(OR05-06-23) Misalignment With 2020-2025 Dietary Guidelines for Americans Among a Rural Population Under 2 Years of Age

Objectives: Rural children experience obesity disparities that may be related to early dietary patterns. Study aimed to evaluate the degree to which infant dietary intake aligned with the 2020-2025 Dietary Guidelines for Americans (DGA).

Methods: The Early Healthy Lifestyles (EHL) tool is a patient-reported outcome measure collected prior to well-child visits for children aged 0-26mo. In a retrospective chart review, data were extracted from EHL responses between 2016-2020 at Geisinger, a rural-serving health system. Patient-reported data include infant consumption in the past week of human milk or formula; water, cow milk, 100% juice, sugar-sweetened beverages, foods with added sugar, and foods higher in sodium. Responses were evaluated for age at first report (e.g., first ‘yes’ to water). Prevalence estimates of percent aligned or misaligned with DGA were calculated based on number of completed EHL at age cut-offs. DGA recommendations include exclusive consumption of human milk and/or formula for first 6mo. of life; some complementary water after 6mo.; introduction of cow milk and 100% juice after 1yr.; avoiding foods and beverages with added sugar; and limiting foods and beverages higher in sodium.

Results: The number of patients with completed EHL surveys across 2016-2020 totaled N=10,614, and mean number of completed EHL surveys per individual was 2.8 [min=1, max=13). The prevalence of exclusive consumption of human milk and/or formula for the first 3mo. was 51.6% (n=2171) and the first 6mo. was 46.3% (n=2548). Early introduction of water ( < 6mo.), cow milk ( < 1yr.), and 100% juice ( < 1yr.) was recorded for 7.2% of infants (n=399), and 4.8% (n=352) and 26.6% (n=1968) of children, respectively. Early introduction ( < 2yr.) foods and beverages with added sugar was as follows: 10.7% (n=1,065) sugar-sweetened beverages; 33.8% (n=3,336) cakes, cookies, pudding; and 29% (n=2,850) sweet cereal. Lastly, early introduction of foods higher in sodium were recorded for 37.6% (n=3718) for snacks (e.g., potato chips) and 53.4% (n=5279) for meats (e.g., hot dogs).

Conclusions: Infants and children are receiving age-inappropriate foods and beverages before the age of 2. Dietary intake aligned with the DGA should be emphasized as a strategy to reduce obesity disparities in a rural population.

Funding Sources: Geisinger