BACKGROUND AND OBJECTIVES Diet quality has improved over time for US adults and youth aged ≥2 years. Trends over time and disparities in the diet quality of toddlers 12 through 23 months old have not been documented. Our objective was to investigate the direction and magnitude of toddler diet quality trends from 1999 to 2018 overall and by household socioeconomic status. METHODS This serial cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data was performed with 2541 toddlers from 10 NHANES cycles from 1999 to 2018. Dietary intake was measured by NHANES study staff using proxy-reported 24-hour recalls. Healthy Eating Index-Toddlers-2020 total scores (0-100 points, higher scores indicate healthier diets) and component scores were calculated from the 24-hour dietary recalls using the population ratio method. Multivariable linear regression was used to evaluate the association between time in years (measured as the midpoint of each NHANES cycle) and diet quality. RESULTS Toddler diet quality improved significantly from 1999 to 2018 (P < .001), from 63.7 points on average in 1999-2000 to 67.7 points in 2017-2018. A significant positive linear trend in total diet quality was observed for all socioeconomic status groups (P < .05). Several dietary component scores improved, as follows: Whole Fruits (P < .001), Whole Grains (P = .016), Fatty Acids (P = .002), Refined Grains (P = .009), and Added Sugars (P < .001). Scores did not significantly change for Total Fruit, Total Vegetables, Greens and Beans, Dairy, Total Protein Foods, Seafood and Plant Proteins, Sodium, or Saturated Fats. CONCLUSIONS From 1999 to 2018, toddler diet quality improved significantly, but mean scores still fell short of dietary guidance.

中文翻译：

---

美国幼儿饮食质量趋势：1999 年至 2018 年。


背景和目标 随着时间的推移，美国成年人和 2 ≥青少年的饮食质量有所改善。尚未记录 12 至 23 个月大幼儿饮食质量随时间变化的趋势和差异。我们的目的是调查 1999 年至 2018 年幼儿饮食质量趋势的整体方向和幅度以及家庭社会经济地位。方法 对 1999 年至 2018 年 10 个 NHANES 周期的 2541 名幼儿进行了全国健康和营养检查调查 （NHANES） 数据的系列横断面分析。NHANES 研究人员使用代理报告的 24 小时回忆来测量膳食摄入量。健康饮食指数-幼儿 - 2020 总分 （0-100 分，分数越高表示饮食更健康） 和成分分数是使用人口比率法从 24 小时饮食回忆中计算得出的。多变量线性回归用于评估以年为单位的时间 （以每个 NHANES 周期的中点衡量） 与饮食质量之间的关联。结果 幼儿饮食质量从 1999 年到 2018 年显着提高 （P < .001），从 1999-2000 年的平均 63.7 分提高到 2017-2018 年的 67.7 分。在所有社会经济地位群体中，观察到总体膳食质量呈显著的正线性趋势 （P < .05）。几种膳食成分得分有所提高，如下：全水果 （P < .001）、全谷物 （P = .016）、脂肪酸 （P = .002）、精制谷物 （P = .009） 和添加糖 （P < .001）。总水果、总蔬菜、蔬菜和豆类、乳制品、总蛋白食物、海鲜和植物蛋白、钠或饱和脂肪的分数没有显着变化。结论 从 1999 年到 2018 年，幼儿饮食质量显着改善，但平均分数仍未达到饮食指导。