Diet quality through adolescence and early adulthood: cross-sectional associations of the Dietary Approaches to Stop Hypertension (DASH) diet index and component food groups with age

Late adolescence to early adulthood is the period of life when prevalence of overweight and obesity rises the fastest, and an important time to understand changes in dietary risk factors. In this study we assess variation in diet quality through analysis of cross-sectional data from 2957 individuals aged 13 to 30 from the National Diet and Nutrition Study (2008-2016). Diet data were self-reported using 4-day food diaries and coded to give diet quality (DASH index, range 0-80) and DASH component food groups (grams/day). Mean DASH index score was low at 34.8 (95% CI 34.3, 35.4). Regression of diet quality score and food groups on age categories revealed no significant change in diet quality score with age category in males, but an improved diet quality score among females aged 19-21 (β=2.04, CI 0.05, 4.03), 25-27 (β=3.77, CI 1.36, 6.19) and 28-30 (β=2.48, CI 0.59, 4.36), compared to age 13-15. Both sexes showed increased vegetable intake with age. Dairy intake was lower in early adult ages among males, while in females there was an increase in the proportion of low-fat dairy consumed with age. Further research should address the determinants of changes in diet in early adulthood, to provide evidence for targeting of public health policy.