Nutrient Intakes and Diet Quality of Toddlers and Preschoolers Participating in STRONG Kids 2 Cohort

Objectives: To measure dietary and nutrient intake of 2-, 3-, and 4-year-olds (yo) in the STRONG Kids 2 (SK2) cohort and assess diet quality and adherence to the 2020-2025 Dietary Guidelines for Americans (DGA). Methods: Dietary intake data were collected at 2- (n=337), 3- (n=317), and 4- (n=289) yo using a 90-item Child Block Food Frequency Questionnaire (FFQ; Nutrition Quest) completed online by the primary care provider. Data from the FFQ were used to calculate the means, standard deviations, percentages of children consuming specific food groups, diet quality, and percent compliance with meeting dietary recommendations. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015) calculated from FFQ data. Kruskal-Wallis tests were conducted with a Dunn's test for multiple comparisons to analyze differences in macronutrients, micronutrients, HEI-2015 scores, and food group consumption between ages. Results: Macronutrient intake varied across age groups, with 2-yo consuming a higher % kcals from fat (P< 0.0001) and protein (P< 0.0001) than 4-yos, while 3-yo exhibited similar trends to the 2-yos. The % kcals from protein (15%) met recommended levels across all ages. The % kcals from carbohydrates and added sugars increased with age (P< 0.0001) but were within recommended amounts. In terms of micronutrients, children met or exceeded recommended intakes, but a concerningly low number (< 34%) of children across all age groups met guidelines for dietary fiber (g), vitamin D (IU), vitamin E (alpha-TE), calcium (mg), iron (mg), and potassium (mg). Mean HEI-2015 scores were 55 at 2- and 3-yo, and 54 at 4-yo, indicating low adherence to the Dietary Guidelines for Americans. Conclusions: Poor diet quality and adherence to dietary recommendations were observed for 2 to 4 yo in the SK2 cohort. Targeted interventions are needed to improve adherence to guidelines and promote balanced eating habits in early childhood that may have long-lasting impacts on health outcomes later in life. Funding Sources: NIH, The National Dairy Council, General Mills.