title: A diet quality index for American preschoolers based on current dietary intake recommendations and an indicator of energy balance.
abstract: OBJECTIVE
  Based on current dietary intake recommendations and a recommendation to limit sedentary activity in preschoolers, an overall diet quality index for preschoolers (RC-DQI) incorporating a component for energy balance to measure adequacy of nutrition for growth, development, and disease prevention was developed.
  
  
  METHODS
  The newly developed index was used in nationally representative samples of 2- to 5-year-olds in the US Department of Agriculture Continuing Survey of Food Intakes by Individuals 1994-96 and 1998 (n=5,437). Index components included added sugar, total fat, polyunsaturated fatty acids, total and whole grains, fruits, vegetables, excess fruit juice, dairy, iron, and an interaction term of total daily energy intake and sedentary behavior (television time). Points were allocated to reflect deficient or excessive intakes.
  
  
  METHODS
  Means and standard errors were used to describe food intakes and RC-DQI scores. Ability to differentiate diets was ascertained using mean intakes of food groups/nutrients followed by a nonparametric test of trends across ordered groups. Correlation coefficients measured dependence among RC-DQI components, nutrients, and overall energy intakes. Component scores of the highest and lowest quartile of RC-DQI were compared.
  
  
  RESULTS
  Mean RC-DQI score was 64 points (range=28 to 93). Increasing RC-DQI scores were associated with improved diet quality. Children in the lowest RC-DQI quartile scored lower in all components.
  
  
  CONCLUSIONS
  The RC-DQI successfully differentiated diets by level of diet quality. Increasing scores were associated with decreasing consumption of added sugar and juices, and increasing intakes of fiber, essential fatty acids, fruits, and vegetables. The RC-DQI can be used to determine diet quality in groups of preschool-age children.
authors.affiliation: Department of Nutritional Sciences, 5 Henderson Building South, The Pennsylvania State University, University Park, PA 16802, USA. sxk72@psu.edu <sxk72@psu.edu>
authors.forename: Sibylle
authors.initials: S
authors.lastname: Kranz
authors.forename: Terryl
authors.initials: T
authors.lastname: Hartman
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Siega-Riz
authors.forename: Amy H
authors.initials: AH
authors.lastname: Herring
mesh_terms: D002675:Child, Preschool; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D002149:Energy Intake / Q000502:physiology*; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011939:Mental Recall; D015596:Nutrition Assessment; D018673:Nutrition Policy; D009751:Nutritional Requirements; D015203:Reproducibility of Results; D013690:Television; D014481:United States