Peer-reviewed article
Toddler diet quality: a factor associated with childhood growth?
Zhu X, Putnick DL, Clayton PK, Lin TC, Yeung E ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study followed over 1,300 children from the United States to examine whether better diet quality in toddlerhood (at ages 2.5 and 3 years) was associated with healthier growth patterns in later childhood (ages 7-9 years). Researchers measured toddler diet quality by looking at servings of foods like dairy, fruits, vegetables, and meat, and calculated a diet quality score. Children with higher diet quality scores in toddlerhood had significantly lower odds of developing central obesity by age 7-9, but diet quality was not associated with other measures of growth or general obesity.
Key points
- Among 1,322 children, mean diet quality score in toddlerhood was 44.4 out of 65, with higher scores indicating better diet quality
- Higher toddler diet quality scores were significantly associated with lower odds of central obesity in later childhood (adjusted OR = 0.74)
- Diet quality scores were not significantly associated with height-for-age, weight-for-age, BMI-for-age z-scores, waist circumference, or general obesity after adjusting for confounding factors
- The study adjusted for multiple maternal and child factors including maternal BMI, breastfeeding duration, and complementary feeding practices
Limitations
The study is observational and cannot establish causation; maternal recall of toddler diet and child measurements via questionnaire rather than direct clinical assessment may introduce measurement error. The findings apply to a specific population in Upstate United States and may not generalize to other contexts.
Abstract
Background Childhood growth is crucial for long-term overall health and well-being. Diet quality is an essential component of nutritional status reflecting dietary patterns and nutrient intake. While research in adults has shown that higher diet quality is associated with a lower risk of obesity, its association with childhood growth has remained unclear. This study aims to evaluate the association between diet quality among toddlers and their growth in later childhood. Methods Mothers from Upstate KIDS, a prospective cohort study, reported numbers of servings/day for specific foods, such as dairy, fruit, vegetables, and meat, fed to their toddlers at 2.5- and 3-years along with behaviors such as breakfast intake. Accordingly, the Youth Healthy Eating Index (YHEI) was calculated to measure toddler diet quality (range 0-65) with higher scores indicating better toddler diet quality. Children's height, weight, and waist circumference were reported up to three times in questionnaires from 7- to 9-years, and corresponding height-for-age (HAZ), weight-for-age (WAZ), body mass index-for-age (BMIZ) z-scores and obesity status were calculated. Mixed effects models were used to estimate associations with YHEI scaled per five-unit increase, adjusting for maternal age, race/ethnicity, education, insurance status, government assistance, fertility treatment, smoking, parity, pre-pregnancy BMI, child age, sex, plurality, breastfeeding duration, and complementary feeding. Results Among 1322 children (52.0% male), the mean YHEI score in toddlerhood was 44.4 ± 8.52 (mean ± standard deviation). Higher YHEI scores were significantly associated with lower odds of developing central obesity (adjusted OR = 0.74, 95% CI: 0.56, 0.98). YHEI scores were not associated with HAZ, WAZ, BMIZ, waist circumference, and obesity after adjusting for covariates. Conclusion Higher toddler diet quality is associated with reduced odds of central obesity in later childhood. Interventions aimed at improving early diet quality are needed to promote healthy growth in childhood.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- None; this is an observational study examining the association between toddler diet quality and later childhood growth
- Population
- 1,322 children from the Upstate KIDS prospective cohort study with diet quality assessed at 2.5-3 years and growth outcomes measured at 7-9 years
Key finding
Higher diet quality significantly associated with lower odds of central obesity (OR = 0.74, 95% CI: 0.56, 0.98)
X et al. · Europe PMC · 18 Jul 2026