# Do 6–9-year-old children in Denmark adhere to national dietary recommendations and are there sociodemographic disparities? The Generation Healthy Kids study

## TL;DR

This study examines how well Danish children aged 6–9 follow dietary guidelines and finds that adherence is low in certain groups, such as older children and those from rural or less-educated families.

## Contribution

The study provides new insights into dietary adherence and sociodemographic disparities among Danish children using a large cohort and multiple dietary assessment methods.

## Key findings

- Only <15% of children met dietary recommendations for fruit + vegetables, fish, and meat.
- Adherence to dietary guidelines decreased with age and shorter parental education.
- Rural children had lower adherence and consumed more added sugar and saturated fat than urban children.

## Abstract

Diet in childhood is important for growth, brain development, and long-term health. Thus, assessing children’s adherence to dietary recommendations and identifying sociodemographic groups with low adherence is of great public health relevance. We investigated dietary intake, adherence to recommendations, and sociodemographic differences in a large cohort of Danish children.

We analyzed baseline data from 1094 children aged 6–9 years from 23 schools across Denmark participating in the Generation Healthy Kids study. Diet was assessed by three-day dietary records and food frequency questionnaires for fish and supplements, focusing on key food groups, macronutrients, and iron. Fasting blood samples were collected from n = 347 and analyzed for nutritional biomarkers of fish, wholegrains, and iron for validation.

Overall adherence to dietary recommendations showed a mean ± SD score of 4.6 ± 1.0 out of 7.0. However, < 15% adhered to the recommendations for fruit + vegetables, fish, and meat, and < 33% to recommendations for saturated fat (SFA) and iron. Adherence decreased with age and shorter parental education, due to lower intakes of fruit + vegetables and dairy with age, and lower wholegrain and higher meat intake with shorter parental education. Also, rural children had lower adherence and consumed less fruit + vegetables and more added sugar and SFA than urban. Non-Danish descendants consumed less wholegrains and sugar than Danish, and weight status was not associated with adherence.

Danish children had relatively good dietary adherence, but intakes of fruit + vegetables, fish, meat, SFA, and iron remain a concern. Attention should be given to children of older age, short parental education, and rural backgrounds.

The online version contains supplementary material available at 10.1007/s00394-025-03863-y.