Low Fruit, Vegetables, and Carotenoids Intake Driving Low Healthy Eating Index in Young Children With Food Insecurity

OBJECTIVES: This pediatric primary care setting implementation program provides supplemental food delivery and intensive family support to decrease food insecurity and improve child nutrition and health. The objective of this preliminary sub-analysis is to use a variety of metrics to describe nutritional profiles of young children and their caregivers. METHODS: 38 families with children ages 0–5 years who are patients in a Washington, DC pediatric primary care clinic and had food insecurity were consented and enrolled in a 12-month program. We utilized Automated Self-Administered 24-hour (ASA24) dietary recalls for adults and children. ASA data were used to score the Healthy Eating Index (HEI, rated to 100) and sub-scores for daily intakes including Total Fruits (TF), Total Vegetables (TV), and Total Carotenoids (TC). The Veggie Meter (VM) portable reflection spectrometer was used to measure skin carotenoids. Statistical analysis included means/medians, distributions, and point-biserial correlations. RESULTS: To date, 26 parent-child dyads completed full baseline assessments; 96% of families were African American, and 100% were Medicaid eligible. Mean child age at enrollment was 3.2 years; 24% of children were overweight. Mean TF and TV (cups/day) were, respectively, 1.08 and 0.61 in children and 0.52 and 0.95 in adults. Mean children's HEI was 52 (U.S. avg. 60.1) and parents’ HEI was 48 (U.S. avg. 58.3). Low intakes of fruits/vegetables, dairy, and healthy protein contributed more to low HEI scores than overconsumption of less healthy foods. Mean TC intakes (mg/day) were 4.09 in children and 6.04 in adults. VM scores were similarly low: 236 for children and 247 for adults. VM weakly correlated with TV and carotenoids, but not TF. In adults, TV was moderately correlated with TC but was negatively correlated with VM. CONCLUSIONS: Young children and families experiencing food insecurity have poor nutritional quality characterized more by low intake of healthful foods rather than excessive processed, fatty, and high carbohydrate foods, supporting public health interventions that provide supplemental fruits, vegetables and nutritional education to families experiencing food insecurity. FUNDING SOURCES: A. James and Alice B. Clark Foundation, Share Our Strength's No Kid Hungry, Power of 10, J. Willard and Alice S. Marriott Foundation.