Western, Healthful, and Low-Preparation Diet Patterns in Preschoolers of the STRONG Kids2 Program

Objective: Identify and describe diet patterns of children during early childhood using confirmatory factor analysis (CFA). Design: Longitudinal data were drawn from the STRONG Kids 2 program. Participants: Mothers were surveyed about their child's diet at 24 (n = 337), 36 (n = 317), and 48 (n = 289) months old. Variables Measured: The Block Food Frequency Questionnaire for children aged 2–7 years was used to derive diet patterns; 23 food groups were created for analyses. Analysis: Principal component analysis was used to obtain preliminary factor loadings, and loadings were used to form a priori hypotheses for CFA-derived diet patterns. Independent samples t tests were used to compare food groups, nutrient intakes, and child and family characteristics by CFA pattern scores above vs at/below the median. Results: Three diet patterns consistently emerged: (1) processed meats, sweets, and fried foods; (2) vegetables, legumes, and starchy vegetables; and (3) grains, nuts/seeds, and condiments (only 24 and 36 months). Patterns were related to differences in added sugars, dietary fiber and potassium intakes, maternal education, and household income. Conclusions and Implications: Opposing healthful vs Western patterns, extant in child and adult literature, were observed across all ages. The third pattern differed between 24/36 and 48 months, representing a potential shift in food choices or offerings as children age.