Dietary Patterns Among US Children: A Cluster Analysis

Priya Fielding-Singh; Jessie X Fan

doi:10.1016/j.jand.2023.12.001

Dietary Patterns Among US Children: A Cluster Analysis

J Acad Nutr Diet. 2023 Dec 9:S2212-2672(23)01719-7. doi: 10.1016/j.jand.2023.12.001. Online ahead of print.

Authors

Priya Fielding-Singh¹, Jessie X Fan²

Affiliations

¹ Sandberg Goldberg Bernthal Family Foundation, San Francisco, California. Electronic address: priyafs@gmail.com.
² Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah.

PMID: 38081384
DOI: 10.1016/j.jand.2023.12.001

Abstract

Background: Most children in the United States consume low-quality diets. Identifying children's dietary patterns and their association with sociodemographic characteristics is important for designing tailored youth dietary interventions.

Objective: This study's objective was to use cluster analysis to investigate children's dietary patterns and these patterns' associations with sociodemographic characteristics.

Design: Data from two cycles (2015-2016 and 2017-2018) of the National Health and Nutrition Examination Survey were evaluated to examine dietary patterns.

Participants and setting: Participants included 3,044 US youth aged 2 to 11 years who completed at least 1 valid 24-hour diet recall.

Main outcome measures: The main outcome measures were Healthy Eating Index (HEI) 2015 component and composite scores.

Statistical analyses performed: A cluster analysis was performed on standardized scores of 11 components of the HEI-2015 to identify dietary patterns. One logistic analysis combined the two higher-HEI score clusters and the 2 lower-HEI score clusters to form a 3-category variable of higher-, medium-, and lower-HEI score clusters. Another logistic analysis contrasted 2 higher- and then the 2 lower-HEI clusters with each other to examine sociodemographic factors contributing to cluster membership.

Results: Five clusters were identified, each displaying a distinct dietary pattern. Older, non-Hispanic Black, and overweight children had higher odds of being in the higher-HEI clusters than the medium-HEI cluster. Being older and non-Hispanic Black were linked to higher odds of being in the lower-HEI clusters than the medium-HEI cluster. Conversely, being Mexican American and living with a college-educated reference person were associated with lower odds of being in the lower-HEI clusters compared with the medium-HEI cluster. Among the higher-HEI clusters, Mexican American and Asian American children had higher odds of being in the Pescatarian cluster. Among the lower-HEI clusters, children who were racially or ethnically minoritized had lower odds of being in the Excess Sugar cluster.

Conclusions: Children in this study displayed different dietary patterns, with key sociodemographic variation.

Keywords: Children; Cluster analysis; Diet quality; Dietary patterns.