1Global Centre for Preventive Health and Nutrition (GLOBE), Deakin University, Geelong, Australia, 2School of Medicine, Deakin University, Geelong, Australia, 3Biostatistics Unit, Deakin University, Melbourne, Australia, 4Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile, 5Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne, Australia
Introduction. Few studies have quantified children’s adherence to sustainable healthy diets, and none have explored whether adherence varies with child or maternal characteristics. Objectives. To describe adherence to sustainable healthy among a sample of 958 Chilean preschoolers (3-6 years) from the Food Environment Chilean Cohort (FECHiC) and explore associations between adherence and child and maternal sociodemographic and anthropometric characteristics. Methods. A single 24-hour multi-pass dietary recall, collected by trained dietitians in 2016, was used to describe FECHiC participants’ adherence to the Planetary Health Diet Index for Children and Adolescents (PHDI-C). Adjusted linear models were fitted to explore associations in total and individual component scores with child and maternal characteristics. Results. This sample of Chilean children obtained low PHDI-C total scores (median 50.0 [IQR 39.5–59.8] out of 150 points). This was due to low reported consumption of nuts & peanuts, legumes, vegetables, whole cereals, and vegetable oils; a lack of balance between dark green and red & orange vegetables, inadequate (either low or excess) consumption of tubers & potatoes and eggs & white meats, and excess consumption of dairy products, palm oil, red meats, and added sugars. Mean PHDI-C total score was significantly higher (50.63 [95%CI 49.60, 51.66] vs 47.26 [95%CI 44.97, 49.54]) among children whose mothers were ≥25 years compared to those with younger mothers. We observed positive associations between scores for fruits and maternal education, vegetables, and maternal age, and added sugars and child weight status, and negative associations between scores for fruits and child age, and vegetable oils and maternal education. Scores for dairy products were lower among girls. Conclusions. Our findings support the need for strategies targeting the low consumption of nuts & peanuts, legumes, vegetables (particularly dark green vegetables), and whole cereals, and high consumption of dairy products, palm oil, red meats, and added sugars, particularly among children with younger mothers and mother with low levels of education. Tripleduty actions aimed at increasing access to and affordability of minimally processed foods and decreasing the availability of animal-source foods and ultra-processed products might contribute to achieving sustainable healthy diets among children.
Keywords: chilean preschoolers, anthropometric characteristics, healthy diets, fruits, vegetables, maternal education