Child Nutrition


Healthy eating habits begin in childhood and can affect a person’s health throughout their lifetime. Poor dietary habits adopted during childhood may have lifelong consequences, as children and adolescents who are overweight and obese are at substantially increased risk of being overweight and obese as adults. Additionally, poor diet quality is associated with an increased risk of osteoporosis, hypertension, type 2 diabetes, cardiovascular disease, and dental caries.1

The Healthy Eating Index-2010 (HEI-2010) is designed to measure dietary quality2 and can be used to assess how well a population eats on average, compared to the recommendations outlined in the 2010 Dietary Guidelines for Americans. Nine of the 12 HEI-2010 components address adequate consumption of healthy foods. The remaining three components assess intake of foods that should be consumed in moderation: refined grains, sodium, and empty calories. In the table below, the HEI-2010 total and component scores are averages across all children, based on a 24-hour dietary recall.

In 2009–2010, the overall composite score for the HEI-2010 among children aged 2–11 years was 53 out of 100 points, where 100 points indicates a diet that aligns with the 2010 Dietary Guidelines for Americans. With regard to the nine components of dietary adequacy, children received 100 percent of the possible points for whole fruit intake and 96 percent for dairy. Children were least likely to consume adequate amounts of greens and beans and whole grains with 18 and 22 percent, respectively, of possible points obtained (Table 1). However, consumption of greens and beans was higher among female than male children (on average 20 versus 16 percent of points, respectively).

diet quality by race-ethnicity

Table 1 Source

With regard to race and ethnicity, scores for individual HEI-2010 components varied, although the total HEI scores varied little between groups. Non-Hispanic White children were less likely than all other racial and ethnic groups to consume adequate amounts of greens and beans, meeting only 13 percent of possible points on average compared to about 25 percent for all other children (table 1). Conversely, non-Hispanic White and non-Hispanic children of other races were closer to consuming adequate amounts of seafood and plant proteins (48 and 62 percent of possible points, respectively) than non-Hispanic Black and Hispanic children (37 and 41 percent, respectively).

Similar differences in the consumption of seafood and plant proteins exist with regard to household income. Children in households with incomes of 200 percent or more of poverty consumed 55 percent of possible points, compared to 39 percent among children in households with incomes of less than 100 percent of poverty.

The overconsumption of refined grains, sodium, and empty calories was present across all racial and ethnic groups. Overall, the diet quality of children would be improved by increasing the consumption of whole grains, vegetables, seafood, and plant proteins; decreasing the consumption of sodium and empty calories; and increasing the relative proportions of mono- and poly-unsaturated to saturated fatty acids.

Data Sources

Table 1. Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey, 2009–2010. Data analyzed by the Maternal and Child Health Epidemiology and Statistics Program.


1 U.S. Department of Agriculture; U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 7th edition (PDF). Washington, DC: Government Printing Office; 2010. Accessed September 30, 2014.

2 Guenther PM, Casavale KO, Reedy J, et al. Update of the Healthy Eating Index: HEI-2010. Journal of the Academy of Nutrition and Dietetics. April 2013;113(4):569–580.


Statistical Significance Test

Calculate the difference between two estimates:

Calculated Z-Test Result 0.9567433 Not statistically significant

We follow statistical conventions in defining a significant difference by a p-value less than 0.05 where there is a less than 5% probability of observing a difference of that magnitude or greater by chance alone if there were really no difference between estimates. The 95% confidence interval includes a plausible range of values for the observed difference; 95% of random samples would include the true difference with fewer than 5% of random samples failing to capture the true difference.

This website allows comparisons between two estimates using the independent z-test for differences in rates or proportions. This test is appropriate for comparing independent populations across years (e.g., 2011 versus 2012) or subgroups (e.g., Male versus Female) on corresponding measures. To the extent possible, the functionality of this application has limited estimate comparisons based on appropriate use of the independent z-test. However, some tables present subgroup categories within broader categories that will allow comparisons between non-independent populations (e.g., low birth weight and very low birth weight). Users should exercise caution when interpreting these test results, which will frequently overstate statistical significance.

For some tables, the website does not allow for comparisons between two estimates, even though the data represent independent populations. Generally, this is because the standard errors were not publicly available at the time this website was created.