Nutritional Adequacy and Diet Quality Are Associated with Standardized Height-for-Age among U.S. Children

Abstract

Nutritional status affects linear growth and development. However, studies on the associations between nutritional status, diet quality, and age-standardized height in children are limited. The aim of this study was to assess the relationship between macro- and micronutrient intake and food consumption and height-for-age Z score (HAZ) among US children in the National Health and Nutrition Examination Survey (NHANES). This cross-sectional population-based study included 6116 US children aged 2-18 years. The usual dietary intake of nutrients and food groups was estimated by the multiple source method (MSM) using two-day food consumption data from NHANES 2007-2014. After adjusting for covariates, HAZ was positively associated with intakes of energy, protein, carbohydrate, fat, vitamins A, D, E, B6, and B12, thiamin, riboflavin, niacin, calcium, and iron. Children in the highest tertile of HAZ were less likely to consume lower than the EAR for vitamin E and calcium. Major foods consumed by children with lower HAZ were soft drinks, high-fat milk products, cakes, cookies, pastries, and pies, whereas children with higher HAZ tended to consume low-fat milk products, tea, and low-calorie fruit juice. These findings suggest that adequate nutritional intake, diet quality, and nutrient-dense food are important factors for height in children.

Keywords: NHANES; children; diet; height-for-age; nutritional adequacy.

Figure 1

(a) Energy intake, (b) protein, carbohydrate, fat intake, (c) % energy from each macronutrient by tertile of HAZ among US children aged 2–18 years, NHANES 2007–2014 (n = 6116) Each tertile was defined as follows: T1 (low HAZ), T2 (medium HAZ), T3 (high HAZ) * Tested by ANOVA and adjusted for age, gender, ethnicity and birth weight.

Figure 2

Intake of five food groups by tertile of HAZ among US children aged 2–18 years, NHANES 2007–2014 (n = 6116). Each tertile was defined as follows: T1 (low HAZ), T2 (medium HAZ), T3 (high HAZ) * Tested by ANOVA and adjusted for age, gender, ethnicity and birth weight. HAZ, height-for-age Z score.