated effort to increase fruit intake and reduce consumption of solid fats, alcoholic beverages, and added sugars.


1. Woo J, Reynolds K, Summer S, Khoury P, Daniels S, Kalkwarf H. Longitudinal nutritional quality pathways suggest goals for early childhood diet improvement. J Acad Nutr Diet. 2021;121(7):1273-1283. doi:10.1016/j.jand.2020.08.084

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