scholarly journals Patterns of Complementary Feeding Behaviors Predict Diet Quality in Early Childhood

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 810
Author(s):  
Karen M. Switkowski ◽  
Véronique Gingras ◽  
Sheryl L. Rifas-Shiman ◽  
Emily Oken
Keyword(s):  
Early Childhood ◽  
Diet Quality ◽  
Latent Class ◽  
Fruit Juice ◽  
Complementary Feeding ◽  
Taste Preference ◽  
Healthy Eating Index ◽  
Dietary Behaviors ◽  
Sensitive Period ◽  
Feeding Behaviors

Infancy is a time of plasticity in development of taste preference. Complementary feeding (CF) may be a “sensitive period” for learning new taste preferences and establishing healthy dietary behaviors that may track later in life. Among 1162 children in the U.S. prospective cohort study Project Viva, we aimed to identify patterns of CF behaviors around 1 year and examine associations with diet quality in early childhood (median age 3.1y). We identified patterns of CF using latent class analysis (LCA) and examined later diet quality based on scores on the Youth Healthy Eating Index (YHEI). We identified four distinct CF patterns (latent classes). Later YHEI scores were highest in the class characterized by “breast milk and delayed sweets and fruit juice” and lowest in the “picky eaters” class. The classes defined as “late flavor introduction and delayed sweets” and “early flavor introduction and more fruit juice” had similar, moderate scores. Our results suggest that CF patterns that increase food acceptance and discourage the innate preference for sweetness may have persistent influences on diet quality.

scholarly journals Estimated Causal Effects of Complementary Feeding Behaviors on Diet Quality in Early Childhood Using Birth Cohort Data

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1085-1085
Author(s):  
Karen Switkowski ◽  
Izzuddin Aris ◽  
Véronique Gingras ◽  
Emily Oken ◽  
Jessica Young
Keyword(s):  
Early Childhood ◽  
Diet Quality ◽  
Fruit Juice ◽  
Complementary Feeding ◽  
Linear Regression Analysis ◽  
Peanut Butter ◽  
Healthy Eating Index ◽  
Fish Eggs ◽  
Introduced Fish ◽  
Feeding Behaviors

Abstract Objectives We aimed to examine effects of 3 complementary feeding behaviors on later diet quality using a causal inference framework. Methods Using data from 1041 mother-child pairs from the Boston, MA-area Project Viva cohort, we estimated effects on the mean Youth Healthy Eating Index (YHEI) score, a measure of diet quality in early childhood, of hypothetical interventions that expose (vs. do not expose) to the following: 1) introduce sweets and fruit juice at ≥12 m and provide no daily fruit juice at age ∼1 y; 2) introduce varied, non-sweet flavors (at least 2/3 of fish, eggs and peanut butter) at <12 m; and 3) continue offering foods initially refused by the child. Mothers reported complementary feeding behaviors (exposures) at 1y and completed food frequency questionnaires for children in early childhood (median age 3.2 y). We estimated average treatment effects (ATEs) using inverse probability weighted linear regression analysis with stabilized weights to adjust for both confounding and selection bias due to censored outcomes. For each effect, we adjusted for child race/ethnicity, maternal socio-demographics, BMI, and diet quality, and the other 2 exposures, and examined effect modification by child sex and infant feeding mode (breastfed at 6 m [BF group] vs. not [FF group]). Results Of 1041 pairs, 12% delayed introducing sweets/fruit juice and provided no daily fruit juice at 1y, 68% introduced fish, eggs and peanut butter before 12 m, and 93% continued to offer refused foods. We estimated that mean YHEI score was higher under “delay sweets and fruit juice” (1.8 points, 95% CI: −1.0, 5.5), particularly among the BF group (ATE 5.1 points, 95% CI: 0.0, 8.7) and females (ATE 4.4 points, 95% CI: −2.0, 9.0). ATEs for the “early flavor variety” exposure were 1.7 points (95% CI: 0.2, 3.0) and similar among males and females but stronger (2.6 points, 95% CI: 0.4, 4.8) among the FF group. Mean YHEI score was also higher (2.6 points, 95% CI: −1.1, 6.5) under the “continue offering refused foods” exposure, particularly among females (ATE 5.7 points, 95% CI: 1.2, 9.6). Conclusions Delayed introduction of sweets and fruit juice, early introduction of varied, non-sweet flavors, and continued offering of initially refused foods may result in better diet quality in early childhood. Effects may differ by child sex and breastfeeding status. Funding Sources US NIH.

scholarly journals Associations of Early Parental Concerns and Feeding Behaviors with Child’s Diet Quality through Mid-Childhood

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3231
Author(s):  
Véronique Gingras ◽  
Karen M. Switkowski ◽  
Sheryl L. Rifas-Shiman ◽  
Sabrina Faleschini ◽  
Emily Oken ◽  
...  
Keyword(s):  
Early Childhood ◽  
Diet Quality ◽  
Maternal Diet ◽  
Healthy Eating Index ◽  
Dietary Intakes ◽  
Z Score ◽  
Linear Regression Models ◽  
Feeding Behaviors ◽  
Parental Concerns ◽  
Parental Feeding

Parental feeding practices have been associated with children’s dietary intakes, yet the directionality of these associations remains unclear. Among 1172 mother-child pairs from Project Viva, we aimed to examine associations of parental concerns and feeding behaviors at 2 years (behaviors dichotomized as yes vs. no), with diet quality (Youth Healthy Eating Index; YHEI) in early (mean 3.2, SD 0.3 years; n = 1076) and mid-childhood (mean 7.8, SD 0.7 years; n = 993). We used multivariable linear regression models adjusted for sociodemographic characteristics, parental body mass index (BMI), maternal diet quality in pregnancy, and child’s BMI z-score and diet quality at 2 years. Early parental concerns about their child becoming overweight (15%) was associated with lower YHEI (β −1.54 points; 95%CI −2.75, −0.33; fully adjusted model) in early childhood. Early parental concerns about their child becoming underweight (7%) was associated with lower YHEI (−2.19 points; −4.31, −0.07) in early childhood, but the association was attenuated after adjustment for child’s BMI z-score and diet quality at 2 years. We did not find associations of parental restrictive feeding (8%) and parental pressure to eat (47%) with child’s YHEI through mid-childhood. In conclusion, we found no evidence that early parental concerns and feeding behaviors independently contribute to child’s diet quality through childhood.

Abstract P210: Associations Of Early Parental Feeding Concerns And Behaviors With Child’s Dietary Intakes Throughout Childhood

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Veronique Gingras ◽  
Karen M Switkowski ◽  
Sheryl L Rifas-Shiman ◽  
Sabrina Faleschini ◽  
Emily Oken ◽  
...  
Keyword(s):  
Early Childhood ◽  
Healthy Eating ◽  
Diet Quality ◽  
Weight Status ◽  
Healthy Eating Index ◽  
Index Score ◽  
Processed Meat ◽  
Dietary Intakes ◽  
Feeding Behaviors ◽  
Parental Feeding

Introduction: Parental feeding behaviors have been found to be associated with dietary intakes and weight status in children, although the longitudinal associations of parental feeding behaviors in early life with diet later in childhood have been scarcely studied. Hypothesis: We hypothesized that parental feeding restriction, pressure to eat, and concerns about child’s weight would be associated with poorer diet quality throughout childhood. Methods: Among 1172 mother-child pairs from Project Viva, we examined associations of parental feeding behaviors at 2 years assessed via questions from the Child Feeding Questionnaire (behaviors dichotomized as yes vs. no) with diet quality in early (mean: 3.2, SD 0.2 years; n=1076) and mid-childhood (mean: 7.8, SD 0.7 years; n=993) assessed via food frequency questionnaires. We used linear regression models adjusted for socio-demographic characteristics, maternal and paternal body mass index, and maternal diet quality in pregnancy. Results: At 2 years postpartum, 47% of parents pressured/encouraged their child to eat more, 8% restricted their intakes, 15% were concerned about their child being overweight and 7% about their child being underweight. Parental pressure to eat at 2 years was associated with higher child intake of fruit juice (β 0.17 serving/day; 95% CI 0.01, 0.34) and snack foods (0.12 serving/day; 0.01, 0.22) in early childhood and with lower youth healthy eating index score (-1.32 points; -2.54, -0.10; score from 0 to 85 points) in mid-childhood. Parental feeding restriction at 2 years was associated with lower intake of sugar-sweetened beverages (-0.17 serving/day; -0.27, -0.06) in early childhood and with lower intake of dairy (-0.29 serving/day; -0.56, -0.02) in mid-childhood. Parental concerns about their child being underweight was associated with lower youth healthy eating index score (-2.18 points; -4.30, -0.05; score from 0 to 95 points) in early childhood while concerns about their child being overweight was associated with higher intakes of red and processed meat (0.14 serving/day; 0.04, 0.23) in early childhood and higher intake of baked products in mid-childhood (0.07 serving/day; 0.01, 0.13). Conclusions: We found that early parental feeding behaviors may have a modest contribution to dietary intakes throughout childhood. However, only a few associations persisted after adjusting for socio-economic and parental characteristics and effect sizes were modest. Strategies to improve diet quality in children might need to focus on the broader family and socio-economic context.

scholarly journals Associations of Maternal Sociodemographic Characteristics and Eating Behaviors with Infant Feeding Behaviors

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1046-1046
Author(s):  
Tonja Nansel ◽  
Leah Lipsky ◽  
Carolina Schwedhelm ◽  
Breanne Wright ◽  
Chelsie Temmen ◽  
...  
Keyword(s):  
Infant Feeding ◽  
Diet Quality ◽  
Maternal Education ◽  
Healthy Eating Index ◽  
Fruit And Vegetables ◽  
Infant Food ◽  
Food Groups ◽  
Feeding Behaviors ◽  
White Race ◽  
Maternal Characteristics

Abstract Objectives This study examines associations of maternal characteristics with infant feeding of discretionary and health-promoting foods. Methods Mothers in PEAS, a prospective cohort study, reported maternal and child dietary intake, demographics, and eating competence (EC). Maternal diet quality (Healthy Eating Index-2015, HEI) was calculated combining 24-hour diet recalls at 6 weeks, 6, and 12 months postpartum (n = 209). Infant food frequency questionnaires were completed at 6, 9, and 12 months, assessing age of introduction and intake frequency of food groups. T-tests examined bivariate associations of demographics with feeding of discretionary sweets, discretionary savory foods, fruit, and vegetables. Linear regressions examined associations of maternal EC and HEI with infant feeding controlling for demographics. Results Fruit, vegetables, discretionary sweet, and discretionary savory foods were introduced at 5.8 ± 1.7, 5.9 ± 1.7, 8.0 ± 2.0, and 8.8 ± 1.8 months, respectively. Earlier introduction of fruit and vegetables was associated with higher maternal education, white race, and nulliparity; earlier introduction of vegetables was also associated with higher income. Age of introduction of discretionary sweet and savory foods was not associated with maternal demographics, HEI, or EC. At age 12 months, greater infant intake frequency of fruit and vegetables was associated with higher education and income, white race, and breastfeeding, while greater intake frequency of discretionary sweet and savory foods was associated with lower maternal education and minority race. Greater intake frequency of sweets was also associated with multiparity and greater intake frequency of discretionary savory foods was associated with lower income. Maternal HEI was positively associated with infant intake frequency of fruit, vegetables, and discretionary sweet and savory foods. Maternal EC was positively associated with infant intake frequency of fruit and vegetables. Conclusions Demographic differences in infant feeding behaviors indicates these behaviors as critical intervention targets to address disparities in child diet quality. Associations of maternal HEI and EC with infant feeding behaviors suggest potential pathways of maternal influence on infant diet. Funding Sources This research was supported by the NICHD Intramural Research Program.

Abstract P211: Diet Quality Declines and Differs by Race in Early Childhood

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Kelly Reynolds ◽  
Heidi Kalkwarf ◽  
Suzanne Summer ◽  
Philip Khoury ◽  
Marcia Gavin ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Early Childhood ◽  
Healthy Eating ◽  
Diet Quality ◽  
Dietary Intervention ◽  
Healthy Eating Index ◽  
Final Visit ◽  
White Children ◽  
Refined Grains ◽  
Component Scores

Introduction: Diet quality is an important determinant of health in children, but little is known about how diet quality progresses during early childhood. We hypothesized that overall diet quality, assessed by the 2010 Healthy Eating Index, would decline during early childhood. Methods: Three hundred seventy-two (372) healthy 3-year-old children were recruited from the Greater Cincinnati area and assessed every 4 months until age 7 at in-person clinical visits, for a total of 13 visits. Parents completed 3-day diet diaries at each visit which were analyzed for nutrient composition using the Nutrition Data Systems for Research system (NDSR). The 2010 Healthy Eating Index (HEI) total and food-group component scores were calculated and averaged by year of study. Longitudinal mixed modeling was used to evaluate longitudinal trends. Results: The population was 52% (195/372) male, 78% (290/372) white and 83% (308/372) completed the final visit. HEI total scores at age 3 were poor (mean±SE: 45.2±0.4) and declined significantly between ages 3-7 (p<0.0001). None of the participants had “good” quality diet (HEI>80) at any point in the study. HEI total scores differed by race, with white children having significantly higher scores (p=0.05, Figure). HEI component scores showed a mixed pattern, with some significantly improving (protein, vegetables and fatty acids), some significantly worsening (dairy, refined grains, sodium, whole fruit and total fruit); other component scores did not change. Differences by race also varied, with African-Americans having consistently better scores for vegetables, greens and beans, protein and fatty acids (all p<0.0001), while white children had better scores for dairy, sodium and refined grains (all p<0.0005). Conclusions: The average HEI scores for young children showed poor baseline diet quality at age 3 that became gradually worse throughout early childhood. The varying patterns in HEI component scores indicate specific areas of focus for early dietary intervention, which may differ by race.

scholarly journals Cooking Frequency and Perception of Diet among US Adults Are Associated with US Healthy and Healthy Mediterranean-Style Dietary Related Classes: A Latent Class Profile Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3268
Author(s):  
Nicole Farmer ◽  
Lena J. Lee ◽  
Tiffany M. Powell-Wiley ◽  
Gwenyth R. Wallen
Keyword(s):  
Diet Quality ◽  
Dietary Patterns ◽  
Latent Class ◽  
Vegetable Intake ◽  
Profile Analysis ◽  
Multinomial Logistic Regression ◽  
Healthy Eating Index ◽  
Dietary Quality ◽  
Meal Time ◽  
Home Cooking

Background: Meal habits are associated with overall dietary quality and favorable dietary patterns determined by the Healthy Eating Index (HEI). However, within dietary patterns, complexities of food combinations that are not apparent through composite score determination may occur. Also, explorations of these food combinations with cooking and perceived diet quality (PDQ) remain unknown. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 were utilized to determine the frequency of cooking at home and PDQ, along with sociodemographic variables. Latent class profile analysis was performed to determine person-centered data-driven analysis using the dietary index, HEI-2010, at both the daily and dinner meal-time levels. Multinomial logistic regression analysis was utilized to evaluate the association of dietary patterns with all covariates. Results: For daily HEI, five distinct dietary classes were identified. For dinner HEI, six classes were identified. In comparison to the standard American diet classes, home cooking was positively associated with daily (p < 0.05) and dinner (p < 0.001) dietary classes that had the highest amounts of total vegetable and greens/beans intake. PDQ was positively associated with these classes at the daily level (p < 0.001), but negatively associated with healthier classes at the dinner level (p < 0.001). Conclusion: The use of latent class profile analysis at the daily and dinner meal-time levels identified that food choices coalesce into diverse intakes, as shown by identified dietary classes. Home cooking frequency could be considered a positive factor associated with higher vegetable intake, particularly greens/beans, at the daily and dinner levels. At the same time, the perception of diet quality has a positive association only with daily choices.

scholarly journals Intake of 100% Fruit Juice Is Associated with Improved Diet Quality of Adults: NHANES 2013–2016 Analysis

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2513 ◽  
Author(s):  
Sanjiv Agarwal ◽  
Victor L. Fulgoni III ◽  
Diane Welland
Keyword(s):  
Dietary Fiber ◽  
Diet Quality ◽  
Nutrient Intake ◽  
Fruit Juice ◽  
Healthy Eating Index ◽  
Dietary Recall ◽  
Health And Nutrition ◽  
Modeling Analysis ◽  
Calcium Magnesium

Fruit intake is generally associated with better diet quality and overall health. This report examined the effect of 100% fruit juice (considered a part of total fruit servings) and its replacement with whole fruits equivalents on nutrient intake and diet quality. National Health and Nutrition Examination Survey 2013–2016 data (24-h dietary recall) from adults 19+ years (n = 10,112) were used to assess the diet quality and nutrient intakes and to isocalorically replace with 100% fruit juice intakes whole fruit equivalents in a modeling analysis. About 15.6% adults were 100% fruit juice consumers. Consumers had higher diet quality (10% higher Healthy Eating Index, HEI 2015 score), and higher intakes of energy, calcium, magnesium, potassium, vitamin C and vitamin D than non-consumers. Consumption of 100% fruit juice was also associated with lower risk of being overweight/obese (−22%) and having metabolic syndrome (−27%). Replacing 100% fruit juice with whole fruits equivalents did not affect nutrient intake except for a modest increase (+6.4%) in dietary fiber. Results show that 100% fruit juice intake was associated with better diet quality and higher nutrient intake. Replacement of 100% fruit juice intake with whole fruits equivalents had no significant effect on nutrients except for dietary fiber.

scholarly journals Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amir Motamedi ◽  
Maryam Ekramzadeh ◽  
Ehsan Bahramali ◽  
Mojtaba Farjam ◽  
Reza Homayounfar
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Diet Quality ◽  
Dietary Diversity ◽  
Antihypertensive Drugs ◽  
Healthy Eating Index ◽  
Cross Sectional ◽  
Common Chronic Disease ◽  
History Of ◽  
Prevention Of Hypertension

Abstract Background Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. Methods This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs. Results Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension. Conclusions Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.

scholarly journals Effect of a High-Intensity Dietary Intervention on Changes in Dietary Intake and Eating Pathology during a Multicomponent Adolescent Obesity Intervention

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1850
Author(s):  
Hollie A. Raynor ◽  
Suzanne E. Mazzeo ◽  
Jessica Gokee LaRose ◽  
Elizabeth L. Adams ◽  
Laura M. Thornton ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Energy Intake ◽  
Diet Quality ◽  
Dietary Intervention ◽  
Secondary Data ◽  
Obesity Treatment ◽  
Healthy Eating Index ◽  
Eating Pathology ◽  
Post Treatment ◽  
Eating Disorder Examination

Concerns remain about dietary changes during pediatric obesity treatment and eating pathology, which have not been investigated. This secondary data analysis from a randomized clinical trial examined associations between adolescents’ changes in energy intake and diet quality during obesity treatment with post-treatment eating pathology. Adolescents (N = 82: 13.7 ± 1.2 y, 34.9 ± 7.0 kg/m2, 63.4% female, 46.3% black) received TEENS+, a 4-month multicomponent intervention. TEENS+ provided individualized dietary goals (1200–1800 kcal/day; number of “Go” foods/day (low-energy, high-nutrient-dense foods)). At 0 and 4 months, 3-day food records assessed energy intake and diet quality (Healthy Eating Index 2015 (HEI-2015)). Two HEI-2015 subscores were created: components to increase (increase), and components to limit (decrease). The Eating Disorder Examination Questionnaire measured eating pathology (total score and subscales: restraint; and eating, weight, and shape concern). Corrected p-values are reported as q-values. Energy intake decreased (−292 ± 418 kcal/day; q < 0.001), while diet quality improved during treatment (total HEI-2015 (4.5 ± 15.1; q = 0.034) and increase (3.3 ± 9.4; q = 0.011)). Restraint increased (+0.6 ± 1.4; q < 0.001), whereas shape (−0.5 ± 1.3; q = 0.004) and weight (−0.5 ± 1.4; q = 0.015) concerns decreased. Greater decreases in energy intake were associated with greater restraint post-treatment (F = 17.69; q < 0.001). No other significant associations were observed. Changes in adolescents’ dietary intake during obesity treatment were unrelated to increased shape, weight, or eating concerns post-treatment.

scholarly journals Caregiver Status and Diet Quality in Community-Dwelling Adults

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1803
Author(s):  
Sharmin Hossain ◽  
May A. Beydoun ◽  
Michele K. Evans ◽  
Alan B. Zonderman ◽  
Marie F. Kuczmarski
Keyword(s):  
Diet Quality ◽  
Healthy Aging ◽  
Healthy Eating Index ◽  
Community Dwelling ◽  
Rate Of Change ◽  
Least Square ◽  
Inverse Association ◽  
Linear Regression Models ◽  
Middle Aged ◽  
Cross Sectional

Objective: We investigated cross-sectional and longitudinal associations of diet quality with middle-aged caregiver status. Methods: Caregiving in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (57.7% women, 62% African American (AA)) was measured at waves 3 (2009–2013) and 4 (2013–2017) (mean follow-up time 4.1 years). Diet quality was assessed by the Healthy Eating Index 2010 (HEI-2010) derived from two separate 24 h diet recalls. Multivariable ordinary least square regression was performed for cross-sectional analyses of the association of wave 4 caregiving with wave 4 HEI-2010. Wave 3 caregiving was examined both cross-sectionally and with annual rate of change in HEI using mixed-effects linear regression Models. Multivariable models were adjusted for age, sex, and poverty status. Results: Cross-sectional analyses at wave 4 demonstrate an inverse association of frequent caregiving (“Daily or Weekly” vs. “Never”) for grandchildren with HEI-2010 total score (i.e., lower diet quality) among Whites (β = −2.83 ± 1.19, p = 0.03, Model 2) and AAs (β = −1.84 ± 0.79, p = 0.02,). The “cross-sectional” analysis pertaining to grandchildren caregiving frequency suggested that frequent caregiving (i.e., “Daily or Weekly” vs. “Never” (β = −2.90 ± 1.17, p = 0.04)) only among Whites was inversely related to HEI-2010 total score. Total HEI-2010 score was also related to caring (Model 1), for the elderly over “5 years vs. Never” among Whites (−7.31 ± 3.54, p = 0.04, Model 2). Longitudinally, we found slight potential improvement in diet quality over time (“Daily or Weekly” vs. Never by TIME interaction: +0.88 ± 0.38, p = 0.02) with frequent caregiving among Whites, but not so among AAs. Conclusions: Frequent caring for grandchildren had an inverse relationship with the diet quality of White and AA urban middle-aged caregivers, while caring for elderly was inversely linked to diet quality among Whites only. Longitudinal studies should address the paucity of research on caregivers’ nutritional quality.

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