Dietary patterns of early childhood and maternal socioeconomic status in a unique prospective sample from a randomized controlled trial of Prenatal DHA Supplementation

Brandon H Hidaka, Elizabeth H Kerling, Jocelynn M Thodosoff, Debra K Sullivan, John Colombo, Susan E Carlson, Brandon H Hidaka, Elizabeth H Kerling, Jocelynn M Thodosoff, Debra K Sullivan, John Colombo, Susan E Carlson

Abstract

Background: Dietary habits established in early childhood and maternal socioeconomic status (SES) are important, complex, interrelated factors that influence a child's growth and development. The aim of this study was to define the major dietary patterns in a cohort of young US children, construct a maternal SES index, and evaluate their associations.

Methods: The diets of 190 children from a randomized, controlled trial of prenatal supplementation of docosahexaenoic acid (DHA) were recorded at 6-mo intervals from 2-4.5 years by 24-h dietary recall. Hierarchical cluster analysis of age-adjusted, average daily intake of 24 food and beverage groups was used to categorize diet. Unrotated factor analysis generated an SES score from maternal race, ethnicity, age, education, and neighborhood income.

Results: We identified two major dietary patterns: "Prudent" and "Western." The 85 (45%) children with a Prudent diet consumed more whole grains, fruit, yogurt and low-fat milk, green and non-starchy vegetables, and nuts and seeds. Conversely, those with a Western diet had greater intake of red meat, discretionary fat and condiments, sweet beverages, refined grains, French fries and potato chips, eggs, starchy vegetables, processed meats, chicken and seafood, and whole-fat milk. Compared to a Western diet, a Prudent diet was associated with one standard deviation higher maternal SES (95% CI: 0.80 to 1.30).

Conclusions: We found two major dietary patterns of young US children and defined a single, continuous axis of maternal SES that differed strongly between groups. This is an important first step to investigate how child diet, SES, and prenatal DHA supplementation interact to influence health outcomes.

Trial registration: NCT00266825 . Prospectively registered on December 15, 2005.

Keywords: Children; Dietary pattern; Early childhood; Empirically derived; Multivariate; Socioeconomic status.

Figures

Fig. 1
Fig. 1
Food Groups and Beverage Categories Intake Changes from Age 2 to 4.5 Years. Mean daily intake of the 6 of 24 food groups that increased or decreased significantly over time during early childhood. Error bars are the standard error. Spearman’s correlations and corresponding p-values are shown
Fig. 2
Fig. 2
Average Daily Food and Beverage Intake of the Dietary Pattern Clusters. Error bars are standard error. P-values were calculated by the Mann-Whitney U test
Fig. 3
Fig. 3
Red blood cell (RBC) Change and SES Score. The change in RBC DHA is related to randomization (placebo or DHA supplementation) and SES score. The effect of supplementation on maternal RBC DHA differed by SES (pinteraction = 0.002); high SES was associated with a larger increase in DHA among those who received DHA (r = 0.34, p = 0.0007), but not among those who received placebo (p = 0.76)

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