Abstract
Background:
This study aimed to assess children's diet quality in Crete and the potential role of several socio-demographic factors related to it.
Methods:
Between October 2005 and March 2006, 481 primary school children were recruited from Crete. Dietary intake data was obtained using a combination of techniques comprising a 24 h recall and 3 food diaries. The Healthy Eating Index (HEI) was calculated summing the individual scores (0–10) assigned to 10 index components.
Results:
The majority of participants (84.5%) had diet that ‘needs improvement’ (HEI score: 51–80). Twelve percent of participants had ‘poor diet’ and only 3.5% of schoolchildren had ‘good diet’ (HEI score >80). The overall mean of the HEI score was 60.5. The mean values of the HEI components score ranged between 2.8 (that is, the HEI component that measures vegetables intake) and 9.9 (that is, component that expresses the variety of consumed foods). Low mean values were found in the total fat and saturated fat components (3.7 and 3.4, respectively). Moreover, the HEI score was strongly associated with dietary macronutrients and micronutrients intake.
Conclusion:
On the basis of the HEI score, the vast majority of children were found to have a diet that ‘needs improvement’. This indicates the increased necessity of drawing and implementing nutrition education programs targeting both children and their families and aiming to increase vegetables and fruits intake and reduce fat intake.
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References
American Academy of Pediatrics (2001). Children, adolescents, and television. Pediatrics 107, 423–426.
Angelopoulos PD, Milionis HJ, Moschonis G, Manios Y (2006). Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: The Children Study. Eur J Clin Nutr 60, 1226–1234.
Ballew C, Kuester S, Gillespie C (2000). Beverage choices affect adequacy of children's nutrient intakes. Arch Pediatr Adolesc Med 154, 1148–1152.
Batsiotis PP, Carlson A, Gerrior SA, Juan WY, Lino M (2002). The Healthy Eating Index:1999-200. US Department of Agriculture, Center for Nutrition Policy and Promotion: Washington, DC.
Boulton TJ, Magarey AM, Cockington RA (1995). Tracking of serum lipids and dietary energy, fat and calcium intake from 1 to 15 years. Acta Paediatr 84, 1050–1055.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000). Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320, 1240–1243.
Devaney B, Ziegler P, Pac S, Karwe V, Barr SI (2004). Nutrient intakes of infants and toddlers. J Am Diet Assoc 104, s14–s21.
Farris R, Nicklas T (1993). Characterizing children's eating behavior. In: SL Suskind RM (ed). Textbook of Pediatric Nutrition. Raven Press: New York, pp 505–516.
Feskanich D, Rockett HR, Colditz GA (2004). Modifying the Healthy Eating Index to assess diet quality in children and adolescents. J Am Diet Assoc 104, 1375–1383.
Ford ES, Mokdad AH, Liu S (2005). Healthy Eating Index and C-reactive protein concentration: findings from the National Health and Nutrition Examination Survey III, 1988–1994. Eur J Clin Nutr 59, 278–283.
Fung TT, McCullough ML, Newby PK, Manson JE, Meigs JB, Rifai N et al. (2005). Diet-quality scores and plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr 82, 163–173.
Hampl JS, Taylor CA, Johnston CS (1999). Intakes of vitamin C, vegetables and fruits: which schoolchildren are at risk? J Am Coll Nutr 18, 582–590.
Hesketh K, Wake M, Waters E, Carlin J, Crawford D (2004). Stability of body mass index in Australian children: a prospective cohort study across the middle childhood years. Public Health Nutr 7, 303–309.
Hu FB (2002). Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 3–9.
Huijbregts PP, Feskens EJ, Rasanen L, Fidanza F, Alberti-Fidanza A, Nissinen A et al. (1998). Dietary patterns and cognitive function in elderly men in Finland, Italy and The Netherlands. Eur J Clin Nutr 52, 826–831.
Institute of Medicine Food and Nutrition Board (2001). Dietary Reference Intakes: Applications in Dietary Assessment. National Academy Press: Washington, DC.
Jacobs Jr DR, Steffen LM (2003). Nutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr 78, 508S–513S.
Kennedy ET, Ohls J, Carlson S, Fleming K (1995). The Healthy Eating Index: design and applications. J Am Diet Assoc 95, 1103–1108.
Knol LL, Haughton B, Fitzhugh EC (2005). Dietary patterns of young, low-income US children. J Am Diet Assoc 105, 1765–1773.
Kranz S, Mitchell DC, Siega-Riz AM, Smiciklas-Wright H (2005a). Dietary fiber intake by American preschoolers is associated with more nutrient-dense diets. J Am Diet Assoc 105, 221–225.
Kranz S, Siega-Riz AM, Herring AH (2004). Changes in diet quality of American preschoolers between 1977 and 1998. Am J Public Health 94, 1525–1530.
Kranz S, Smiciklas-Wright H, Siega-Riz AM, Mitchell D (2005b). Adverse effect of high added sugar consumption on dietary intake in American preschoolers. J Pediatr 146, 105–111.
Langevin DD, Kwiatkowski C, McKay MG, Maillet JO, Touger-Decker R, Smith JK et al. (2007). Evaluation of diet quality and weight status of children from a low socioeconomic urban environment supports ‘at risk’ classification. J Am Diet Assoc 107, 1973–1977.
LaRowe TL, Moeller SM, Adams AK (2007). Beverage patterns, diet quality, and body mass index of US preschool and school-aged children. J Am Diet Assoc 107, 1124–1133.
Magkos F, Manios Y, Christakis G, Kafatos AG (2006). Age-dependent changes in body size of Greek boys from 1982 to 2002. Obesity (Silver Spring) 14, 289–294.
Manios Y, Grammatikaki E, Papoutsou S, Liarigkovinos T, Kondaki K, Moschonis G (2008). Nutrient intakes of toddlers and preschoolers in Greece: the GENESIS study. J Am Diet Assoc 108, 357–361.
Metcalf PA, Scragg RK, Stewart AW, Scott AJ (2007). Design effects associated with dietary nutrient intakes from a clustered design of 1 to 14-year-old children. Eur J Clin Nutr 61, 1064–1071.
Muntner P, He J, Cutler JA, Wildman RP, Whelton PK (2004). Trends in blood pressure among children and adolescents. JAMA 291, 2107–2113.
National Research Council (1986). Nutrient Adequacy: Assessment Using Food Consumption Surveys. Report of the Food and Nutrition Board. National Academy of Sciences: Washington, DC.
Panagiotakos DB, Pitsavos C, Stefanadis C (2006). Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis 16, 559–568.
Patterson RE, Haines PS, Popkin BM (1994). Diet quality index: capturing a multidimensional behavior. J Am Diet Assoc 94, 57–64.
Pick ME, Edwards M, Moreau D, Ryan EA (2005). Assessment of diet quality in pregnant women using the Healthy Eating Index. J Am Diet Assoc 105, 240–246.
Royo-Bordonada MA, Gorgojo L, Martin-Moreno JM, Garces C, Rodriguez-Artalejo F, Benavente M et al. (2003). Spanish children's diet: compliance with nutrient and food intake guidelines. Eur J Clin Nutr 57, 930–939.
Telama R, Yang X, Viikari J, Valimaki I, Wanne O, Raitakari O (2005). Physical activity from childhood to adulthood: a 21-year tracking study. Am J Prev Med 28, 267–273.
Trichopoulou A (2004). Traditional Mediterranean diet and longevity in the elderly: a review. Public Health Nutr 7, 943–947.
Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, Gnardellis C, Lagiou P, Polychronopoulos E et al. (1995). Diet and overall survival in elderly people. BMJ 311, 1457–1460.
University of Crete (1991). Food Composition Tables. nutrition.med.uoc.gr/GreekTables.
van Mechelen W, Twisk JW, Post GB, Snel J, Kemper HC (2000). Physical activity of young people: the Amsterdam Longitudinal Growth and Health Study. Med Sci Sports Exerc 32, 1610–1616.
Veugelers PJ, Fitzgerald AL, Johnston E (2005). Dietary intake and risk factors for poor diet quality among children in Nova Scotia. Can J Public Health 96, 212–216.
Acknowledgements
This study is a part of Archimedes I Research Programme, which was supported with a research grant from the Operational Programme for Education and Initial Vocational Training ‘(O.P. ‘Education’), which is managed by the Greek Ministry of Education.
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Angelopoulos, P., Kourlaba, G., Kondaki, K. et al. Assessing children's diet quality in Crete based on Healthy Eating Index: The Children Study. Eur J Clin Nutr 63, 964–969 (2009). https://doi.org/10.1038/ejcn.2009.10
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DOI: https://doi.org/10.1038/ejcn.2009.10
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