March 31, 2020
3 min read

Kids’ healthy diet scores improve by 27%

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According to data published in JAMA, children’s healthy diet scores improved by 27% during a recent 18-year period. The scores were based on the American Heart Association’s continuous diet score, which measures targeted consumption of total fruits and vegetables, whole grains, fish and shellfish, sugar-sweetened beverages and sodium.

The researchers included 31,420 adolescents in the study and examined trends in diet over 2 decades using the National Health and Nutrition Examination Survey. Although the overall diet quality in U.S. adolescents improved, more than half of youth still had poor-quality diets, the study determined.

When observing specific trends in foods and nutrients, they found changes in individual components of diet scores.

From 1999 to 2016, the estimated mean consumption of sugar-sweetened beverages decreased from two servings to one serving (CI, 95% –1.2 to –0.78); the consumption of whole grains increased from 0.46 to 0.95 servings (CI, 95% 0.40-0.59); total fruits and vegetables increased from 1.62 to 1.81 servings (CI, 95% 0.06-0.32); poultry consumption increased from 0.28 to 0.36 servings (CI, 95% 0.02-0.12); and consumption of eggs increased from 0.25 to 0.39 servings (CI, 95% 0.10-0.19).

The intake of processed meats, refined grains, nuts and seeds, and fish and shellfish did not significantly change.

Overall, they found that the participants’ estimated primary AHA diet score increased from 14.8 (95% CI, 14.1-15.4) to 18.8 (95% CI, 18.1-19.6), a 27% improvement.

Subcomponents of the listed food groups were also accounted for. The intake of whole fruit significantly increased from 0.46 to 0.68 servings (CI, 95% 0.12-0.32); intake of 100% fruit juice significantly decreased from 0.63 to 0.46 servings (CI, 95% –0.27 to –0.07); milk consumption significantly decreased from 1.36 to 1.19 servings (CI, 95% –0.30 to –0.04); cheese consumption significantly increased from 0.56 to 0.78 servings (CI, 95% 0.14-0.29); and yogurt significantly increased from 0.03 to 0.06 servings (CI, 95% 0.02-0.05).

Observing the intake of other foods and nutrients, the researchers found that consumption of unprocessed red meat significantly decreased from 0.35 to 0.31 servings (CI, 95% –0.09 to 0.01), whereas processed meat consumption stayed stable.

Significant increases were reported for total fat, with estimated means increasing from 33.2% to 34.5% of energy (CI, 95% 1.62%-3.06%), polyunsaturated fat from 6.17% to 7.58% (CI, 95% 1.23%-1.58%), and protein from 13.4% to 14.8% of energy (CI, 95% 0.90%1.69%).

The estimated consumption of total carbohydrates significantly decreased from 55.4% to 51.9% of energy (CI, 95% –4.34% to –2.69%).


The estimated consumption of plant omega-3 fat significantly increased from 116 mg per day to 146 mg per day (CI, 95% 24.9-34.6). The estimated consumption of seafood omega-3 fat significantly decreased from 51 mg per day to 42.3 mg per day (CI, 95% –19.8 to 2.33).

Dietary cholesterol significantly increased from 218 mg per day to 254 mg per day (CI, 95% 24.8-47.2), with significant increases in fiber — 12.4 mg per day to 15.6 mg per day (CI, 95% 2.53-3.76), and calcium — 875 mg per day to 1,061 mg per day (CI, 95% 132-240).

Exceptions in the study included legumes, in which observed increases were partially reduced (by 53.2%) by these adjustments, total dairy (increased further by 14.7%), and unprocessed red meat (increased further by 13.7%). – by Ken Downey Jr.

Disclosures: The authors report no relevant financial disclosures.