Added Sugar, Macro- and Micronutrient Intakes and Anthropometry of Children in a Developing World Context

Dietary Patterns, Socio-Demographic Predictors Thereof, and Associations of Dietary Patterns with Stunting and Overweight/Obesity in 1-<10-Year-Old Children in Two Economically Active Provinces in South Africa

A review of the literature showed that there were only a few studies that reported on the dietary patterns of children in South Africa. The aim of the present study was to characterise the dietary patterns of children aged 1-<10 years who were studied during the Provincial Dietary Intake Survey (PDIS) in 2018 and to investigate the socio-demographic predictors thereof, as well as the associations with stunting and overweight/obesity. Dietary pattern analysis was conducted within three age groups, namely 1-<3-year-olds, 3-<6-year-olds, and 6-<10-year-olds using iterated principal factor analysis with varimax rotation and 24 h recall data from the PDIS. The dietary patterns that emerged seem to be far from ideal. Energy-dense, nutrient-poor patterns were included in the top three strongest patterns in all three age groupings that were investigated. Few of the dietary patterns included vegetables other than starchy vegetables, fruit, dairy, quality proteins, and unrefined carbohydrates. There were no associations between any of the dietary patterns and stunting or overweight/obesity in the children. Key predictors of greater adherence to the mostly unhealthy patterns included indicators of a higher socio-economic status in all three age groups, as well as having an obese mother in the 6-<10-year-old group. Key predictors of greater adherence to the mostly healthy patterns were a higher wealth index and having an obese mother in the two younger groups, with no predictors in the 6-<10-year-old group. We conclude that the dietary patterns of children in the Western Cape contain strong elements of the energy-dense, nutrient-poor dietary patterns. Interventions to improve the dietary intake of children should be directed at both poorer and higher income communities.

High unhealthy food and beverage consumption is associated with poor diet quality among 12-35-month-olds in Guédiawaye Department, Senegal

Background

High consumption of unhealthy foods and beverages (UFB) during early childhood is cause for concern, with growing evidence from low- and middle-income countries finding associations with poor diet quality and malnutrition. Research from sub-Saharan Africa remains limited, with no studies quantifying the contribution of UFB to total energy intakes among young children or exploring the relationship between such intakes and diet quality or anthropometric outcomes.

Objectives

Assess UFB consumption patterns and their contribution to total energy intake from non-breastmilk foods/beverages (TEI-NBF), assess the association between high UFB consumption and dietary/nutrition outcomes, and explore drivers of unhealthy food choice among young children in Guédiawaye Department, Senegal.

Methods

We conducted a cross-sectional study of a representative sample of 724 primary caregivers and their 12-35.9-month-old children. The study included a questionnaire, a quantitative four-pass 24-h dietary recall, and anthropometric measurements. The contribution of UFB to TEI-NBF was calculated and terciles generated. Logistic and linear models were used to compare outcomes of high versus low UFB consumption terciles.

Results

UFB contributed on average 22.2% of TEI-NBF, averaging 5.9% for the lowest tercile and 39.9% for the highest. Diets of high UFB consumers, as compared to low, were significantly less dense in protein, fiber, and seven of the 11 micronutrients assessed and significantly denser in total fat, saturated fat, and total sugar. No associations were found with anthropometric outcomes. High UFB consumers were older and more likely to be living in food insecurity. The most common drivers of commercial UFB consumption were related to child preference, the use of these products as behavior management tools, treats, or gifts, and the sharing of these products by someone else eating them.

Conclusion

High UFB consumption is associated with poor diet quality among 12-35-month-olds in Guédiawaye Department, Senegal. Addressing high UFB consumption during this critical developmental period should be prioritized in young child nutrition research, programming, and policy development.

Caries Incidence Is Associated with Wasting among Cambodian Children

Evidence suggests that dental caries is associated with chronic and acute malnutrition, manifested as stunting and wasting in children. However, studies have not always appropriately accounted for confounding factors or for the temporal ordering between exposure and outcome. This study examined relationships between the development of caries lesions with subsequent stunting and wasting outcomes using data from a population-based cohort in Cambodia. Caries incidence was assessed based on the presence of a new cavitated carious lesion or a new pulpally involved lesion across a 6-mo observation period. Anthropometric measurements were taken at regular intervals. Effects of carious lesions on stunting and wasting were assessed using inverse probability treatment weighting, adjusting for potential confounders, using z scores for height-for-age (HAZ) and weight-for-height (WHZ) as outcomes. In total, 894 children (mean age 20 mo at baseline) were followed over 2 y. At baseline, 350 (39.1%) were identified as having stunting malnutrition. At follow-up, 58 (6.5%) had a new pulpally involved lesion. There was no association between incidence of cavitated or pulpally involved carious lesions at follow-up and stunting (relative risk [RR] = 1.06; 95% confidence interval [CI]: 0.75, 1.50). The incidence of pulpally involved carious lesions had an effect on wasting prevalence (WHZ <-2; RR = 1.35; 95% CI: 0.70, 2.62) and WHZ scores (average treatment effect = -0.294; 95% CI: -0.538, -0.050). This study offers evidence that the development of pulpally involved carious lesions has an effect on WHZ scores. Oral health promotion and clinical prevention and management of dental caries should be explored as interventions to promote normal growth and development among preschool children, particularly in low-income settings.

Do sugar warning labels influence parents' selection of a labeled snack for their children? A randomized trial in a virtual convenience store

Despite growing evidence that warning labels reduce purchases of sugary drinks, less is known about warnings' impact on purchases of sugary snacks. This paper aimed to experimentally test whether a front-of-package label warning about high sugar content ("sugar warning label") would reduce parents' likelihood of selecting a labeled snack versus a non-labeled snack for their child in a food store setting. Participants (n = 2,219 parents of at least one child aged 1-5y) were recruited via an online panel and asked to complete a shopping task in a virtual convenience store. Participants were randomized to one of three labeling conditions: barcode control, text-only sugar warning label, or pictorial sugar warning label. Participants viewed two granola snacks, one labeled and one unlabeled, and selected one for purchase. A post-shopping survey measured secondary outcomes. Predictions and analyses were preregistered on www.clinicaltrials.gov (NCT04381481). Participants exposed to the text or pictorial sugar warning labels were less likely to select the labeled snack than those in the barcode control group (21%, 18%, and 34% respectively; p < 0.001 for both comparisons of warning to control). Relative to the barcode control label, the text and pictorial sugar warning labels resulted in greater attention, anticipated social interactions, negative affect, cognitive elaboration, and perceived message effectiveness, as well as lower perceptions of healthfulness, appeal, and intentions to purchase or consume the product (p < 0.001 for all comparisons of warnings to control). There were no differences in outcomes between text and pictorial sugar warning labels. In conclusion, text and pictorial sugar warning labels reduced parents' likelihood of selecting a labeled granola snack for their children. These results contribute to a growing body of evidence showing that warning labels influence food purchasing behaviors.

Individual, household and national factors associated with iron, vitamin A and zinc deficiencies among children aged 6-59 months in Nepal

Iron, vitamin A and zinc deficiencies are the top three micronutrients contributing to disability-adjusted life years globally. The study assessed the factors associated with iron, vitamin A, and Zinc deficiencies among Nepalese children (n = 1709) aged 6-59 months using data from the 2016 Nepal National Micronutrient Status Survey. The following cut-off points were applied: iron deficiency [ferritin < 12 μg/L or soluble transferrin receptor (sTfR) > 8.3 mg/L], vitamin A deficiency (retinol-binding protein < 0.69 μmol/L) and zinc deficiency (serum zinc < 65 μg/dl for morning sample and <57 μg/dl for afternoon sample). We used multiple logistic regression adjusted for sampling weights and clustering to examine the predictors of micronutrient deficiencies. The prevalence of iron depletion (ferritin), tissue iron (sTfR), vitamin A and zinc deficiencies were 36.7%, 27.6%, 8.5% and 20.4%, respectively. Children were more likely to be iron deficient (ferritin) if aged 6-23 months, stunted, and in a middle-wealth quintile household. Vitamin A deficiency was associated with development region and was higher among children living in severe food-insecure households and those who did not consume fruits. Zinc deficiency was higher among children in rural areas and the poorest wealth quintile. The Government of Nepal should focus on addressing micronutrient deficiencies in the early years, with emphasis on improving food systems, promote healthy diets, among younger and stunted children and provide social cash transfer targeting high-risk development regions, poorest and food insecure households.

Association between dietary diversity score and anthropometric indices among children and adolescents: the weight disorders survey in the CASPIAN-IV study

BACKGROUND

The aim of this study was to determine the association between the dietary diversity score (DDS) and anthropometric indices in a nationally representative sample of Iranian children and adolescents.

METHODS

The nationwide cross-sectional study included 5178 students aged 6-18 years. A validated 168-item food frequency questionnaire (FFQ) was used. The DDS was assessed by dividing food items into five groups.

RESULTS

An increase of 1 in the total DDS score was associated with 0.08 increase in the body mass index z-score (BMIz), 0.06 increase in waist circumference z-score (WCz), and 0.07 increase in hip circumference z-score (HCz) (P < 0.05) in girls. An increase of 1 in the DDS score of the dairy group was associated with an 0.11 increases in BMIz (P < 0.05). An increase of 1 in the DDS score of the fruit-vegetable group was associated with 0.09 and 0.08 increase in BMIz and HCz among girls respectively (P < 0.05). The odds of excess weight (overweight or obesity) and abdominal obesity increased with each unit increase in total DDS in girls (odds ratio, OR _{excess weight}  = 1.11 (95% confidence interval, CI: 1.003-1.23), OR _{abdominal obesity}  = 1.11 (95% CI: 1.001-1.23)). The odds of excess weight increased with each unit increase in dairy DDS (OR _{excess weight}  = 1.20 (95% CI: 1.002-1.43) among boys.

CONCLUSION

Higher DDS was associated with higher anthropometric indices and greater risk of obesity among children and adolescents. Our findings emphasize the importance of increasing the diversity of healthy food items to reduce weight disorders in the pediatric age group. © 2021 Society of Chemical Industry.

Traditional food taboos and practices during pregnancy, postpartum recovery, and infant care of Zulu women in northern KwaZulu-Natal

BACKGROUND

Traditional practices and beliefs influence and support the behavior of women during pregnancy and childbirth in different parts of the world. Not much research has been conducted to examine whether and how cultural traditions continue to shape maternity experiences of Zulu women. The aim of this study is to establish the extent at which women in certain rural communities adhere to traditional food taboos and practices during pregnancy, postpartum recovery, and infants feeding, in comparison to what is recommended by health care workers.

METHODS

A survey was conducted in the rural northern KwaZulu-Natal between 2017 and 2020. A total of 140 women between the ages of 18 and 90 years were interviewed and they were chosen purposively based on their experiences in pregnancy, postpartum recovery, infant care, and their willingness to share the knowledge. Data were analyzed using descriptive statistics.

RESULTS

Most (64%) of the participants said that they adhered to these cultural food taboos and practices. The most common foods avoided were certain fruits [mango, naartjie, orange, papaya, and peach], butternut, eggs, sweets (sugar, commercial juice, sweet food, and honey), chili, ice, and alcohol. The most recommended foods during pregnancy were leafy vegetables, fruits (except the avoided ones), liver, and fish. For postpartum recovery, women mostly consumed soft porridge, all fruits and vegetables, beetroot, and tea. Food not allowed for children younger than 2 years included meat, sugar and sweets, and chewable foods.

CONCLUSION

Differences on food taboos and practices between participants who received formal education and those who did not received it were insignificant. The beliefs about the detrimental effects of some foods were not backed up by scientific research. Restriction of some orange/yellow colored fruits during pregnancy that are rich in vitamin A and/or C may affect daily requirements of these micronutrients, and the foods recommended during pregnancy and postpartum period would not provide all the essential nutrients required for successful pregnancy. However, some of the food taboos would protect women from unhealthy eating. Our findings provide a basis for developing culturally appropriate nutritional mediation programs for Zulu women with a view to provide effective nutritional counseling.

A cross-country exploratory study to investigate the labelling, energy, carbohydrate and sugar content of formula milk products marketed for infants

Aims The first aim was to describe the energy, carbohydrate and sugar contents of formula milk products in eleven countries. The second was to assess the labelling methods used. Based on the findings, approaches to facilitate the selection of infant-appropriate formula milk products were proposed.Background Consumption of excess sugar during infancy can increase the risk of non-communicable diseases (NCDs) including obesity, diabetes and dental caries. Reduction of sugar consumption has been high on the global public health agenda. Although most infants are fed formula milk products in addition to, or instead of, breastmilk (with only 38% exclusively breastfed), the sugar content of these products is often not included in sugar reduction strategies.Methods An exploratory study was conducted to describe the labelling and nutritional composition of a sample of infant formula products available in 11 countries. The sample, which was collected between May and August 2019, included commercially available formula products (n = 257) targeted at infants aged <3 years of age. The products were sold in supermarkets and by other major retailers across the sample countries. Primary data were obtained from labels on the packaging of the formula products.Results Findings suggest that the majority of products sampled were higher in total carbohydrate and carbohydrates of which sugar and lactose, than breastmilk, supporting previous research. The nutrition information presented on the products was often unclear and was inconsistent across the 11 counties sampled. None of the products had front-of-pack (FOP) nutritional information.Conclusion Findings suggest that globally, infant formula products are higher in carbohydrates, sugar and lactose than breastmilk. Labelling is unclear and inconsistent across brands and between countries. Based on the findings of this study, mandatory regulation of sugar content in formula products is needed with clear FOP nutrition information to help consumers choose the healthy option for their infants.

Snack food and beverage consumption and young child nutrition in low- and middle-income countries: A systematic review

Although snacks can provide important nutrients for young children during the complementary feeding period, the increasing availability of snack foods and sugar‐sweetened beverages (SSB), often energy‐dense and nutrient‐poor, in low‐ and middle‐income countries (LMIC) is a concern. Such foods may displace consumption of nutritious foods in contexts where diets are often nutritionally inadequate and the burden of childhood malnutrition is high. This systematic review summarizes literature on the contribution of snack food/SSB consumption to total energy intakes (TEI) of children below 23 months of age in LMIC and associations between this consumption and nutritional outcomes. It also identifies areas where further research is needed. A systematic search of Embase, Global Health, and MEDLINE for literature published in January 1990–July 2018 was conducted. This search yielded 8,299 studies, 13 of which met inclusion criteria: Nine studies assessed % TEI from snack foods/SSB, and four studies assessed associations between snack food/SSB consumption and nutritional outcomes. Average % TEI from snack foods/SSB ranged from 13% to 38%. Findings regarding associations with growth were inconclusive, and no studies assessed associations with nutrient intakes. Variation in measurement of consumption and definitions of snack foods and SSB limited study comparisons. Further research is needed to understand how consumption of energy‐dense, nutrient‐poor snack foods and SSB influences undernutrition and overnutrition among young children during the complementary feeding period in settings that are experiencing dietary transitions and the double burden of malnutrition.

Exploratory Analysis of Nutritional Quality and Metrics of Snack Consumption among Nepali Children during the Complementary Feeding Period

The World Health Organization recommends feeding snacks between meals to young children. This study explored nutritional quality of snacks consumed between meals and consumption metrics (% total energy intakes (%TEI) and amount of kcal from snacks) to understand correlations with dietary outcomes (total energy intakes and dietary adequacy) and body-mass-index-for-age z-scores (BMIZ). Data used were 24-h dietary recalls and anthropometric measurements among a representative sample (n = 679) of one-year-olds in Nepal. Nepali meal patterns for young children were identified through formative research and all foods/beverages consumed outside of meals were categorized as snacks. A nutrient profiling model was used to categorize snacks as healthy or unhealthy, based on positive and negative nutrient content. Snacks consumed between meals provided half of all energy consumed, and were associated with increased energy and nutrient intakes. The positive effect of snacks between meals on dietary adequacy was greater when these snacks were healthy, while increasing %TEI from unhealthy snacks consumed between meals was negatively associated with dietary adequacy. Consumption of snacks between meals was not associated with mean BMIZ among the children. These findings indicate that the provision of and nutritional quality of snacks are important considerations to communicate to caregivers. Discouragement of unhealthy, nutrient-poor snacks is critical for complementary feeding dietary guidelines in contexts experiencing nutrition transition.

Unhealthy Snack Food and Beverage Consumption Is Associated with Lower Dietary Adequacy and Length-for-Age z-Scores among 12-23-Month-Olds in Kathmandu Valley, Nepal

BACKGROUND

Consumption of unhealthy snack foods and beverages (USFBs) in low- and middle-income countries (LMICs) is rising, with global awareness increasing about risks of overnutrition. However, little is known about the relation between USFB consumption and young children's diet/nutritional outcomes in contexts where nutrient density of complementary foods is often low.

OBJECTIVES

This study assessed the association of high USFB consumption, compared with low consumption, with nutrient intakes, dietary adequacy, iron status, and growth in young children in Kathmandu Valley, Nepal.

METHODS

A cross-sectional survey was conducted in a representative sample of 745 primary caregivers of children aged 12-23 mo. Food consumption was measured through quantitative 24-h recalls, and child anthropometric measurements and capillary blood samples were collected. Using adjusted linear/logistic regression models, nutrient intakes, dietary adequacy, length-for-age and weight-for-length z-scores (LAZ and WLZ, respectively), and iron status were compared between lowest and highest tertiles of consumption based on the contribution of USFBs to total energy intakes (TEIs). Mediation of the relation between USFB consumption and LAZ via lowered dietary adequacy was explored using structural equations modeling.

RESULTS

On average, USFBs contributed 46.9% of TEI among the highest tertile of consumers, compared with 5.2% of TEI among the lowest. Compared with low-USFB consumers, high-USFB consumers had lower nutrient intakes and a greater proportion were at risk of inadequate intakes for 8 nutrients. Mean LAZ was nearly 0.3 SD lower among high-USFB consumers than low consumers (P = 0.003), with this relationship partially mediated through dietary adequacy. No associations were found with stunting prevalence or iron status. Prevalence of overweight/obesity was low.

CONCLUSIONS

In this LMIC context, high USFB consumption among young children was associated with inadequate micronutrient intakes, which can contribute to poor growth outcomes. Addressing increased availability of USFBs in LMIC food systems should be a priority for policies and programs aiming to safeguard child nutrition.

Energy intake from unhealthy snack food/beverage among 12-23-month-old children in urban Nepal

Unhealthy snack food and beverage (USFB) consumption among young children has been noted in many low‐income and middle‐income countries (LMIC), however, there is a lack of information on the contribution of these foods to children's diets in these contexts. This study describes the nutrient profiles and costs of snacks consumed by young children in Kathmandu Valley, Nepal, and assesses the proportion of total energy intake from nonbreastmilk foods (%TEI‐NBF) contributed by USFB and factors associated with high USFB consumption. A cross‐sectional survey was conducted among 745 randomly sampled primary caregivers of children aged 12–23 months. Of 239 unique snack foods and beverages consumed, 180 (75.3%) were classified as unhealthy based on nutrient profiling, with 158 of these being commercially branded. Median cost/100 kcal of USFB was lower as compared with healthy snacks. Ninety‐one percent of children had consumed a USFB in the previous 24 hr, with these foods contributing a mean %TEI‐NBF of 24.5 ± 0.7 among all children. Biscuits (10.8%), candy/chocolate (3.5%), and savoury snacks (3.4%) provided the largest %TEI‐NBF. Children who were older, female, or from the poorest households had significantly higher odds of high USFB consumption, whereas children whose caregivers were of upper caste/ethnicity or had achieved tertiary education had lower odds of consumption than other children. To reduce USFB consumption, interventions should seek to further understand social/cultural drivers of feeding practices, target disadvantaged populations, and ensure caregivers are fully aware of the nutritional quality of food products they choose for their children.

Dietary Inadequacies in HIV-infected and Uninfected School-aged Children in Johannesburg, South Africa

OBJECTIVES

The World Health Organization recommends that human immunodeficiency virus (HIV)-infected children increase energy intake and maintain a balanced macronutrient distribution for optimal growth and nutrition. Few studies have evaluated dietary intake of HIV-infected children in resource-limited settings.

METHODS

We conducted a cross-sectional analysis of the dietary intake of 220 perinatally HIV-infected children and 220 HIV-uninfected controls ages 5 to 9 years in Johannesburg, South Africa. A standardized 24-hour recall questionnaire and software developed specifically for the South African population were used to estimate intake of energy, macronutrients, and micronutrients. Intake was categorized based on recommendations by the World Health Organization and Acceptable Macronutrient Distribution Ranges established by the IOM.

RESULTS

The overall mean age was 6.7 years and 51.8% were boys. Total energy intake was higher in HIV-infected than HIV-uninfected children (1341 vs 1196 kcal/day, P = 0.002), but proportions below the recommended energy requirement were similar in the 2 groups (82.5% vs 85.2%, P = 0.45). Overall, 51.8% of the macronutrient energy intake was from carbohydrates, 13.2% from protein, and 30.8% from fat. The HIV-infected group had a higher percentage of their energy intake from carbohydrates and lower percentage from protein compared with the HIV-uninfected group. Intakes of folate, vitamin A, vitamin D, calcium, iodine, and selenium were suboptimal for both groups.

CONCLUSIONS

Our findings suggest that the typical diet of HIV-infected children and uninfected children in Johannesburg, South Africa, does not meet energy or micronutrient requirements. There appear to be opportunities for interventions to improve dietary intake for both groups.

Dietary Calcium Intake and Adherence to the Mediterranean Diet in Spanish Children: The ANIVA Study

The aim of this study was to evaluate the relationship of dietary calcium intake with anthropometric measures, physical activity and adherence to the Mediterranean diet (MedDiet) in 1176 Spanish children aged 6-9 years. Data were obtained from "Antropometría y Nutrición Infantil de Valencia" (ANIVA), a cross-sectional study of a representative sample. Dietary calcium intake assessed from three-day food records was compared to recommended daily intakes in Spain. Anthropometric measures (weight and height) were measured according to international standards and adherence to the MedDiet was evaluated using the Mediterranean Diet Quality Index (KIDMED) test. For the total sample of children, 25.8% had inadequate calcium intake, a significantly higher prevalence in girls (p = 0.006) and inadequate calcium intake was associated with lower height z-score (p = 0.001) for both sexes. In girls, there was an inverse relationship between calcium intake and body mass index (p = 0.001) and waist/hip ratio (p = 0.018). Boys presented a polarization in physical activity, reporting a greater level of both physical and sedentary activity in comparison with girls (p = 0.001). Children with poor adherence to MedDiet, even if they consume two yogurts or cheese (40 g) daily, adjusted by gender, age, total energy intake, physical activity and father's level of education, are at risk of inadequate total calcium intake (odds ratio adjusted [ORa]: 3.36, 95% confidence interval [CI]: 1.13-9.94, p = 0.001). The intake of these dairy products was insufficient to cover calcium intake recommendations in this age group (6-9 years). It is important to prioritize health strategies that promote the MedDiet and to increase calcium intake in this age group.

Nutrient Intake and Depression Symptoms in Spanish Children: The ANIVA Study

The aim of this study was to examine the relationship between nutritional intake and depressive symptoms in Valencian schoolchildren. The ANIVA (Antropometria y Nutricion Infantil de Valencia) study is a descriptive cross-sectional study. During academic year 2013–2014, 710 schoolchildren aged 6–9 years were selected from eleven primary schools in Valencia (Spain). Children’s dietary intake was measured on three-day food records, completed by parents/guardians; children completed the 20-item Center for Epidemiologic Studies Depression Scale for Children (CES-DC) Questionnaire to measure depressive symptoms. Weight, height, and body mass index (BMI), and z-scores were evaluated in all subjects. Nutrient adequacy was assessed using Spanish dietary recommended intakes (DRIs); 20.70% of the sample presented depressive symptoms. We identified a positive association between children with depressive symptoms and non-depressive symptoms for thiamin, vitamin K, and bromine (p < 0.05), and a negative association for protein, carbohydrates, pantothenic acid, biotin, vitamin B₁₂ and E, zinc, manganese, cobalt, and aluminum (p < 0.05). Statistically significant differences were found between both groups according to the DRIs for intakes of total energy (p = 0.026), fiber (p < 0.001), vitamin C (p < 0.001), vitamin E (p = 0.004), magnesium (p = 0.018), and iron (p = 0.013). Our results demonstrated that carbohydrates were the most closely associated factor with depressive symptoms, and highlight the potential significant public health implications of inadequate nutritional intake on schoolchildren’s mental health.

Anthropometric Status and Nutritional Intake in Children (6-9 Years) in Valencia (Spain): The ANIVA Study

The aim of our study was to assess nutritional intake and anthropometric statuses in schoolchildren to subsequently determine nutritional adequacy with Spanish Dietary Reference Intake (DRIs). The ANIVA study, a descriptive cross-sectional study, was conducted in 710 schoolchildren (6–9 years) in 2013–2014 in Valencia (Spain). Children’s dietary intake was measured using 3-day food records, completed by parents. Anthropometric measures (weight and height) were measured according to international standards, and BMI-for-age was calculated and converted into z-scores by WHO-Anthro for age and sex. Nutrient adequacy was assessed using DRI based on estimated average requirement (EAR) or adequate intake (AI). Pearson’s chi-square and Student’s t-test were employed. Of our study group (47.61% boys, 52.39% girls), 53.1% were normoweight and the weight of 46.9% was inadequate; of these, 38.6% had excess body weight (19.6% overweight and 19.0% obesity). We found intakes were lower for biotin, fiber, fluoride, vitamin D (p < 0.016), zinc, iodine, vitamin E, folic acid, calcium and iron (p < 0.017), and higher for lipids, proteins and cholesterol. Our results identify better nutritional adequacy to Spanish recommendations in overweight children. Our findings suggest that nutritional intervention and educational strategies are needed to promote healthy eating in these children and nutritional adequacies.