Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Dietary Assessment
2.3. Assessment of Covariates
2.4. Outcome Assessment
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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CQI | |||||
---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | p for Trend | |
n | 252 | 178 | 219 | 174 | |
Range of CQI | 4 to 9 | 10 to 11 | 12 to 14 | 15 to 20 | |
Mother’s Characteristics | |||||
Maternal age (years) | 39.58 (4.81) | 39.93 (4.10) | 40.32 (4.19) | 39.86 (4.13) | 0.32 |
Maternal age (years), % | 0.65 | ||||
<35 | 33 (13.10) | 16 (8.99) | 23 (10.50) | 24 (13.79) | |
35–40 | 107 (42.46) | 74 (41.57) | 80 (36.53) | 64 (36.78) | |
40–45 | 81 (32.14) | 67 (37.64) | 92 (42.01) | 69 (39.66) | |
>45 | 31 (12.30) | 21 (11.80) | 24 (10.96) | 17 (9.77) | |
Maternal high education, % | 199 (78.97) | 144 (80.90) | 181 (82.65) | 145 (83.33) | 0.20 |
Number of Children, % | <0.001 | ||||
1 | 32 (12.70) | 17 (9.55) | 25 (11.42) | 33 (18.97) | |
2 | 123 (48.81) | 85 (47.75) | 125 (57.08) | 101 (58.05) | |
3–4 | 79 (31.35) | 63 (35.39) | 62 (28.31) | 36 (20.69) | |
5 or more | 18 (7.14) | 13 (7.30) | 7 (3.20) | 4 (2.30) | |
Family history of obesity, % | 51 (20.40) | 37 (21.02) | 45 (20.64) | 24 (14.04) | 0.16 |
Parental Attitudes Towards Child’s Dietary Habits, % | <0.001 | ||||
Low score (<40%) | 29 (11.51) | 7 (3.93) | 3 (1.37) | 4 (2.30) | |
Medium score (40–70%) | 116 (46.03) | 60 (33.71) | 62 (28.31) | 30 (17.24) | |
High score (>70%) | 107 (42.46) | 111 (62.36) | 154 (70.32) | 140 (80.46) | |
Parental Knowledge About the Child’s Nutritional Recommendations, % | <0.001 | ||||
Low score (<40%) | 71 (28.17) | 50 (28.09) | 41 (18.72) | 24 (13.79) | |
Medium score (40–70%) | 157 (62.30) | 110 (61.80) | 144 (65.75) | 115 (66.09) | |
High score (>70%) | 24 (9.52) | 18 (10.11) | 34 (15.53) | 35 (20.11) | |
Children’s Characteristics | |||||
Sex (female), % | 124 (49.21) | 93 (52.25) | 103 (47.03) | 84 (48.28) | 0.64 |
Age (years) | 5.08 (0.86) | 5.13 (0.90) | 4.93 (0.82) | 4.83 (0.76) | <0.001 |
Race (white), % | 242 (96.03) | 171 (96.07) | 216 (99.08) | 165 (94.83) | 0.99 |
Gestational Age (Weeks), % | 0.04 | ||||
<38 | 36 (14.34) | 25 (14.12) | 35 (16.06) | 17 (9.88) | |
38 to 40 | 109 (43.43) | 77 (43.50) | 81 (37.16) | 64 (37.21) | |
>40 | 106 (42.23) | 75 (42.37) | 102 (46.79) | 91 (52.91) | |
Birthweight (g) | 3216 (568.72) | 3211 (570.72) | 3273 (477.50) | 3250 (475.23) | 0.24 |
Birthweight (g), % | 0.23 | ||||
<2500 | 27 (10.76) | 20 (11.30) | 17 (7.80) | 12 (6.98) | |
2500–3000 | 59 (23.51) | 35 (19.77) | 43 (19.72) | 39 (22.67) | |
3000–3500 | 92 (36.65) | 69 (38.98) | 94 (43.12) | 70 (40.70) | |
3500–4000 | 60 (23.90) | 48 (27.12) | 48 (22.02) | 43 (25.00) | |
>4000 | 13 (5.18) | 5 (2.82) | 16 (7.34) | 8 (4.65) | |
Breastfeeding Duration (Months), % | <0.001 | ||||
No breastfeeding | 49 (19.44) | 37 (20.79) | 34 (15.53) | 17 (9.77) | |
<6 | 90 (35.71) | 50 (28.09) | 57 (26.03) | 40 (22.99) | |
6 to 12 | 64 (25.40) | 48 (26.97) | 58 (26.48) | 42 (24.14) | |
>12 | 49 (19.44) | 43 (24.16) | 70 (31.96) | 75 (43.10) | |
Child’s Position Among Siblings, % | 0.09 | ||||
The oldest/singletons | 70 (27.78) | 69 (38.76) | 87 (39.73) | 72 (41.38) | |
2nd/3, 2nd or 3rd/4 | 48 (19.05) | 36 (20.22) | 31 (14.16) | 11 (6.32) | |
The youngest or beyond the fourth | 134 (53.17) | 73 (41.01) | 101 (46.12) | 91 (52.30) | |
Z-score of the BMI | 0.18 (1.12) | (−) 0.08 (1.14) | 0.12 (1.20) | (−) 0.05 (1.10) | 0.16 |
Nutritional Status, % | 0.08 | ||||
Low weight | 32 (12.70) | 32 (17.98) | 34 (15.53) | 27 (15.52) | |
Normal weight | 184 (73.02) | 123 (69.10) | 154 (70.32) | 136 (78.16) | |
Overweight/obese | 36 (14.29) | 23 (12.92) | 31 (14.16) | 11 (6.32) | |
Moderate–vigorous physical activity (h/day) | 1.00 (0.70) | 1.02 (0.72) | 1.21 (0.84) | 1.26 (0.80) | <0.001 |
Screen time (h/day) | 1.19 (0.90) | 1.07 (0.89) | 1.14 (1.21) | 0.97 (0.70) | 0.05 |
CQI | |||||
---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | p for Trend | |
n | 252 | 178 | 219 | 174 | |
TEI (Kcal/d) | 1923 (445.5) | 2143 (469.9) | 2072 (501.0) | 2042 (436.2) | 0.01 |
Carbohydrate intake (% of TEI) | 42.84 (4.94) | 42.47 (5.11) | 43.76 (5.31) | 44.60 (5.38) | <0.001 |
Protein intake (% of TEI) | 17.09 (1.96) | 17.09 (2.40) | 17.20 (2.18) | 16.84 (2.13) | 0.40 |
Fat intake (% of TEI) | 40.06 (5.00) | 40.44 (5.21) | 39.04 (5.40) | 38.56 (5.33) | <0.001 |
SFA intake (% of TEI) | 11.73 (2.13) | 11.67 (2.07) | 10.87 (2.04) | 10.28 (2.02) | <0.001 |
PUFA intake (% of TEI) | 4.72 (1.34) | 4.70 (0.94) | 4.68 (1.03) | 4.64 (1.03) | 0.40 |
MUFA intake (% of TEI) | 15.25 (3.32) | 15.53 (3.60) | 15.08 (3.56) | 15.46 (3.50) | 0.90 |
Fibre intake (g/d) | 15.91 (4.19) | 20.21 (3.87) | 22.51 (5.42) | 27.17 (6.10) | <0.001 |
KIDMED score (p50 (IQR)) | 5 (4–6) | 6 (5–7) | 7 (6–8) | 7 (6–8) | < 0.001 |
Food Groups | |||||
Vegetables (g/d) | 132.1 (79.1) | 192.7 (95.3) | 209.7 (103.8) | 254.2 (116.3) | <0.001 |
Fruits (g/d) | 266.3 (157.6) | 333.1 (155.0) | 415.9 (216.3) | 516.2 (247.2) | <0.001 |
Legumes (g/d) | 24.42 (12.55) | 31.51 (13.99) | 22.59 (16.61) | 42.04 (24.93) | <0.001 |
Dairy (g/d) | 528.5 (235.3) | 518.3 (260.6) | 471.4 (225.2) | 397.3 (225.0) | <0.001 |
Cereals (g/d) | 77.28 (37.02) | 76.73 (40.67) | 78.41 (41.59) | 74.32 (34.31) | 0.59 |
Potatoes (g/d) | 14.69 (15.13) | 18.82 (16.93) | 20.38 (24.17) | 21.90 (17.78) | <0.001 |
Meat (g/d) | 133.43 (42.44) | 146.15 (44.36) | 133.2 (47.17) | 119.2 (46.20) | <0.001 |
Fish (g/d) | 30.77 (15.06) | 36.18 (17.77) | 36.75 (16.83) | 38.45 (16.38) | <0.001 |
Nuts (g/d) | 3.08 (4.40) | 4.46 (6.00) | 5.80 (6.53) | 8.98 (11.88) | <0.001 |
Bakery and sweets (g/d) | 77.32 (44.67) | 95.75 (71.37) | 79.44 (49.02) | 79.44 (49.02) | 0.16 |
Sugar-sweetened beverages (g/d) | 57.67 (95.31) | 52.24 (66.83) | 37.23 (70.77) | 23.93 (39.29) | <0.001 |
Fast Food (g/d) | 58.72 (25.69) | 64.72 (28.46) | 59.84 (31.67) | 52.33 (25.32) | 0.01 |
Eggs (g/d) | 18.24 (11.17) | 19.83 (7.18) | 20.96 (10.90) | 20.26 (7.86) | 0.01 |
Olive oil (g/d) | 9.96 (11.99) | 13.08 (15.92) | 9.95 (12.40) | 8.21 (11.95) | 0.05 |
Other fats (g/d) | 3.22 (4.55) | 2.52 (3.67) | 2.48 (3.13) | 2.22 (3.43) | 0.009 |
CQI | |||||
---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | p for Trend | |
n | 252 | 178 | 219 | 174 | |
Micronutrients | |||||
Vitamin A (equiv Retinol) (µg/d) | 922 (26.7) | 1008 (31.7) | 1143 (28.4) | 1255 (31.8) | 0.001 |
Vitamin C (mg/d) | 106 (3.37) | 124 (4.00) | 155 (3.59) | 184 (4.03) | 0.001 |
Vitamin D (µg/d) | 2.98 (0.11) | 2.93 (0.13) | 3.27 (0.12) | 3.41 (0.13) | 0.002 |
Vitamin E (mg/d) | 8.02 (0.17) | 7.83 (0.20) | 8.36 (0.18) | 9.36 (0.20) | 0.001 |
Vitamin B1 (mg/d) | 1.40 (0.01) | 1.40 (0.02) | 1.47 (0.02) | 1.50 (0.02) | 0.001 |
Vitamin B2 (mg/d) | 2.03 (0.03) | 2.05 (0.04) | 2.08 (0.03) | 2.02 (0.04) | 0.93 |
Vitamin B3 (mg/d) | 33.6 (0.47) | 35.6 (0.55) | 36.6 (0.50) | 38.1 (0.55) | 0.001 |
Vitamin B6 (mg/d) | 2.08 (0.26) | 2.21 (0.03) | 2.37 (0.03) | 2.58 (0.03) | 0.001 |
Folic acid (µg/d) | 262 (4.42) | 282 (5.25) | 318 (4.70) | 355 (5.27) | 0.001 |
Vitamin B12 (µg/d) | 4.63 (0.08) | 4.63 (0.10) | 4.84 (0.88) | 4.60 (0.10) | 0.68 |
Ca (mg/d) | 1205 (15.8) | 1155 (18.7) | 1165 (16.8) | 1137 (18.8) | 0.01 |
I (µg/d) | 111 (1.45) | 109 (1.71) | 110 (1.54) | 107 (1.72) | 0.18 |
Fe (mg/d) | 12.9 (0.12) | 13.6 (0.14) | 14.4 (0.13) | 15.3 (0.14) | 0.001 |
P (mg/d) | 1667 (40.6) | 1655 (48.2) | 1788 (43.2) | 1841 (48.5) | 0.001 |
Mg (mg/d) | 269 (2.37) | 289 (2.81) | 310 (2.52) | 341 (2.82) | <0.001 |
Se (µg/d) | 71.0 (0.83) | 70.4 (0.99) | 73.6 (0.89) | 72.8 (0.99) | 0.03 |
Zn (mg/d) | 9.02 (0.12) | 9.62 (0.15) | 9.95 (0.13) | 10.07 (0.15) | <0.001 |
Cr (µg/d) | 62.3 (1.25) | 66.1 (1.49) | 67.0 (1.33) | 74.7 (1.50) | <0.001 |
K (mg/d) | 3073 (34.4) | 3278 (40.8) | 3542 (36.6) | 3848 (41.0) | <0.001 |
Na (mg/d) | 3060 (53.2) | 2994 (56.7) | 2886 (63.5) | 2886 (63.5) | 0.01 |
CQI | p for Trend | ||||
---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | ||
n | 252 | 178 | 219 | 174 | |
Crude | 1.00 (ref) | 0.29 (0.16–0.51) | 0.29 (0.17–0.51) | 0.27 (0.15–0.48) | <0.001 |
Multivariate adjusted model 1 | 1.00 (ref) | 0.34 (0.17–0.67) | 0.30 (0.16–0.54) | 0.24 (0.12–0.48) | <0.001 |
Multivariate adjusted model 2 | 1.00 (ref) | 0.33 (0.16–0.67) | 0.29 (0.15–0.54) | 0.22 (0.11–0.47) | <0.001 |
Multivariate adjusted model 3 | 1.00 (ref) | 0.33 (0.16–0.66) | 0.28 (0.15–0.54) | 0.22 (0.10–0.48) | <0.001 |
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Fabios, E.; Martínez-González, M.Á.; García-Blanco, L.; de la O, V.; Santiago, S.; Zazpe, I.; Martín-Calvo, N. Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project. Children 2023, 10, 1711. https://doi.org/10.3390/children10101711
Fabios E, Martínez-González MÁ, García-Blanco L, de la O V, Santiago S, Zazpe I, Martín-Calvo N. Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project. Children. 2023; 10(10):1711. https://doi.org/10.3390/children10101711
Chicago/Turabian StyleFabios, Elise, Miguel Ángel Martínez-González, Lorena García-Blanco, Víctor de la O, Susana Santiago, Itziar Zazpe, and Nerea Martín-Calvo. 2023. "Association between the Carbohydrate Quality Index (CQI) and Nutritional Adequacy in a Pediatric Cohort: The SENDO Project" Children 10, no. 10: 1711. https://doi.org/10.3390/children10101711