Relations between child-reported food exposure and preferences, and parent-reported food availability to child dietary intake and quality

Introduction: Little evidence is available regarding the contribution of food exposure, preferences and availability to child dietary intake and diet quality. Methods: For 61 foods, 292 children (8-18y) with type 1 diabetes reported exposure (y/n) and preferences (do not like/like a little/like a lot), and parents reported past-week household availability (y/n). Foods were categorized as fruit, vegetables, whole grains, refined grains and snacks/sweets. Mean daily servings of food groups consumed and the Healthy Eating Index-2005 (HEI) were calculated from children's 3-day diet records. Multiple linear regressions for each food group intake variable and HEI assessed relations with all food group exposure, preference and availability variables, adjusting for age, sex and household income. Results: Positive relations were found between fruit intake and corresponding preference (β=0.9, p<0.001), exposure (β=0.09, p=0.03) and availability (β=0.08, p=0.02), whole grain intake and corresponding preference (β=0.7, p=0.007) and availability (β=0.2, p<0.001), and snacks/sweets intake and corresponding preference (β=0.7, p=0.002). Additionally, whole grain intake was inversely related to refined grains availability (β=-0.3, p=0.002). Vegetable intake was related inversely to snacks/sweets preference (β=-0.5, p=0.02) and positively to whole grains exposure (β=0.2, p=0.02). Refined grain intake was related positively to vegetable exposure (β=0.1,p=0.04) and inversely to whole grain (β=-0.2, p=0.046) exposure. HEI was related positively to fruit preference (β=4.9, p=0.02) and whole grain availability (β=1.3p=0.002), and inversely to availability of vegetables (β=-0.5, p=0.03) and refined grains (β=-1.8, p=0.01). Discussion: Food exposure, preferences and availability influence intake of corresponding and competing foods, as well as overall diet quality.