More-To-Less Home Healthful Foods Ratio is Associated With Diet Quality in Preadolescents With Elevated Body Mass Index

Objective: To examine home food availability (HFA) and the association with diet quality in preadolescents with elevated body mass index. Methods: A cross-sectional analysis examined HFA and diet quality (using the 2015-Health Eating Index [HEI] derived from 1 or 2 24-hour dietary recalls) among preadolescents (n = 111; aged 8–12 years; body mass index ≥ 75th percentile). A novel ratio of more-to-less healthful items was created to represent HFA. Multivariate linear regression models examined the HFA ratio and individual food and beverage groups as correlates of HEI. Results: The HFA ratio was associated with higher HEI (β = 5.3 [1.3]; P < 0.001). Home food availability of sweets (β = −2.6 [0.9]; P = 0.003) and sugar-sweetened beverages (β = −2.3 [1.0]; P = 0.02) were associated with lower HEI. Home food availability of fruits was associated with higher HEI (β = 1.3 [0.7]; P = 0.05). Conclusions and Implications: Structuring the HFA so that more healthful choices are available relative to less healthful foods could be an effective approach for improving diet quality in preadolescents at risk for obesity.