EAT5 Non-core - An investigation of the 'non-core' food intake of five-year old children in New Zealand

Background: The term 'non-core' describes those foods and beverages that fall outside the four main food groups: (i) breads and cereals, (ii) meat, fish, poultry and alternatives, (iii) milk and alternatives, (iv) fruit and vegetables; that are energy dense; and that contribute large amounts of saturated fat, salt and/or sugar while providing few other essential nutrients to the diet. There is evidence to suggest that excessive consumption of 'non-core' foods and beverages is associated with greater body mass index, and the displacement of more nutrient-dense foods, however there has been no published research in New Zealand children. Objective: To investigate the 'non-core' food intake of 5-year old New Zealand children, and whether the amount of 'non-core' food consumed was associated with dietary, anthropometric, and demographic factors. Methods: EAT5 Non-core was a cross-sectional study that recruited the primary caregivers of healthy 5-year old children in Dunedin, and combined the data with previously conducted EAT5 studies based in Wellington, Auckland and Dunedin. Brief demographic data were collected from both the primary caregiver and child at baseline, and the height and weight of the child were also measured. Primary caregivers completed a weighed diet record on their child's food and beverage intake over three non-consecutive days, including one weekend day, conducted over approximately four weeks. A food frequency questionnaire was completed twice, once at baseline and again approximately four weeks later. Foods were classified as either 'everyday', 'sometimes' or 'occasional' based on the Food and Beverage Classification System. The dietary assessment software, Kai-culator, was used to enter and analyse the data from the weighed diet records. Results: Seventeen children were recruited as part of the EAT5 Non-core phase of the EAT5 study, achieving a final combined sample size of 99. The results are presented for the total sample of 99 children. The mean contribution of 'occasional' foods to total energy intake was 39%. 'Occasional' foods also contributed 29% of protein, 36% of carbohydrate, 49% of fat, 47% of sodium and 22-39% of calcium, iron, zinc and vitamin C. A significant inverse trend was observed between proportion of energy from 'occasional' foods and absolute intakes of protein (p = 0.002) and zinc (p = 0.009). 'Everyday' foods contributed 31% of total energy intake and the greatest proportion of carbohydrate (37%), sugars (41%), iron (38%), zinc (35%), and vitamin C (68%). 'Sometimes' foods contributed 30% of total energy intake and the greatest proportion of protein (37%) and calcium (42%). No statistically significant differences were observed between weight status and percentage of energy from 'occasional' foods (p = 0.068). However, the intake of 'everyday' foods was significantly lower for those children living in the most socio-economically deprived areas than for children living in the least deprived areas (p = 0.024). Conclusion: 'Occasional' foods were consumed well above the recommended amounts by five-year old children in New Zealand, regardless of weight status. The high percentage of energy, sodium and saturated fat contributed by 'occasional' foods and their negative association with protein and zinc intakes suggests the need for improved recommendations regarding 'occasional' food intake for parents of five-year old children