Diet quality in a nationally representative sample of American children by sociodemographic characteristics

Background: To date, Healthy Eating Index 2015 (HEI-2015) scores have not been published in the peer-reviewed literature for nationally representative samples of American children. Objective: The aim of this study was to use the HEI-2015 to describe the diet quality of American children overall and within various sociodemographic populations. Design: We used 3 cycles of NHANES dietary data sets (20092010, 2011-2012, and 2013-2014) to calculate HEI-2015 total and component scores by use of the population ratio method for children aged 2-18 y (n = 9000). Diet-quality scores were computed overall and by age (2-5, 6-11, and 12-18 y), gender, race or ethnicity (non-Hispanic black, non-Hispanic white, Mexican American, other Hispanic, and other race), and family poverty-to-income ratio (below or at or above the poverty threshold). HEI-2015 mean total and component scores were computed along with 95% CIs. Results: The HEI-2015 total mean score for children overall was 54.9 (range: 0-100). As the age group increased, the total scores decreased; the total mean score was significantly higher for children in the youngest age group compared with the 2 older age groups (60.1 compared with 53.9 compared with 52.0, respectively). The total mean score was significantly lower for non-Hispanic black children compared with Mexican American children, other Hispanic children, and children of other races (52.6 compared with 57.0, 56.8, and 57.1, respectively). The total mean score was significantly lower for non-Hispanic white children compared with Mexican-American children (54.2 compared with 57.0). No differences in total mean scores were apparent between boys and girls or between poverty threshold classes. The total mean scores for cross-classified sociodemographic characteristics generally followed the same patterns observed for single characteristics, with notable differences occurring within age and race or ethnicity classes. Conclusions: The diet quality of American children remains low overall, with continued disparities across some sociodemographic populations, notably age and race or ethnicity. The results of these analyses can help guide the efforts of child nutrition researchers, practitioners, and other stakeholders.