(P26-52-26) Diet Quality of Children in Multigenerational Households in the Pacific Region

Objectives: The influence of household structure on children's diet quality remains understudied in the Pacific region, where multigenerational living is common. This study evaluates associations between household composition (multigenerational vs. non-multigenerational) and diet quality among children aged 2–8 years.

Methods: Diet quality was measured using the Healthy Eating Index-2020 (HEI-2020; higher scores indicate better diet quality) in a cross-sectional cluster sample using 2 days of dietary records from 3,529 children in the Children's Healthy Living Program across 11 US-affiliated Pacific jurisdictions (2013–2014). Multigenerational households were defined as three or more generations living together. Mean HEI-2020 scores were compared by household structure using ANOVA models adjusted for child age, sex, energy intake, and survey design.

Results: Of 3,529 children, 1,248 (35.4%) lived in multigenerational households and 2,281 (64.6%) in non-multigenerational households. Children in multigenerational households had significantly lower mean HEI-2020 scores (47.2 ± 0.4 vs. 49.7 ± 0.6, p < 0.001), with lower scores in Total Vegetables (1.5 vs. 1.8), Greens & Beans (0.3 vs. 0.5), Total Fruits (2.2 vs. 2.7), Whole Fruits (2.5 vs. 2.9), Whole Grains (1.0 vs. 1.6), and Dairy (4.0 vs. 5.0), and higher scores in Total Protein (4.5 vs. 4.3) and Seafood & Plant Proteins (2.7 vs. 2.4) (all p ≤ 0.002). For moderation components, multigenerational households scored lower in Refined Grains (3.0 vs. 3.8, p < 0.001) and higher in Added Sugars (8.1 vs. 8.0, p = 0.005) and Saturated Fat (6.5 vs. 6.2, p = 0.04). No differences were found in Fatty Acid or Sodium scores.

Conclusions: Children in multigenerational Pacific households had higher protein and refined grain intake and lower intake of vegetables, fruits, whole grains, and dairy. These findings highlight the need for nutrition interventions that account for household composition in the Pacific region.

Funding Sources: USDA NIFA, NIH