More-To-Less Home Healthful Foods Ratio is Associated With Diet Quality in Preadolescents With Elevated Body Mass Index

Abstract

Objective: To examine home food availability (HFA) and the association with diet quality in preadolescents with elevated body mass index.

Methods: A cross-sectional analysis examined HFA and diet quality (using the 2015-Health Eating Index [HEI] derived from 1 or 2 24-hour dietary recalls) among preadolescents (n = 111; aged 8-12 years; body mass index ≥ 75th percentile). A novel ratio of more-to-less healthful items was created to represent HFA. Multivariate linear regression models examined the HFA ratio and individual food and beverage groups as correlates of HEI.

Results: The HFA ratio was associated with higher HEI (β = 5.3 [1.3]; P < 0.001). Home food availability of sweets (β = -2.6 [0.9]; P = 0.003) and sugar-sweetened beverages (β = -2.3 [1.0]; P = 0.02) were associated with lower HEI. Home food availability of fruits was associated with higher HEI (β = 1.3 [0.7]; P = 0.05).

Conclusions and implications: Structuring the HFA so that more healthful choices are available relative to less healthful foods could be an effective approach for improving diet quality in preadolescents at risk for obesity.

Keywords: diet quality; dietary intake; home environment; home food availability; pediatric obesity.