198243 Diet quality indicators associated with early childhood caries prevalence in children ages 25 in the National Health and Nutrition Examination Survey (NHANES)

Monday, November 9, 2009

Nadine S. Braunstein, PhD, RD, LDN , Office of Collaborative Programs, Towson University, College of Health Professions, Towson, MD
Barbara E. Millen, DPH, RD, FADA , Graduate Programs in Medical Nutrition Sciences, Boston University School of Medicine, Boston, MA
Sibylle Kranz, PhD, RD , Purdue University, Indianapolis, IN
Elizabeth Krall Kaye, PhD, MPH , Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA
Carole A. Palmer, EdD, RD , Division of Nutrition and Oral Health Promotion, Tufts University School of Dental Medicine, Boston, MA
Martha E. Nunn, DDS, PhD , Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA
Background: Early childhood caries (ECC) is an insidious form of dental caries that strikes the primary dentition. Dental caries represents the most common chronic childhood disease, 5X > asthma and 7X> hay fever. Diet quality and eating behaviors contribute to early childhood caries prevalence. Consistencies in associations between multiple diet quality indicators and ECC have not been studied.

Objective: To examine consistencies between dietary quality indicators and ECC prevalence in children ages 2 to 5 years in the National Health and Nutrition Examination Survey (NHANES).

Methods: The Rao-Scott chi-squared test of independence was used to test for associations between ECC prevalence and diet in NHANES III [1988-1994] (n=4119) and NHANES 2001-2002 (n=801) adjusting for complex survey design for mean Food Pyramid Servings, Healthy Eating Index (HEI), Revised Child Diet Quality Index (RC-DQI) and eating behaviors (meal/snack frequency and soda and water consumption). Significance was established at p<0.05. SAS version 9.1.3, service pack 4 was used to perform the analyses.

Results: Diet quality scores, food servings, and eating behaviors that were significantly associated with ECC prevalence in both NHANES III and NHANES 2001-2002 indicated that children with ECC: (1) Consumed significantly greater Food Pyramid Servings of eggs, lean meat from meat, poultry, and fish and total vegetables (including starchy vegetables); significantly less whole grain, total fruit, other fruit and milk; (2) Had significantly lower HEI total, grain, fruit and cholesterol scores; (3) Had significantly lower RC-DQI whole grain and fruit scores; significantly higher excess juice score (indicating lower intake); and (4) ate fewer than 3 meals daily and drank soda compared to those without ECC.

Conclusion: Specific diet components and poorer dietary quality indicators were consistently associated with a greater likelihood of ECC in young children in both NHANES III and NHANES 2001-2002. Nutrition, dental and medical professionals could reduce children's ECC risk by providing guidance to caregivers of young children to improve diet quality, especially promoting whole grains and fruit. This research identifies a need to develop a Diet Quality Index specific for early childhood caries prevention.

Learning Objectives:
Participants will identify foods and diet quality components associated with early childhood caries in both NHANES III (1988-1994) and NHANES 2001-2002.

Keywords: Dietary Assessment, Early Childhood Caries

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed this research as part of my PhD dissertation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Maternal and Child Health
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