(P18-005-23) Differences in Infant Diet Quality by Race and Ethnicity Predict Differences in Later Diet Quality

Objectives: This study investigated maternal racial/ethnic and language (English/Spanish) differences in infant diet quality, later diet quality, and weight status at 2-5 years, and if differences at 2-5 years were explained through early infant diet quality among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Methods: Using the WIC Infant and Toddler Feeding Practices Study-2 (n=2,936), the relationships between the Infant Dietary Quality Index (IDQI) and Healthy Eating Index-2015 (HEI-2015) and body mass index z-score (BMIz) at 2-5 years were analyzed by race/ethnicity (Hispanic Spanish-speakers (Hispanic Spanish), Hispanic English-speakers (Hispanic English), Non-Hispanic Whites (White), and Non-Hispanic Blacks (Black)). Statistical interaction between IDQI and each group was estimated in multivariable models. Mediation of race/ethnicity through the IDQI was assessed using causal mediation methods.

Results: Racial/ethnic differences in IDQI (mean,SD) were observed between: Hispanic Spanish (0.41(0.10)), Hispanic English (0.37(0.10)), White (0.36(0.10)), and Black (0.35(0.09)), range 0-1, P< 0.001. Differences were seen in HEI-2015 at 2-5 years with Hispanic Spanish having consistently higher HEI-2015 scores. Differences in BMIz were observed at 5 years, with higher scores among Hispanic Spanish. Interaction between race/ethnicity and IDQI was observed for all outcomes except for BMIz at 3 years. Through mediation, IDQI explained 13-21% of the difference in HEI-2015 scores during 2-5 years between Hispanic Spanish and White participants. IDQI explained 21% of the difference in HEI-2015 scores at 4 years between Hispanic Spanish and Black participants.

Conclusions: Higher infant diet quality scores observed in Hispanic Spanish-speaking participants explained some of the racial and ethnic differences observed in later diet quality, suggesting that improving infant diet quality may help reduce disparities in diet quality in early childhood.

Funding Sources: National Heart, Lung, And Blood Institute