Abstract
Background: The Alternative Healthy Eating Index 2010 (AHEI-2010) score has been associated with less increase in body mass index (BMI) in adults, however, data is sparse on the association between AHEI-2010 and weight change in children and adolescents. Objective: To examine the association between the AHEI-2010 and BMI z-score change among children and adolescents. We explored the association between AHEI-2010 with prospective change in BMI z-score over four years (2004-2008) as well as four year changes in AHEI-2010 and concurrent changes in BMI z-score. Methods: Data from 5321 children and adolescents in the Growing Up Today Study 2, aged 9-15 years at baseline were collected by questionnaire in 2004, 2006, and 2008. A modified version of the AHEI-2010 score was computed using data from a food frequency questionnaire. We used generalized estimating equations with repeated measures within subjects to assess the association between AHEI-2010 and BMI z-score change, adjusting for potential confounders. Results: Baseline AHEI-2010 score was not association with changes in BMI z-score over 4 years. However, a 3 points decrease or more in AHEI-2010 score was associated with higher gains in BMI z-score (0.80 units; 95% CI= 0.02, 0.14) in children and adolescents in the same 4 year period. Conclusion: Decreasing AHEI-2010 score over four years was associated with concurrent higher gains in BMI z-score among children and adolescents.