Diet quality and adherence to nutritional recommendations: a multicenter study based on caregiver-child dyads

In recent decades, overweight and obesity among school-aged children have steadily increased, accompanied by a marked rise in the consumption of processed and ultra-processed foods, highlighting the need to examine school dietary patterns. This study aimed to assess diet quality and adherence to nutritional recommendations among schoolchildren, based on caregiver-reported information, within caregiver-child dyads across seven municipalities in Chile. A cross-sectional, descriptive, and correlational study was conducted with a sample of 2,115 dyads. Associations between sociodemographic variables and categories of the Global Diet Quality Index were analyzed using chi-squared tests and multinomial logistic regressions, and relative risks were calculated to estimate the magnitude of these associations. Statistical significance was set at p < 0.05. Children attending subsidized private schools showed higher overall diet quality (p ≤ 0.001), while those enrolled in municipal schools were more likely to meet recommendations for fruits (p = 0.001), vegetables (p = 0.009), and legumes (p = 0.000). Preschool children demonstrated greater adherence to nutritional recommendations compared with those in primary and secondary education. In conclusion, diet quality and adherence to nutritional recommendations vary significantly according to school type and educational level, reinforcing the need for tailored strategies to promote healthy eating across educational stages and school contexts.