Neighborhood Deprivation Predicts Diet Quality at One Year of Age

Abstract

Abstract Objectives Diet quality in childhood predicts diet quality and obesity in adulthood. Breastfeeding (BF) history and neighborhood socio-economic position (SEP) are associated with diet quality in school-age children, but little is known about the effect of neighborhood on the developing diet in infancy. We analyzed data from PREVAIL, a birth cohort in Cincinnati, OH, to examine residence in a low-SEP neighborhood as a predictor of diet quality in infants. Methods PREVAIL subjects (n = 153) with a completed a food frequency questionnaire (FFQ) at 12 months of age were included for analysis. The FFQ estimated infant daily intake of tubers, fruits, vegetables, nuts/legumes, meats and grains. BF initiation and duration, and household confounding factors were determined via periodic questionnaires throughout infancy. Diet quality was measured in terms of BF history, daily portions of fruits & vegetables (F&V) and sugar sweetened beverages, and a calculated dietary diversity score. Subject residence was geocoded and assigned a Deprivation Index (DI) score, a composite of US census-derived factors describing community-level SEP. Diet quality measures were analyzed in relation to the infant's Deprivation Index quartile (DIQ), with quartiles ranked from the least (Q1) to most (Q4) deprived neighborhoods. Results DIQ was inversely associated with diet quality measured by median daily F&V intake (Q1 3.1, Q2 3.4, Q3 3.5, Q4 1.7, P < 0.001), median dietary diversity score (Q1 4.0, Q2 3.7, Q3 3.5, Q4 3.1, P = 0.03), BF initiation (Q1 93.6%, Q2 93.5%, Q3 88.9%, Q4 74.4%, P = 0.03) and BF duration (Q1 296 days, Q2 214 days, Q3 70 days, Q4 32 days, P < 0.001). DIQ was positively associated with sugar-sweetened beverage portions (Q1 0, Q2 0, Q3 0.4, Q4 0.4, P < 0.001). In Poisson regression models, DI was negatively predictive of dietary diversity score (P = 0.04) and F&V intake (P < 0.001) and positively predicted sugar-sweetened beverage portions (P = 0.004). Furthermore, BF initiation (P < 0.001) and BF ≥ 3 weeks (P < 0.001) positively predicted F&V portions. Conclusions In the PREVAIL cohort, infants residing in lower-SEP neighborhoods had significantly lower diet quality based on several measures. Improving diet quality in infancy should focus on low-SEP communities and incorporate BF promotion and support. Funding Sources Centers for Disease Control and Prevention.