Western, Healthful, and Low-Preparation Diet Patterns in Preschoolers of the STRONG Kids2 Program

Identify and describe diet patterns of children during early childhood using confirmatory factor analysis (CFA).

Longitudinal data were drawn from the STRONG Kids 2 program.

Mothers were surveyed about their child's diet at 24 (n = 337), 36 (n = 317), and 48 (n = 289) months old.

The Block Food Frequency Questionnaire for children aged 2-7 years was used to derive diet patterns; 23 food groups were created for analyses.

Principal component analysis was used to obtain preliminary factor loadings, and loadings were used to form a priori hypotheses for CFA-derived diet patterns. Independent samples t tests were used to compare food groups, nutrient intakes, and child and family characteristics by CFA pattern scores above vs at/below the median.

Three diet patterns consistently emerged: (1) processed meats, sweets, and fried foods; (2) vegetables, legumes, and starchy vegetables; and (3) grains, nuts/seeds, and condiments (only 24 and 36 months). Patterns were related to differences in added sugars, dietary fiber and potassium intakes, maternal education, and household income.

Opposing healthful vs Western patterns, extant in child and adult literature, were observed across all ages. The third pattern differed between 24/36 and 48 months, representing a potential shift in food choices or offerings as children age.