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Diet Quality in Young Children Is Influenced by Beverage Consumption

Department of Preventive and Community Dentistry, University of Iowa College of Dentistry (T.A.M., J.M.E., B.B., S.M.L.)
Clinical Research Center, University of Iowa Roy H. and Lucille A. Carver College of Medicine (P.J.S.), University of Iowa, Iowa City, Iowa

Address reprint requests to: Teresa A. Marshall, PhD, Assistant Professor, Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, N335 Dental Science Building, Iowa City, IA 52242. E-mail: teresa-marshall{at}uiowa.edu

Background: Replacement of milk with sugar-containing beverages could affect calcium intake and overall diet quality.

Objective: To describe dairy food, 100% juice and added sugar beverage intakes, contributions of dairy foods to diet quality, and effects of beverages on diet quality in young children.

Methods: We surveyed participants in the Iowa Fluoride Study (n = 645) at ages 1, 2, 3, 4 and 5 years and calculated intakes for 1–5 years (i.e. weighted averages). Nutrient, dairy food and beverage intakes were obtained from 3-day diaries; nutrient adequacy ratios were calculated as the nutrient intake to Recommended Dietary Allowance/Adequate Intake ratio; and dairy-dependent percentages were calculated as fractions of total diet nutrient adequacy ratios (truncated at 1) not met by non-dairy foods.

Results: Milk intakes were inversely associated with intakes of juice drinks (2, 4, 5 and 1–5 years), soda pop (2, 3, 4, 5 and 1–5 years) and added sugar beverages (2, 3, 4, 5 and 1–5 years). Dairy dependent fractions of 1–5 year nutrient adequacy ratios were 68% for calcium and 61% for vitamin D. Higher 1–5 year calcium adequacy was predicted by higher energy, higher other dairy and lower added sugar beverage intakes while higher vitamin D adequacy was predicted by higher energy and higher other dairy intakes. Overall diet quality was predicted by higher energy, higher other dairy, lower 100% juice and lower added sugar beverage intakes.

Conclusions: Dairy foods remain an important source of calcium and vitamin D, while added sugar beverages and, to a lesser extent, 100% juice decrease diet quality of young children.

Key words: diet quality, milk, juice, soda pop, AI = adequate intake, CSFII = Continuing Survey of Food Intakes by Individuals, IFS = Iowa Fluoride Study, MAR = mean adequacy ratio, NAR = nutrient adequacy ratio, RDA = recommended dietary allowance, USDA = United States Department of Agriculture

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