Public Health Nutrition


Racial/ethnic and immigrant differences in early childhood diet quality

Marieke LA de Hooga1a2 c1, Ken P Kleinmana3, Matthew W Gillmana3a4, Tanja GM Vrijkottea1, Manon van Eijsdena2a5 and Elsie M Taverasa3a6

a1 Department of Public Health, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands

a2 Department of Epidemiology, Documentation and Health Promotion, Public Health Service, Amsterdam, The Netherlands

a3 Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA

a4 Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

a5 Institute of Health Sciences, VU University, Amsterdam, The Netherlands

a6 Division of General Pediatrics, Children's Hospital Boston, Boston, MA, USA


Objective To assess racial/ethnic differences in the diet in young children and the explanatory role of maternal BMI, immigrant status and perception of child's weight.

Design Among white, black and Hispanic 3-year-olds, we used negative binomial and linear regression to examine associations of race/ethnicity with foods and nutrients assessed by a validated FFQ.

Setting Project Viva, Boston (MA), USA.

Subjects Children aged 3 years (n 898).

Results Mean age was 38·3 (sd 2·8) months; 464 (52 %) were boys and 127 mothers (14 %) were immigrants. After adjustment for sociodemographic factors, black and Hispanic children (v. white) had a higher intake of sugar-sweetened beverages (rate ratio (RR) = 2·59 (95 % CI 1·95, 3·48) and RR = 1·59 (95 % CI 1·07, 2·47), respectively) and lower intakes of skimmed/1 % milk (RR = 0·42 (95 % CI 0·33, 0·53) and RR = 0·43 (95 % CI 0·31, 0·61), respectively) and trans-fat (−0·10 (95 % CI −0·18, −0·03) % of energy and −0·15 (95 % CI −0·26, −0·04) % of energy, respectively). Among Hispanics only, a lower intake of snack food (RR = 0·83 (95 % CI 0·72, 0·98)) was found and among blacks only, a higher intake of fast food (RR = 1·28 (95 % CI 1·05, 1·55)) and lower intakes of saturated fat (−0·86 (95 % CI −1·48, −0·23) % of energy), dietary fibre (0·85 (95 % CI 0·08, 1·62) g/d) and Ca (−120 (95 % CI −175, −65) mg/d) were found. Being born outside the USA was associated with more healthful nutrient intakes and less fast food.

Conclusions Three-year-old black and Hispanic (v. white) children ate more sugar-sweetened beverages and less low-fat dairy. Total energy intake was substantially higher in Hispanic children. Snack food (Hispanic children) and fat intakes (black children) tended to be lower. Children of immigrants ate less fast food and bad fats and more fibre.

(Received July 30 2012)

(Revised March 10 2013)

(Accepted March 17 2013)

(Online publication May 07 2013)


  • Race/ethnicity;
  • Pre-school children;
  • Diet;
  • Acculturation;
  • Maternal perception


c1 Corresponding author: Email