title: Interrelationships of More Healthful and Less Healthful Aspects of Diet Quality in a Low-Income Community Sample of Preschool-Aged Children.
abstract: OBJECTIVE
  To investigate whether higher intake of "healthy" foods was associated with lower intake of "unhealthy" foods among a sample of low-income preschool-aged children, and if associations differed for younger (2-3 years) and older (4-5 years) children.
  
  
  METHODS
  Between May 2012 and May 2013, we studied 298 parents/guardians of 357 preschool-aged children living in a low-income area of a large Midwestern city in the United States. Parents reported on children's past week frequency of intake of juice, fruits, vegetables, milk, sugar-sweetened beverages, fast food, sweets, and salty snacks with seven response options (coded 0-6) ranging from none to ≥4 times/day. We combined fruits, vegetables, and milk to create a healthy diet score, and denoted a healthy diet behavior if frequency of intake of these foods was ≥2 times/day. Sugar-sweetened beverages, fast food, sweets, and salty snacks were considered unhealthy aspects of children's diets. Juice was examined separately.
  
  
  RESULTS
  The number of healthy diet behaviors was not related to the number of unhealthy diet behaviors or the unhealthy diet score. This was true overall and by age group (P trend values ranged from 0.26 to 0.90), and the pattern did not differ by age (P interaction >0.3). Correlations between healthy and unhealthy diet scores overall and for younger and older preschool-aged children were not statistically significant (Spearman correlation coefficients = 0.05, -0.01 and 0.11 respectively).
  
  
  CONCLUSIONS
  Healthy and unhealthy aspects of children's diets may be independent of one another. Additional research in heterogeneous populations is needed.
authors.affiliation: Division of Epidemiology, The Ohio State University College of Public Health, 336 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, USA. sanderson@cph.osu.edu.|Prevention Research Center, The Ohio State University College of Public Health, Columbus, OH, USA. sanderson@cph.osu.edu.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Anderson
authors.affiliation: Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, OH, USA.|Prevention Research Center, The Ohio State University College of Public Health, Columbus, OH, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Kaye
authors.affiliation: Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA.|Prevention Research Center, The Ohio State University College of Public Health, Columbus, OH, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Andridge
authors.affiliation: Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, OH, USA.|Ohio State University Extension, College of Food, Agricultural and Environmental Sciences, Columbus, OH, USA.|Prevention Research Center, The Ohio State University College of Public Health, Columbus, OH, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Smathers
authors.affiliation: Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA.|Prevention Research Center, The Ohio State University College of Public Health, Columbus, OH, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Peng
authors.affiliation: Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, OH, USA.|Prevention Research Center, The Ohio State University College of Public Health, Columbus, OH, USA.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Pirie
mesh_terms: D001628:Beverages / Q000009:adverse effects / Q000706:statistics & numerical data; D002675:Child, Preschool; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D009753:Nutritive Value; D011203:Poverty / Q000706:statistics & numerical data*; D014481:United States; D014675:Vegetables
keywords: Community survey; Diet quality; Nutrition; Preschool-aged children