(P10-059-24) Infant Feeding Practices and Diet Quality in the First Year of Life Are Associated With Healthy Eating Index-Toddlers-2020 Scores in the Second Year of Life

Objectives: The Healthy Eating Index-Toddlers-2020 (HEI-Toddlers) was recently developed to measure toddler dietary alignment with the Dietary Guidelines for Americans. This analysis aims to understand whether the Infant Diet Quality Index (IDQI) and the Diet Quality Index Score (DQIS) measured during the first year of life are associated with diet quality in the second year of life as measured by the HEI-Toddlers.

Methods: Data from the WIC Infant and Toddlers Feeding Practices Study-2 was used. IDQI scores, assessing feeding practices, were calculated utilizing questionnaires and 24-hour diet recalls taken across the first year (n=1028). Average DQIS scores, measuring diet variety and quantity, were calculated using 24 hour-recall data collected across 7, 9, and 11 months (n=1151). The multivariate outcome of HEI-Toddlers score was calculated using 24-hour diet recalls collected at 13, 15, 18 and 24 months. Mixed effects models were used to assess the relations between each infant index and the HEI-Toddlers score across the second year of life, adjusted for covariates.

Results: Close to half the sample were female (48.5%), born to mothers with at least a twelfth-grade education (77.6%), and lived in food secure households (68.3%). Caregivers were Hispanic (38.8%), Non-Hispanic (NH) Black (24.5%), NH White (31.9%), or NH Other Races (4.8%). Mean IDQI score in the sample was 0.37 (0.10) out of 1. Mean DQIS score was 28.5 (3.4) out of 45. Average HEI-Toddler score was 56.4 (11.9) out of 100 at 24 months. In adjusted models, a 10% increase in infant IDQI score was associated with a 1.74-point increase (95% CI 1.48-1.99) in total HEI-Toddlers score in the second year of life, and a 1-point increase in average DQIS score was associated with a 0.43-point increase (95% CI 0.33-0.52) in the total HEI-Toddlers score in the second year.

Conclusions: Two metrics for measuring diet quality during infancy, one focusing on feeding practices (IDQI), and one on diet variety/amounts (DQIS), are each positively associated with toddler diet quality during the second year of life. This finding is an important first step in understanding whether greater alignment with infant feeding recommendations could improve toddler diet quality, and a step toward exploring the trajectory of diet quality beginning at birth.

Funding Sources: None