Comparison of Healthy Eating Index‐2010 Scores of Preschool‐Aged Children in a High Risk Community to Those of an Age‐Matched National Sample (NHANES 2009–2012)
Authors: Page Jessi DeGruy , Crixell Sylvia Hurd , Beidiger‐Friedman Lesli , Markides Brittany , Bishop Nicholas D 
Published: November 2023

IntroductionChildhood overweight and obesity have reached epidemic proportions in the US. Because eating patterns established in childhood often track into adulthood, and overweight and obesity are associated with significant health consequences, community interventions to mitigate the development of these conditions should consider the diets of children when they are young. San Marcos, Texas, the fastest growing mid‐sized city in the US for the past three years, is home to a diverse, low‐income population exhibiting rates of childhood overweight and obesity higher than state and national averages. The purpose of this study was to examine diets of a sample of San Marcos preschoolers for potential obesogenic patterns and compare to a national age‐matched sample.MethodsThe Healthy Eating Index‐2010 (HEI‐2010) was used to assess the diet quality of a convenience sample of 124 children ages 2–5 who were enrolled in local childcare centers. The HEI‐2010 measures compliance with recommendations of the 2010 Dietary Guidelines for Americans. Diets with HEI‐2010 scores above 80 are categorized as ‘good’; those with scores between 51 and 80 ‘need improvement’; and scores below 51 are considered ‘poor’. Twenty‐four hour dietary recalls were collected via telephone interviews with parents of preschoolers using Nutrition Data System for Research 2013 (NDSR) software. NDSR output was used to calculate HEI‐2010 scores. HEI‐2010 scores were also calculated for an age‐matched national sample from National Health and Nutrition Examination Survey datasets (files DR1TOT_G and DEMO_G from 2009–2010 and DR1TOT_F and DEMO_F from 2011–2012) using the HEI‐2010 macro developed by the National Cancer Institute for use in SAS software. Further analysis included comparison of nutrient intakes to HEI category among the local sample.ResultsMean total HEI‐2010 scores for both the local (62.1) and national (59.9) samples were lower than the optimal score of 100. Total Fruit, Whole Fruit, Dairy, and Total Protein Foods were among the components closest to meeting maximum scores for both samples. Empty Calories was one of the highest‐scoring components among the local but not the national sample. Scores for Greens and Beans and Fatty Acids were among the lowest scores for both samples. Nutrient analysis by HEI‐2010 score category revealed conflicting trends in intakes of vitamins B12 and D among the San Marcos sample. Mean intakes of both vitamins were significantly lower among those in the ‘good’ category than those in the ‘needs improvement’ category.ConclusionThe low HEI‐2010 scores observed among both the local and national sample are concerning. Results of this study should inform nutrition education and training of caregivers of preschool‐aged children in San Marcos. Of particular interest would be interventions aimed at increasing consumption of vitamin D rich foods, dark green vegetables, legumes, whole grains, and unsaturated fats.Support or Funding InformationTexas State University Research Enhancement Grant