The Development of a Diet Quality Score for

Background: Although many studies have examined health effects of infant feeding, studies on diet quality shortly after the weaning and lactation period are scarce. Objectives: Our aims were to develop and evaluate a diet score that measures overall diet quality in preschool children and to examine the sociodemographic and lifestyle determinants of this score. Methods: On the basis of national and international dietary guidelines for young children, we developed a diet score containing 10 components: intake of vegetables; fruit; bread and cereals; rice, pasta, potatoes, and legumes; dairy; meat and eggs; fish; oils and fats; candy and snacks; and sugar-sweetened beverages. The total score ranged from 0 to 10 on a continuous scale and was standardized to an energy intake of 1200 kcal/d with the residual method. The score was evaluated in 3629 children participating in the Generation R Study, a population-based prospective cohort study. Food consumption was assessed with a food-frequency questionnaire (FFQ) at a median age of 13 mo. Results: Mean (6SD) diet score was 4.1 6 1.3. The food-based diet score was positively associated with intakes of many nutrients, including n–3 (v-3) fatty acids [FAs; 0.25 SD increase (95 % CI: 0.22, 0.27) per 1 point increase in the diet score], dietary fiber [0.32 (95%CI: 0.30, 0.34)], and calcium [0.13 (95%CI: 0.11, 0.16)], and was inversely associated with intakes of sugars [20.28 (95%CI:20.31,20.26)] and saturated fat [20.03 (95%CI:20.05,20.01)]. A higher diet scorewas associate