(OR23-04-23) Application of the HEI-Toddlers-2020: Assessing Diet Quality in Toddlers Among WIC Recipients and by Duration of WIC Participation

Objectives: To describe the diet quality of low-income toddlers between ages 13 and 24 months using the new Healthy Eating Index (HEI)-Toddlers-2020, and to compare scores by duration of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation.

Methods: Utilizing 24-hour diet recall data from the WIC Infants and Toddlers Feeding Practices Study-2 (ITFPS-2), which enrolled 4367 infants from 80 WIC sites, mean HEI-Toddlers-2020 total and component scores were calculated at ages 13 months (n=2660), 15 months (n=1968), 18 months (n=1901), and 24 months (n=2356) for the entire sample, as well as grouped by WIC participation duration (≤12 months versus >12 months as of the 13-month interview). Participants were excluded at each timepoint if recalls did not meet data quality standards or if they reported long-term medical conditions that affect eating. Cross-sectional survey weights were used to account for sampling design and survey non-response.

Results: Average total HEI-Toddlers-2020 scores were 58.1 (SE 0.37), 57.5 (SE 0.32), 57.0 (SE 0.39), and 56.8 (SE 0.36) at ages 13 months, 15 months, 18 months, and 24 months, respectively. At all timepoints, mean component scores for Total Fruits, Whole Fruits, Total Vegetables, Dairy, Total Protein Foods, Refined Grains, Added Sugars, and Saturated Fats achieved greater than half of the possible points available for that component. At all timepoints, mean component scores on the Greens & Beans and Seafood and Plant Proteins were low ( < 2 out of a maximum 5). Total HEI-Toddler scores did not vary by duration of WIC participation at 13, 15, or 18 months; however, at 24 months, total score was significantly higher when comparing longer versus shorter duration (57.0 (SE 0.37) vs. 54.5 (SE 0.99)). Components scores did not show consistent patterns when comparing by WIC participation duration at the given timepoints examined.

Conclusions: Diet quality among toddlers in ITFPS-2, as assessed by the new HEI-Toddlers-2020, does not align closely with recommendations in the 2020-2025 Dietary Guidelines for Americans. Differences in total and component scores by duration of WIC participation varied by timepoint. Additional research is needed to understand the impact of WIC participation at different ages.

Funding Sources: None