Diet quality of children in the United States by body mass index and sociodemographic characteristics

OBJECTIVE: The primary objective was to use the Healthy Eating Index‐2015 (HEI‐2015) to describe diet quality by categories of body mass index (BMI) and by sociodemographic characteristics within categories of BMI using a nationally representative sample of US children. METHODS: Dietary datasets from three cycles of the National Health and Nutrition Examination Survey (2009‐2014) were analysed for children 2 to 18 years of age (N = 8894). Using the population ratio method, mean and 95% confidence intervals for HEI‐2015 total and component scores were computed by BMI (underweight, normal weight, overweight, and obese) and by age (2‐5, 6‐11, and 12‐18 y), gender, race/ethnicity (non‐Hispanic black, non‐Hispanic white, Mexican American, other Hispanic, and other race), and family poverty to income ratio (below and at/above poverty threshold). RESULTS: HEI‐2015 mean total scores were 50.4, 55.2, 55.1, and 54.0 out of 100 points for children with underweight, normal weight, overweight, and obesity, respectively, and were not significantly different. Within BMI categories, significant differences in total and mean component scores were present for age and race/ethnicity groups. CONCLUSIONS: Total and most components of diet quality did not significantly differ among child populations classified by BMI status. Within BMI categories, significant diet quality differences were found for age and race/ethnicity groups, although scores were low for all child groups. Researchers may need to address or target specific dietary components with low quality in various child populations to have the greatest effect on improving nutrition nationwide.