Prevalence of nutrition risk and associated risk factors among New Zealand (NZ) preschool children : a thesis presented for the partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany Campus, Auckland, New Zealand

Abstract

Background: There are limited studies on the prevalence of nutrition risk among preschool children (aged two to five years) living in New Zealand (NZ) as most studies focus on a broader age group which include younger and older children. This age group may be vulnerable to developing poor eating habits and inadequate nutrition intake during these years may have adverse health outcomes later in life. Objectives: To determine the prevalence of nutrition risk using a validated nutrition screening tool Nutrition Screening Tool for Every Preschooler (NutriSTEP) among preschool children in NZ and to identify factors associated with nutrition risk. Method/Design: An observational study design was used; we conducted a cross-sectional online survey using convenience sampling. Parents/caregivers of NZ preschool children (aged two to five years) completed an online survey which included NutriSTEP, parent and child height, weight and sociodemographic characteristics. The 17-item NutriSTEP responses were scored zero to four; item scores ≥2 indicate risk; maximum score 68. Participants were stratified into; low risk (NutriSTEP score ≤20) and moderate/high risk (NutriSTEP score >20) and associations between nutrition risk and sociodemographic characteristics were explored using a Pearson chi-square test and binary regression. Results: Of 505 preschool children, 96 (19%) were at moderate to high risk (median IQR NutriSTEP score 24 [22,26]) and 409 (81%) were at low risk (median IQR NutriSTEP score 13 [10,16]). Preschool children at highest risk were non-NZ European (p=0.002), of solo parents (p=0.002), with household incomes ≤$50,000 (p≤0.021) and non-university educated parents (p≤0.0001). Of the NutriSTEP items, >30% of preschoolers were at high risk for inadequate consumption of fruit, vegetables, grains, milk products, meat and meat alternatives, exposure to screens during meals and overuse of supplements. Conclusion: A fifth of NZ preschool children were at moderate/high nutrition risk. Economic and ethnic disparities were apparent which suggests social inequity may increase nutrition risk in NZ preschool children. Prevalent nutrition risk factors were inadequate intakes of all major food groups, excessive screen-watching during meals and overuse of supplements. Using NutriSTEP may assist to identify NZ preschool children at highest nutrition risk who may benefit from appropriate nutrition support.