Background Diet quality is an important determinant of childhood obesity. However, no agreement on the best measure of diet quality exists. Diet pattern analysis is emerging in research investigating child diet-disease associations. An a-priori approach, comparing children’s adherence to a pre-defined healthy diet pattern, is one measure of diet quality and the Dietary Approach to Stop Hypertension (DASH) is a healthy diet pattern. The DASH diet plan has been successfully used in adult populations to assess diet-obesity relationships and is under-utilised in children. Therefore, the aim of the present research is to adapt the DASH score (kidDASH) for use in children to assess whether adherence to a DASH style diet is associated with a reduced risk of childhood overweight/obesity.

Methods A cross-sectional survey of 1075, 8–11 year-old children from Cork, Ireland. Measured Child height and weight were used to calculate BMI. The modified kidDASH score was developed from child completed 3-day estimated food diaries. Food-group weights in grams were used to divide each kidDASH component into quintiles. Higher quintiles were assigned higher scores for healthy components and reverse scoring was used for unhealthy components. Energy under reporters were identified and excluded from analysis. Linear and Poisson regression was used to explore the relationship between kidDASH and childhood overweight and obesity.

Results Mean kidDASH scores were higher in children who were normal weight, whose paretns had third level education and for girls. In fully adjusted models children with the highest adherence to kidDASH had a significant decreased odds of obesity compared to those with lowest adherence (OR 0.53 95% CI 0.30 0.92).

Conclusion KidDASH is associated with the risk of childhood overweight/obesity. As childhood obesity rates are high public health strategies targeting healthy eating patterns are urgently needed.