The Relationship Between Healthy Eating Indices and School Absences

<b>Background and Objectives</b><br>COVID-19 has contributed to increased child poverty and food insecurity in the United States, and while government programs help alleviate food insecurity, they do not always ensure nutritional security. Prior research has demonstrated a correlation between food insecurity and increased school absences. However, the role of child nutritional quality is less well understood. The current study enhanced this understanding by merging two data sources to create a novel dataset and analyzing the association between child nutritional quality and school absences.<br> <br><b>Methods</b><br>A subset of the data from a 3-year randomized control trial to prevent obesity in 3-5-year-old children was linked to data from a public school system. Data from 354 children were analyzed using negative binomial regression models to examine the relationship between school absences and nutritional quality as measured by the 2010 Healthy Eating Index (HEI) and each of its 12 subcomponents.<br><b> </b><br><b>Results</b><br>The primary model found a significant relationship between healthier total HEI scores and fewer school absences (IRR=0.989; 95% CI=[0.981, 0.996]; <i>p</i>=0.003). Subcomponent analyses found that absences were significantly related to intake of whole fruits (IRR=0.934; 95% CI=[0.878, 0.993]; <i>p</i>=0.03) and marginally significantly related to whole grains (IRR=0.975; 95% CI=[0.949, 1.002]; <i>p</i>=0.07), sodium (IRR=0.968; 95% CI=[0.934, 1.002]; <i>p</i>=0.07), and refined grains (IRR=0.975; 95% CI=[0.949, 1.003]; <i>p</i>=0.08).<br> <br><b>Conclusions</b><br>The relationship between HEI and school absences among young children in public schools suggests that it could be beneficial to direct funding towards improving nutrition in school settings in addition to meeting USDA requirements.