New Diet Quality Measures Make a Difference: Data from WIC ITFPS-2

As part of a landmark nationally representative study following a cohort of young children, Westat repeatedly collected detailed data on what children eat. Called the WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2), the study offers a rich source of detailed information on children’s food, energy, and micro- and macronutrient intakes at ages 1 month through age 6 years.

New methodology will soon be released for the 2020 Healthy Eating Index (HEI) for Toddlers (HEI-Toddlers-2020), aligning it with the new 2020-25 Dietary Guidelines for Americans (DGA). Prior to the release of the new methodology, researchers from Westat and Duke University used WIC ITFPS-2 data to compare how new dietary recommendations may affect diet quality assessments around age 2. Because methodology for the HEI-Toddlers-2020 was not yet available, the researchers used the Toddler Diet Quality Index (TDQI), which aligns with the 2020 DGA guidelines for toddlers and compared it with the current HEI-2015. They found the following: TDQI yielded lower diet quality scores than the HEI-2015 around age 2; significant discordance between TDQI and HEI-2015 scores by racial-ethnic groups.

Dietary components driving these differences included greens and beans, dairy, sodium, added sugars, and the 2020 DGA recommendation for toddlers’ consumption of 100% fruit juice.

The findings appear in a recent issue of the Journal of Nutrition: Comparing Diet Quality Indices for Low-Income 24-Month-Old Toddlers: Exploring Changes Driven by 2020–2025 Dietary Guidelines for Americans. Westat staff among the coauthors include Christine Borger, PhD, and Brenda Sun, MS. “How we measure the diet quality of toddlers is vitally important because dietary patterns are laid down very early in life. This work shows that a measure based on the 2020 DGA could reveal important disparities that we need to address,” says Borger.