title: Diet quality across early childhood and adiposity at 6 years: the Southampton Women's Survey.
abstract: BACKGROUND
  Poor diet quality in early childhood is inconsistently linked to obesity risk. Understanding may be limited by the use of cross-sectional data and the use of body mass index (BMI) to define adiposity in childhood.
  
  
  OBJECTIVE
  The objective of this study is to examine the effects of continued exposure to diets of varying quality across early childhood in relation to adiposity at 6 years.
  
  
  METHODS
  One thousand and eighteen children from a prospective UK birth cohort were studied. Diet was assessed using food frequency questionnaires when the children were aged 6 and 12 months, and 3 and 6 years; diet quality was determined according to scores for a principal component analysis-defined dietary pattern at each age (characterized by frequent consumption of fruits, vegetables and fish). At each age, children were allocated a value of 0/1/2 according to third of the distribution (bottom/middle/top) their diet quality score was in; values were summed to calculate an overall diet quality index (DQI) for early childhood (range 0-8). Obesity outcomes considered at 6 years were dual-energy X-ray absorptiometry-assessed fat mass and BMI.
  
  
  RESULTS
  One hundred and seven (11%) children had a DQI=0, indicating a consistently low diet quality, 339 (33%) had a DQI=1-3, 378 (37%) had a DQI=4-6 and 194 (19%) had a DQI=7-8. There was a strong association between lower DQI and higher fat mass z-score at 6 years that was robust to adjustment for confounders (fat mass s.d. per 1-unit DQI increase: β=-0.05 (95% confidence interval (CI): -0.09, -0.01), P=0.01). In comparison with children who had the highest diet quality (DQI=7-8), this amounted to a difference in fat mass of 14% (95% CI: 2%, 28%) at 6 years for children with the poorest diets (DQI=0). In contrast, no independent associations were observed between DQI and BMI.
  
  
  CONCLUSIONS
  Continued exposure to diets of low quality across early childhood is linked to adiposity at the age of 6 years.
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.|Department of Health Promotion, National Institute of Public Health, Saitama, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Okubo
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.
authors.forename: S R
authors.initials: SR
authors.lastname: Crozier
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.|National Institute of Health Research, Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK.
authors.forename: N C
authors.initials: NC
authors.lastname: Harvey
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.|National Institute of Health Research, Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK.
authors.forename: K M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.
authors.forename: H M
authors.initials: HM
authors.lastname: Inskip
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.|National Institute of Health Research, Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK.|National Institute for Health Research Musculoskeletal Biomedical Research Unit, Nuffield Orthopedic Centre, University of Oxford, Oxford, UK.
authors.forename: C
authors.initials: C
authors.lastname: Cooper
authors.affiliation: MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK.|National Institute of Health Research, Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Robinson
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000328:Adult; D001294:Attitude to Health; D015992:Body Mass Index; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004032:Diet / Q000592:standards*; D015930:Diet Records; D002149:Energy Intake; D004734:Energy Metabolism; D004739:England / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D005638:Fruit; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015596:Nutrition Assessment; D018673:Nutrition Policy; D009751:Nutritional Requirements; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D011446:Prospective Studies; D012959:Socioeconomic Factors; D014675:Vegetables