Skip to main content

Racial/ethnic and immigrant differences in early childhood diet quality

  • Marieke LA de Hoog (a1) (a2), Ken P Kleinman (a3), Matthew W Gillman (a3) (a4), Tanja GM Vrijkotte (a1), Manon van Eijsden (a2) (a5) and Elsie M Taveras (a3) (a6)...
Abstract 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.


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.


Project Viva, Boston (MA), USA.


Children aged 3 years (n 898).


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.


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.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Racial/ethnic and immigrant differences in early childhood diet quality
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Racial/ethnic and immigrant differences in early childhood diet quality
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Racial/ethnic and immigrant differences in early childhood diet quality
      Available formats
Corresponding author
*Corresponding author: Email
Hide All
1. Gortmaker SL, Swinburn BA, Levy D et al. (2011) Changing the future of obesity: science, policy, and action. Lancet 378, 838847.
2. Ogden CL, Carroll MD, Kit BK et al. (2012) Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA 307, 483490.
3. Singh GK, Kogan MD, Van Dyck PC et al. (2008) Racial/ethnic, socioeconomic, and behavioral determinants of childhood and adolescent obesity in the United States: analyzing independent and joint associations. Ann Epidemiol 18, 682695.
4. Skelton JA, Cook SR, Auinger P et al. (2009) Prevalence and trends of severe obesity among US children and adolescents. Acad Pediatr 9, 322329.
5. Swinburn BA, Sacks G, Hall KD et al. (2011) The global obesity pandemic: shaped by global drivers and local environments. Lancet 378, 804814.
6. Craigie AM, Lake AA, Kelly SA et al. (2011) Tracking of obesity-related behaviours from childhood to adulthood: a systematic review. Maturitas 70, 266284.
7. Walker SE, Gurka MJ, Oliver MN et al. (2010) Racial/ethnic discrepancies in the metabolic syndrome begin in childhood and persist after adjustment for environmental factors. Nutr Metab Cardiovasc Dis 22, 141148.
8. Moreno LA & Rodriguez G (2007) Dietary risk factors for development of childhood obesity. Curr Opin Clin Nutr Metab Care 10, 336341.
9. Dorgan JF, Liu L, Barton BA et al. (2011) Adolescent diet and metabolic syndrome in young women: results of the Dietary Intervention Study in Children (DISC) follow-up study. J Clin Endocrinol Metab 96, E1999E2008.
10. Mennella JA, Ziegler P, Briefel R et al. (2006) Feeding infants and toddlers study: the types of foods fed to Hispanic infants and toddlers. J Am Diet Assoc 106, S96S106.
11. Park SY, Murphy SP, Wilkens LR et al. (2005) Dietary patterns using the Food Guide Pyramid groups are associated with sociodemographic and lifestyle factors: the multiethnic cohort study. J Nutr 135, 843849.
12. Donin AS, Nightingale CM, Owen CG et al. (2010) Nutritional composition of the diets of South Asian, black African-Caribbean and white European children in the United Kingdom: the Child Heart and Health Study in England (CHASE). Br J Nutr 104, 276285.
13. Kleiser C, Mensink GB, Neuhauser H et al. (2010) Food intake of young people with a migration background living in Germany. Public Health Nutr 13, 324330.
14. Lytle LA, Himes JH, Feldman H et al. (2002) Nutrient intake over time in a multi-ethnic sample of youth. Public Health Nutr 5, 319328.
15. Troiano RP, Briefel RR, Carroll MD et al. (2000) Energy and fat intakes of children and adolescents in the United States: data from the national health and nutrition examination surveys. Am J Clin Nutr 72, 5 Suppl., 1343S1353S.
16. Xie B, Gilliland FD, Li YF et al. (2003) Effects of ethnicity, family income, and education on dietary intake among adolescents. Prev Med 36, 3040.
17. Fisk CM, Crozier SR, Inskip HM et al. (2011) Influences on the quality of young children's diets: the importance of maternal food choices. Br J Nutr 105, 287296.
18. Ohlund I, Hernell O, Hornell A et al. (2010) BMI at 4 years of age is associated with previous and current protein intake and with paternal BMI. Eur J Clin Nutr 64, 138145.
19. Batis C, Hernandez-Barrera L, Barquera S et al. (2011) Food acculturation drives dietary differences among Mexicans, Mexican Americans, and Non-Hispanic Whites. J Nutr 141, 18981906.
20. Dave JM, Evans AE, Saunders RP et al. (2009) Associations among food insecurity, acculturation, demographic factors, and fruit and vegetable intake at home in Hispanic children. J Am Diet Assoc 109, 697701.
21. Desilets MC, Rivard M, Shatenstein B et al. (2007) Dietary transition stages based on eating patterns and diet quality among Haitians of Montreal, Canada. Public Health Nutr 10, 454463.
22. Mazur RE, Marquis GS & Jensen HH (2003) Diet and food insufficiency among Hispanic youths: acculturation and socioeconomic factors in the third National Health and Nutrition Examination Survey. Am J Clin Nutr 78, 11201127.
23. Francis LA, Hofer SM & Birch LL (2001) Predictors of maternal child-feeding style: maternal and child characteristics. Appetite 37, 231243.
24. Macfarlane A, Crawford D & Worsley A (2010) Associations between parental concern for adolescent weight and the home food environment and dietary intake. J Nutr Educ Behav 42, 152160.
25. Gillman MW, Rich-Edwards JW, Rifas-Shiman SL et al. (2004) Maternal age and other predictors of newborn blood pressure. J Pediatr 144, 240245.
26. Gillman MW (1996) Enjoy your fruits and vegetables. BMJ 313, 765766.
27. Johnston CC Jr, Miller JZ, Slemenda CW et al. (1992) Calcium supplementation and increases in bone mineral density in children. N Engl J Med 327, 8287.
28. Oh K, Hu FB, Manson JE et al. (2005) Dietary fat intake and risk of coronary heart disease in women: 20 years of follow-up of the Nurses’ Health Study. Am J Epidemiol 161, 672679.
29. Posner BM, Cobb JL, Belanger AJ et al. (1991) Dietary lipid predictors of coronary heart disease in men. The Framingham Study. Arch Intern Med 151, 11811187.
30. Salmeron J, Manson JE, Stampfer MJ et al. (1997) Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 277, 472477.
31. Willett WC (1994) Diet and health: what should we eat? Science 264, 532537.
32. Blum RE, Wei EK, Rockett HR et al. (1999) Validation of a food frequency questionnaire in Native American and Caucasian children 1 to 5 years of age. Matern Child Health J 3, 167172.
33. Hu FB, Stampfer MJ, Manson JE et al. (1997) Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 337, 14911499.
34. National Center for Health Statistics (2010) Homepage. (accessed September 2010).
35. Venables WN & Ripley BD (2002) Modern Applied Statistics with S, 4th ed. New York: Springer.
36. R Development Core Team (2011) R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing; available at
37. Dennison BA, Rockwell HL & Nichols MJ (2001) Use of low-fat milk by children in the New York State WIC varies with parental characteristics. J Am Diet Assoc 101, 464466.
38. O'Neil CE, Nicklas TA, Liu Y et al. (2009) Impact of dairy and sweetened beverage consumption on diet and weight of a multiethnic population of head start mothers. J Am Diet Assoc 109, 874882.
39. LaRowe TL, Moeller SM & Adams AK (2007) Beverage patterns, diet quality, and body mass index of US preschool and school-aged children. J Am Diet Assoc 107, 11241133.
40. Vyas A (2003) Nutrient intakes of an adult Pakistani, European and African-Caribbean community in inner city Britain. J Hum Nutr Diet 16, 327337.
41. Crawford PB, Obarzanek E, Schreiber GB et al. (1995) The effects of race, household income, and parental education on nutrient intakes of 9- and 10-year-old girls. NHLBI Growth and Health Study. Ann Epidemiol 5, 360368.
42. North K & Emmett P (2000) Multivariate analysis of diet among three-year-old children and associations with socio-demographic characteristics. The Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) Study Team. Eur J Clin Nutr 54, 7380.
43. Schefske SD, Bellows AC, Byrd-Bredbenner C et al. (2010) Nutrient analysis of varying socioeconomic status home food environments in New Jersey. Appetite 54, 384389.
44. Elfhag K & Rasmussen F (2008) Food consumption, eating behaviour and self-esteem among single v. married and cohabiting mothers and their 12-year-old children. Public Health Nutr 11, 934939.
45. Delisle H (2010) Findings on dietary patterns in different groups of African origin undergoing nutrition transition. Appl Physiol Nutr Metab 35, 224228.
46. Satia-Abouta J, Patterson RE, Neuhouser ML et al. (2002) Dietary acculturation: applications to nutrition research and dietetics. J Am Diet Assoc 102, 11051118.
47. Gordon-Larsen P, Harris KM, Ward DS et al. (2003) Acculturation and overweight-related behaviors among Hispanic immigrants to the US: the National Longitudinal Study of Adolescent Health. Soc Sci Med 57, 20232234.
48. Kocturk T (1995) Structure and change in food habits. Scand J Nutr 39, 24.
49. Mellin-Olsen T & Wandel M (2005) Changes in food habits among Pakistani immigrant women in Oslo, Norway. Ethn Health 10, 311339.
50. Dammann KW, Smith C & Richards R (2011) Low-income minority and homeless mothers’ perceptions of their 9–13 year-old children's weight status, diet, and health. Matern Child Health J 15, 106114.
51. Dixon B, Pena MM & Taveras EM (2012) Lifecourse approach to racial/ethnic disparities in childhood obesity. Adv Nutr 3, 7382.
52. Killion L, Hughes SO, Wendt JC et al. (2006) Minority mothers’ perceptions of children's body size. Int J Pediatr Obes 1, 96102.
53. Stewart AW, Jackson RT, Ford MA et al. (1987) Underestimation of relative weight by use of self-reported height and weight. Am J Epidemiol 125, 122126.
54. Wen M & Kowaleski-Jones L (2012) Sex and ethnic differences in validity of self-reported adult height, weight and body mass index. Ethn Dis 22, 7278.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 17
Total number of PDF views: 153 *
Loading metrics...

Abstract views

Total abstract views: 257 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th November 2017. This data will be updated every 24 hours.