Development of the Chinese preschooler dietary index: a tool to assess overall diet quality

Xiaoyu Wang; Yujie Xu; Bingbing Tan; Ruonan Duan; Shufang Shan; Linan Zeng; Kun Zou; Li Zhao; Jingyuan Xiong; Lingli Zhang; Shuang Rong; Guo Cheng

doi:10.1186/s12889-022-14672-x

Development of the Chinese preschooler dietary index: a tool to assess overall diet quality

BMC Public Health. 2022 Dec 26;22(1):2428. doi: 10.1186/s12889-022-14672-x.

Authors

Xiaoyu Wang¹, Yujie Xu¹, Bingbing Tan², Ruonan Duan^{1

3

4}, Shufang Shan¹, Linan Zeng⁵, Kun Zou⁵, Li Zhao⁶, Jingyuan Xiong⁷, Lingli Zhang⁵, Shuang Rong⁸, Guo Cheng⁹

Affiliations

¹ Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
² Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
³ Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
⁴ Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁵ Department of Pharmacy, Evidence-Based Pharmacy Center, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University), West China Second University Hospital, Sichuan University, Chengdu, China.
⁶ Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
⁷ Healthy Food Evaluation Research Center, West China School of Public Health and West China Fourth Hospital,, Sichuan University, Chengdu, China.
⁸ Department of Nutrition Hygiene and Toxicology, Academic of Nutrition and Health, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China.
⁹ Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China. gcheng@scu.edu.cn.

Abstract

Background: Diet quality in early childhood has a long-term impact on health outcomes. However, there are scarce dietary indexes for Chinese preschool children, and the existing indexes had limited validity and reliability. This study thus aimed to develop a dietary index for preschool children based on the Chinese Dietary Guideline and Chinese Dietary Reference Intakes and to assess their overall diet quality using the China Health and Nutrition Survey (CHNS).

Methods: The Chinese Preschooler Dietary Index (CPDI) included 11 components, covering 9 food group components and two nutrient components. The total scores of CPDI ranged from 0 to 90, with a higher score indicating greater diet quality. This study assessed the diet quality of 1742 preschoolers aged two to five years old from CHNS using the CPDI. Dietary intake data were obtained using three-day 24-h diet recalls, and sociodemographic information was also collected. Cochran-Mantel-Haensel (CMH) test was used to explore the association between demographic and CPDI total scores. The principal component analysis, correlation analysis and Cronbach's alpha were used to evaluate the relative reliability and validity of the CPDI. Finally, a stepwise multiple regression analysis was performed to explore potential influencing factors of CPDI.

Results: Among the 1742 CHNS preschool children, more than 70% resided in rural areas and 41.2% of the sample were raised in a low-income family. The mean CPDI score of the preschoolers was 38.8 ± 12.9. Higher diet scores were correlated with higher energy and nutrient intake. Children with higher age (β = 0.93, SE = 0.26, P = 0.0003), raised in a home with higher household income (β = 3.11, SE = 0.27, P < 0.0001) or living in urban areas (β = -4.44, SE = 0.66, P < 0.0001) were associated with higher CPDI scores.

Conclusions: The CPDI is useful in evaluating the diet quality of preschool children. Based on the CPDI, the diet quality of Chinese preschoolers needs to be improved, especially in rural areas.

Keywords: China; Diet; Diet quality; Dietary index; Preschool children.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child, Preschool
Diet*
East Asian People*
Eating
Humans
Nutrition Surveys
Nutritional Status
Reproducibility of Results

Abstract

Publication types

MeSH terms

Grants and funding