The association between diet quality as measured by healthy eating index and early childhood caries
Hamdan, Hebah Mohammed
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OBJECTIVES: This dissertation was divided into two studies. The aim of the first study was to investigate whether there is an association between diet quality of preschool children and their caregivers. The aim of the second study was to examine the relationship of children diet quality and dental caries risk. METHODS: The study utilized a longitudinal population-based data of a representative sample of low-income African American families in Detroit, Michigan. Analyses were limited to 522 children aged 3-5 years old and their primary caregivers. For caregivers, dietary histories were obtained at wave I using the Block 98.2 food frequency questionnaire. For children, dietary histories were obtained at wave I and wave II using the Block Kids Food Questionnaire. Healthy Eating Index-2005 was used to evaluate overall diet quality. Dental caries in primary teeth were measured by the ICDAS criteria. The mean number of decayed surfaces (noncavitated and cavitated), missing, and filled surfaces for each child was estimated. Statistical analyses were conducted using SAS 9.4 and STATA 14 to account for the complex sampling design. RESULTS: The first study found that the mean total HEI-2005 scores were 57.47 for caregivers at wave I, 56.04 for children at wave I, and 57.39 for children at wave II indicating that the diet quality of this population needs improvement. Significant, positive relationship was found between caregivers-child overall diet quality at wave I (β=0.35; p <0.0001) and wave II (β=0.31; p <0.0001). The second study found that children who had high diet quality or improved their diet quality throughout the study period had significantly lower dental caries incidence compared to those with low diet quality scores (IRR = 0.59 and 0.55, respectively) (CI = 0.36-0.96 and 0.35-0.86 , respectively). CONCLUSION: Our findings suggest that caregiver’s and children’s diet quality are associated. Therefore, caregiver’s diet quality should be considered in efforts to improve diets of their children. Additionally, preschooler children in our study with improved diet quality showed lower caries incidence. These results suggest that strategies and intervention to prevent dental caries among children should focus on improving overall diet quality.