(PTFS17-06-24) Barriers to Accessing High-Quality Diet for Chinese Children and Adolescents

Objectives: The dietary quality scores of children and adolescents in China are generally very low. The purpose of this study is to explore the barriers that affect their access to high-quality diet.

Methods: We used data from 5219 subjects aged 2 to 20 years who participated in the China Health and Nutrition Survey in 2015 and 2018. We collected dietary data using three consecutive 24-hour recalls combined with weighing methods. Based on specific cut points for estimated energy requirements and physical activity levels in children, we developed a 14-component diet quality index for assessing diet quality and a 17-component questionnaire for assessing parental dietary knowledge. We used generalized linear regression models to explore factors influencing diet quality in children and adolescents.

Results: According to the 110-point scale, the average diet quality scores of children aged 2-5, 6-11 and 12-19 years old were 47.6 points, 50.0 points and 51.0 points respectively. The diet quality score of children aged 2-5 years in rural areas is lower than that in urban areas (40.3 vs. 44.1, p< 0.001); low-income families are lower than high-income families (41.9 vs. 43.1, p=0.05). Among children aged 6-11 years, girls had lower diet quality scores than boys (49.7 vs. 50.9, p=0.03); fathers with lower dietary knowledge had lower scores than those with higher dietary knowledge (49.3 vs. 51.3, p=0.02 ); Among adolescents aged 12-20 years, girls’ diet quality scores are lower than boys (45.4 vs. 47.5, p=0.002); Rural areas are lower than urban areas (44.1 vs. 48.9, p< 0.001); Low-income families Lower than those from high-income families (44.1 vs. 48.3, p< 0.001); fathers with lower dietary knowledge were lower than fathers with higher dietary knowledge (49.8 vs. 52.7, p=0.004).

Conclusions: Parents (especially fathers) lack sufficient dietary knowledge, girls, living in rural areas, and low family income are the main obstacles for Chinese children and adolescents to obtain high-quality diets. Different age groups have different barriers.

Funding Sources: The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute on Aging (NIA), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Heart, Lung, and Blood Institute (NHLBI), the National Institute for Health (NIH).