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Influence of Parental Healthy-Eating Attitudes and Nutritional Knowledge on Nutritional Adequacy and Diet Quality among Preschoolers: The SENDO Project

Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31008 Pamplona, Spain
Department of Nutrition, Food science and Physiology, School of Pharmacy, University of Navarra, 31008 Pamplona, Spain
Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, 28029 Madrid, Spain
IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Navarra, Spain
San Jorge Primary Care Health Center, Servicio Navarro de Salud-Osasunbidea, 31008 Pamplona, Spain
Author to whom correspondence should be addressed.
Nutrients 2018, 10(12), 1875;
Received: 11 September 2018 / Revised: 31 October 2018 / Accepted: 27 November 2018 / Published: 3 December 2018
(This article belongs to the Special Issue Diet Diversity and Diet Quality)
PDF [595 KB, uploaded 3 December 2018]


Parental nutrition knowledge and attitudes play a fundamental role in their children’s food knowledge. However, little is known about their influence on their children’s diet quality and micronutrient intake. Thus, we aimed to assess the association of parental nutrition knowledge and healthy-eating attitudes with their children’s adherence to the Mediterranean dietary pattern and micronutrient adequacy. Parental healthy-eating attitudes and knowledge of the quality of their child’s diet as well as anthropometric, lifestyle, and nutrient intake characteristics were recorded with a basal questionnaire that included a 140-item-food frequency-questionnaire. A total of 287 pre-school children were included in the analyses. Intake adequacy was defined using the Estimated Average Requirements (EAR) cut-off point method. We developed a parental nutrition knowledge and healthy-eating attitudes scores and evaluated whether they were independently associated with 1) children’s inadequate intake (probability of failing to meet ≥3 EAR) of micronutrients, using logistic regression analyses, and 2) children’s diet quality (adherence to the Mediterranean Diet according to a Mediterranean Diet Quality Index for children and adolescents, the KIDMED index), using multiple linear regression models. A higher score in the parental healthy-eating attitudes score was associated with lower risk of failing to meet ≥3 EAR compared with the reference category (odds ratio (OR): 0.3; 95% confidence interval (CI) 0.12–0.95; p for trend: 0.037) and a higher adherence to the Mediterranean diet in the most adjusted model (β coefficient: 0.34; 95% CI 0.01–0.67; p for trend: 0.045). Our results suggest a positive association of parental healthy-eating attitudes with nutritional adequacy and diet quality in a sample of Spanish preschoolers. Public health strategies should focus on encouraging parental healthy-eating attitudes rather than simply educating parents on what to feed their children, recognizing the important influence of parental behavior on children’s practices. View Full-Text
Keywords: diet quality; preschool children; nutritional adequacy diet quality; preschool children; nutritional adequacy

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Romanos-Nanclares, A.; Zazpe, I.; Santiago, S.; Marín, L.; Rico-Campà, A.; Martín-Calvo, N. Influence of Parental Healthy-Eating Attitudes and Nutritional Knowledge on Nutritional Adequacy and Diet Quality among Preschoolers: The SENDO Project. Nutrients 2018, 10, 1875.

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