America's Children: Key National Indicators of Well-Being, 2009
Diet Quality
The diet quality of children and adolescents is of concern. Poor eating patterns established in childhood may transfer to adulthood; such patterns are major factors in the increasing rate of childhood obesity over the past decades and are contributing factors to related health outcomes (see HEALTH7). The Healthy Eating Index-2005 (HEI-2005) is a dietary assessment tool comprising the 12 components shown below. HEI measures quality in terms of how well diets meet the recommendations of the 2005 Dietary Guidelines for Americans and MyPyramid, USDA's food guidance system (http://www.MyPyramid.gov).132,133,134 The HEI-2005 component scores are averages across all children which reflect usual dietary intakes.135 Nine components of the HEI-2005 address nutrient adequacy. The remaining three components assess saturated fat, sodium, and extra calories, all of which should be consumed in moderation.
Indicator HEALTH6: Average diet scores for children ages 2–17 expressed as a percentage of Federal diet quality standards by age group, 2003–2004
a DGOV means dark green and orange vegetables.
NOTE: HEI-2005 scores are expressed as percentages of recommended dietary intake levels. A score corresponding to 100 percent indicates that the recommendation was met or exceeded on average. A score below 100 percent indicates that average intake does not meet the recommendations for that component. For the adequacy components, higher scores reflect higher intakes. For the moderation components, higher scores reflect lower intakes because lower intakes are more desirable. For all components, a higher percentage indicates a higher quality diet. "Extra calories" refers to calories from other sources, such as solid fats and added sugars.
SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey, 2003–2004 and U.S. Department of Agriculture, Center for Nutrition Policy and Promotion, Healthy Eating Index-2005.
- In 2003–2004, on average, the quality of the diets of younger children was better when compared with that of older children with regard to fruit, milk, and extra calories. The quality of the diets of older children was better with regard to meat, oils, and saturated fat.
- The average diet score for all age groups (2–5, 6–11, and 12–17) met the quality standards for total grains, but only children ages 2–5 met the standards for total fruit and milk.
- The average diet score across all age groups, especially those of children ages 6–11 and 12–17, did not meet quality standards for a number of food groups, indicating a need to increase intakes of all types of fruit and vegetables, but especially dark green and orange vegetables (DGOV) and cooked dry beans and peas (legumes); whole grains; and oils.136
- Average intakes of sodium, saturated fat, and calories from solid fats and added sugars in foods and beverages did not meet the quality standards in any age group. This indicates a need to limit intake of foods high in salt, added sugar (i.e., not naturally occurring), and solid fat. For example, non-fat or low-fat milk and lean meat products should replace foods that have a higher fat content.132
132 U.S. Health and Human Services and U.S. Department of Agriculture. (2005). Dietary Guidelines for Americans (6th ed.). Washington, DC: U.S. Government Printing Office.
133 Guenther, P.M., Reedy, J., and Krebs-Smith, S.M. (2008). Development of the Healthy Eating Index-2005. Journal of the American Dietetic Association, 108, 1896–1901.
134 Guenther, P.M., Reedy, J., Krebs-Smith, S.M., and Reeve, B.B. (2008). Evaluation of the Healthy Eating Index-2005. Journal of the American Dietetic Association, 108, 1854–1864.
135 Freedman, L.S., Guenther, P.M., Krebs-Smith, S.M., and Kott, P.S. (2008). A population's mean Healthy Eating Index-2005 scores are best estimated by the score of the population ratio when one 24-hour recall is available. Journal of Nutrition, 138, 1725–1729.
136 Oils include the oils found in fish, nuts, seeds, and soft margarines, as well as liquid vegetable oils, such as olive, canola, corn, and soybean.