The utility of household Grocery Purchase Quality Index scores as an individual diet quality metric

Abstract The validated Grocery Purchase Quality Index (GPQI) reflects concordance between household grocery purchases and US dietary recommendations. However, it is unclear whether GPQI scores calculated from partial purchasing records validly reflect individual-level diet quality. Within the 9-month randomized controlled Smart Cart study examining the effect of targeted coupons on grocery purchase quality (n=209), this secondary analysis examined concordance between the GPQI (range 0-75, scaled to 100) calculated from 3-months of loyalty-card linked partial (≥50%) household grocery purchasing data and individual-level Healthy Eating Index (HEI) scores at baseline and 3-months calculated from food frequency questionnaires. HEI and GPQI concordance was assessed with overall and demographic-stratified partially-adjusted correlations; covariate-adjusted percent score differences, cross-classification, and weighted kappa coefficients assessed concordance across GPQI tertiles (T). Participants were mostly middle-aged (55.4(13.9) years), female (90.3%), from non-smoking households (96.4%), without children (70.7%). Mean GPQI (54.8(9.1)%) scores were lower than HEI scores (baseline: 73.2(9.1)%, 3-months: 72.4(9.4)%), and moderately correlated (baseline r=0.41 vs. 3-month r=0.31, p<0.001). Correlations were stronger among participants with ≤ bachelor’s degree, obesity, and children. Concordance was highest in T3. Participants with high (T3) vs. low (T1) GPQI scores had 7.3-10.6 higher odds of having HEI scores >80% at both timepoints. Weighted kappas (k=0.25) indicated moderate agreement between scores. Household-level GPQI derived from partial grocery purchasing data were moderately correlated with self-reported intake, indicating their promise for evaluating diet quality. Partial purchasing data appears to moderately reflect individual diet quality and may be useful in interventions monitoring changes in diet quality.

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Sociodemographic Differences in the Dietary Quality of Food-at-Home Acquisitions and Purchases among Participants in the U.S. Nationally Representative Food Acquisition and Purchase Survey (FoodAPS)

Nutrients ◽

10.3390/nu12082354 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2354 ◽

Cited By ~ 1

Author(s):

Maya K. Vadiveloo ◽

Haley W. Parker ◽

Filippa Juul ◽

Niyati Parekh

Keyword(s):

Diet Quality ◽

Healthy Eating Index ◽

Food Acquisition ◽

Assistance Program ◽

Household Level ◽

Individual Level ◽

Sociodemographic Differences ◽

Race Ethnicity ◽

Nationally Representative ◽

At Home

Insufficient research has explored whether sociodemographic differences in self-reported, individual-level diet quality are similarly reflected by grocery purchase quality. This cross-sectional analysis of n = 3961 U.S. households from the nationally representative Food Acquisition and Purchase Survey (FoodAPS) compared Healthy Eating Index (HEI)-2015 scores from 1 week of food-at-home acquisitions across self-reported demographic factors (race/ethnicity, Supplemental Nutrition Assistance Program (SNAP) participation, food security, and household-level obesity status). Multivariable-adjusted, survey-weighted regression models compared household HEI-2015 scores across sociodemographic groups. Respondents were primarily White and female, with a mean age of 50.6 years, 14.0% were food insecure, and 12.7% were SNAP-participating. Mean HEI-2015 scores were 54.7; scores differed across all sociodemographic exposures (p < 0.05). Interactions (p < 0.1) were detected between SNAP participation and (1) food insecurity and (2) household-level obesity, and race/ethnicity and (1) household-level obesity. HEI-2015 scores were higher among food secure, non-SNAP households than among food insecure, SNAP-participating households (53.9 ± 0.5 vs. 50.3 ± 0.7, p = 0.007); non-SNAP households without obesity had significantly higher HEI-2015 scores than other households. Household-level obesity was associated with lower HEI-2015 scores in White (50.8 ± 0.5 vs. 52.5 ± 0.7, p = 0.046) and Black (48.8 ± 1.5 vs. 53.1 ± 1.4, p = 0.018) but not Hispanic households (54.4 ± 1.0 vs. 52.2 ± 1.2, p = 0.21). Sociodemographic disparities in household HEI-2015 scores were consistent with previous research on individual-level diet quality.

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Scoring models of a diet quality index and the predictive capability of mortality in a population-based cohort of Swedish men and women

Public Health Nutrition ◽

10.1017/s1368980012002789 ◽

2012 ◽

Vol 16 (3) ◽

pp. 468-478 ◽

Cited By ~ 16

Author(s):

Isabel Drake ◽

Bo Gullberg ◽

Emily Sonestedt ◽

Peter Wallström ◽

Margaretha Persson ◽

...

Keyword(s):

Diet Quality ◽

Quality Index ◽

Population Based ◽

Dietary Recommendations ◽

Predictive Capability ◽

Men And Women ◽

Scoring Model ◽

Diet Quality Index ◽

Specific Mortality ◽

Dietary Indices

AbstractObjectiveTo examine how different scoring models for a diet quality index influence associations with mortality outcomes.DesignA study within the Malmö Diet and Cancer cohort. Food and nutrient intakes were estimated using a diet history method. The index included six components: SFA, PUFA, fish and shellfish, fibre, fruit and vegetables, and sucrose. Component scores were assigned using predefined (based on dietary recommendations) and population-based cut-offs (based on median or quintile intakes). Multivariate Cox regression was used to model associations between index scores (low, medium, high) and all-cause and cause-specific mortality by sex.SettingMalmö, the third largest city in Sweden.SubjectsMen (n 6940) and women (n 10 186) aged 44–73 years. During a mean follow-up of 14·2 years, 2450 deaths occurred, 1221 from cancer and 709 from CVD.ResultsThe predictive capability of the index for mortality outcomes varied with type of scoring model and by sex. Stronger associations were seen among men using predefined cut-offs. In contrast, the quintile-based scoring model showed greater predictability for mortality outcomes among women. The scoring model using median-based cut-offs showed low predictability for mortality among both men and women.ConclusionsThe scoring model used for dietary indices may have a significant impact on observed associations with disease outcomes. The rationale for selection of scoring model should be included in studies investigating the association between dietary indices and disease. Adherence to the current dietary recommendations was in the present study associated with decreased risk of all-cause and cause-specific mortality, particularly among men.

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Associations between frequency of food shopping at different store types and diet and weight outcomes: findings from the NEWPATH study

Public Health Nutrition ◽

10.1017/s1368980016000355 ◽

2016 ◽

Vol 19 (12) ◽

pp. 2268-2277 ◽

Cited By ~ 19

Author(s):

Leia M Minaker ◽

Dana L Olstad ◽

Mary E Thompson ◽

Kim D Raine ◽

Pat Fisher ◽

...

Keyword(s):

Diet Quality ◽

Saturated Fat ◽

Healthy Eating Index ◽

Farmers Markets ◽

Food Store ◽

Individual Level ◽

Food Shopping ◽

Different Types ◽

Weight Outcomes ◽

Purchasing Patterns

AbstractObjectiveThe present study aimed to: (i) examine associations between food store patronage and diet and weight-related outcomes; and (ii) explore consumer motivations for visiting different types of food store.DesignA stratified probability sample of residents completed household and individual-level surveys in 2009/2010 on food purchasing patterns and motivations, dietary intake, waist circumference (WC), weight and height. Diet quality was calculated using the Healthy Eating Index for Canada from a subset of participants (n 1362). Generalized estimating equations were created in 2015 to examine how frequency of patronizing different types of food store was associated with diet quality, intake of fruits and vegetable, mean intake of energy (kcal) sodium and saturated fat, WC and BMI.SettingThree mid-sized urban municipalities in Ontario, Canada.SubjectsA representative sample of residents (n 4574).ResultsParticipants who shopped frequently at food co-ops had significantly better diet quality (β=5·3; 99 % CI 0·3, 10·2) than those who did not. BMI and WC were significantly lower among those who frequently shopped at specialty shops (BMI, β=−2·1; 99 % CI −3·0, −1·1; WC, β=−4·8; 99 % CI −7·0, −2·5) and farmers’ markets (BMI, β=−1·4; 99 % CI −2·3, −0·5; WC, β=−3·8; 99 % CI −6·0, −1·6) compared with those who did not. Relative importance of reasons for food outlet selection differed by large (price, food quality) v. small (proximity, convenient hours) shopping trip and by outlet type.ConclusionsFindings contribute to our understanding of food store selection and have implications for potentially relevant retail food intervention settings.

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Association between energy-dense food consumption at 2 years of age and diet quality at 4 years of age

British Journal Of Nutrition ◽

10.1017/s0007114513003620 ◽

2013 ◽

Vol 111 (7) ◽

pp. 1275-1282 ◽

Cited By ~ 8

Author(s):

Sofia Vilela ◽

Andreia Oliveira ◽

Elisabete Ramos ◽

Pedro Moreira ◽

Henrique Barros ◽

...

Keyword(s):

Healthy Eating ◽

Diet Quality ◽

Population Based ◽

Healthy Eating Index ◽

Soft Drinks ◽

Inverse Association ◽

Food Groups ◽

Dietary Recommendations ◽

Daily Consumption ◽

Energy Dense Food

The present study aimed to evaluate the association between the consumption of energy-dense foods at 2 years of age and the consumption of foods and diet quality at 4 years of age. The sample included 705 children evaluated at 2 and 4 years of age, as part of the population-based birth cohort Generation XXI (Porto, Portugal). Data on sociodemographic and lifestyle factors of both children and mothers were collected by face-to-face interviews. The weight and height of children were measured by trained professionals. Based on FFQ, four energy-dense food groups were defined: soft drinks; sweets; cakes; salty snacks. A healthy eating index was developed using the WHO dietary recommendations for children (2006) aged 4 years. The associations were evaluated through Poisson regression models. After adjustment for maternal age and education, child's carer, child's siblings and child's BMI, higher consumption of energy-dense foods at 2 years of age was found to be associated with higher consumption of the same foods 2 years later. An inverse association was found between the intake ( ≥ median) of soft drinks (incidence rate ratio (IRR) = 0·74, 95 % CI 0·58, 0·95), salty snacks (IRR = 0·80, 95 % CI 0·65, 1·00) and sweets (IRR = 0·73, 95 % CI 0·58, 0·91) at 2 years of age and the consumption of fruit and vegetables at 4 years of age ( ≥ 5 times/d). Weekly and daily consumption of energy-dense foods at 2 years of age was associated with a lower healthy eating score at 4 years of age (IRR = 0·75, 95 % CI 0·58, 0·96; IRR = 0·56, 95 % CI 0·41, 0·77, respectively). The consumption of energy-dense foods at young ages is negatively associated with the diet quality of children a few years later.

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The interaction between brain-derived neurotrophic factor (BDNF) Val66met polymorphism and dietary indices, The Healthy Eating Index (HEI), The Diet Quality Index-International (DQI-I) , and Phytochemical index (PI) , on anthropometric indices, inflammatory, and oxidative stress markers in patient with type2 diabetes

10.21203/rs.3.rs-239163/v2 ◽

2021 ◽

Author(s):

Zeinab Naeini ◽

Negin Aghazadeh ◽

Elmira Karimi ◽

Zahra Esmaeily ◽

Faezeh Abaj ◽

...

Keyword(s):

Oxidative Stress ◽

Healthy Eating ◽

Diet Quality ◽

Quality Index ◽

Healthy Eating Index ◽

Quality Indices ◽

Val66met Polymorphism ◽

Diet Quality Index ◽

Bdnf Val66met Polymorphism ◽

And Oxidative Stress

Abstract Background: Although many studies suggest an association between BDNF Val66Met with eating disorders and obesity especially in type 2 diabetes mellitus (T2DM), the interaction between BDNF Val66Met polymorphism and diet quality indices in diabetic patients have not been investigated yet. The current study was aimed to evaluate the interaction between the diet quality indices including Healthy Eating Index (HEI), Diet Quality Index-International (DQI-I), Phytochemical Index (PI) and BDNF Val66Mat (rs6265) polymorphism on markers of inflammation, and oxidative stress in T2DM patients.Methods: This current cross-sectional study was conducted on 634 Iranian T2DM patients aged 35–65 years of both genders were randomly recruited. Dietary intakes was estimated by a food frequency questionnaire (FFQ) with 148 food items. All participants were categorized into three categories, based on DQI, HEI, and PI scores. The interactions were tested using analysis of covariance (ANCOVA) in adjusted and unadjusted models.Results: There were significant gene-diet interactions between BDNF Val66Met polymorphism and HEI, DQI, and PI scores in modulating body mass index (BMI) and waist circumference (WC) values. Our results showed that higher scores for all diet-quality indices were significantly associated with a lower BMI and WC values after adjustment (P Interactions < 0.05). We also observed a significant interaction between the DQI scores and Val66Met polymorphism on level of superoxide dismutase (SOD) (p-interaction= 0.01). The highest quartile of DQI was associated with elevated level of SOD in the Val/Met and Met/Met genotype group. Moreover, the interaction between the DQI scores and Val66Met polymorphism on total antioxidant capacity (TAC) tended to be significant.Conclusions: Higher scores for all diet-quality indices were significantly associated with a lower BMI and WC values. There were significant differences for PTX and PGF2A among HEI tertiles. The interaction between the polymorphism and DQI on TAC and SOD levels were significant.

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Development of a diet quality index to assess adherence to Canadian dietary recommendations in 3-year-old children

Public Health Nutrition ◽

10.1017/s1368980019002039 ◽

2019 ◽

Vol 23 (3) ◽

pp. 385-393 ◽

Cited By ~ 2

Author(s):

Megan Jarman ◽

Nisha Vashi ◽

Amy Angus ◽

Rhonda C Bell ◽

Gerald F Giesbrecht ◽

...

Keyword(s):

Preschool Children ◽

Diet Quality ◽

Quality Index ◽

Dietary Recommendations ◽

Diet Quality Index ◽

Sweetened Beverages ◽

Canadian Context ◽

Grain Products ◽

Dietary Data

AbstractObjective:Little is known about the diet quality of preschool children in Canada. We adapted an established diet quality index for European preschool children to align with the Canadian context and applied the index to dietary data of 3-year-old children to assess patterns of diet quality.Design:Our diet quality index (DQI-C) consists of four components that align with Canada’s Food Guide (Vegetables and Fruit, Grain Products, Milk and Alternatives and Meat and Alternatives) and two components that account for less healthy intakes (Candy/Snacks, and Sugar-Sweetened Beverages (SSB)). The ratio between consumption v. recommended intakes is calculated for each component and summed to give a total score from 0 to 6.Setting:Alberta, Canada.Participants:The DQI-C was applied to FFQ data from 1260 3-year-old children.Results:Mean DQI-C was 3·69 (sd 0·6). Most children met recommendations for Vegetables and Fruit (73 %) and Meat and Alternatives (70 %); however, fewer met recommendations for Milk and Alternatives (38 %) and Grain Products (13 %). Children in the lowest quartile for DQI-C score consumed a mean of 82 g of Candy/Snacks and 193 g of SSB daily, whereas those in the highest quartile consumed 45 g/d and 17 g/d of Candy and Snacks and SSB, respectively.Conclusion:This DQI-C score is useful for ranking Canadian preschool children according to their overall diet quality. There is room for improvement for consumptions of Grain Products, Meat and Alternatives, Candy/Snacks and SSB, which could be a target for initiatives to improve diet quality of preschool children in Canada.

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Abstract P357: Relative Validity and Reliability of a Diet Risk Screener (DRS) for Clinical Practice

Circulation ◽

10.1161/circ.141.suppl_1.p357 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Emily A Johnston ◽

Kristina S Petersen ◽

Linda VAN HORN ◽

Diane C Mitchell ◽

Jeannette M Beasley ◽

...

Keyword(s):

High Risk ◽

Diet Quality ◽

High Reliability ◽

Random Order ◽

Weighted Kappa ◽

Healthy Eating Index ◽

Food Groups ◽

Validity And Reliability ◽

Relative Validity ◽

Diet Assessment

Poor diet quality contributes significantly to cardiometabolic mortality in the US. Diet assessment methodology is burdensome and non-standardized. Screeners for clinical use that rapidly assess dietary choices associated with cardiometabolic risk could enhance prevention. This study evaluated the relative validity and reliability of the Diet Risk Screener (DRS) in a sample of US adults with the hypothesis that the DRS would correlate with a validated measure of diet quality. The DRS includes nine questions related to foods/food groups strongly associated with cardiometabolic mortality based on previous evidence. Adults ages 35-75 were recruited through a national health volunteer registry (ResearchMatch.org). Participants completed the DRS and a validated food frequency questionnaire (FFQ) (Vioscreen.com) in random order on one occasion. To assess reliability, participants who completed the DRS were asked to repeat it within three months. The DRS was scored 0 (low risk) to 27 (high risk) and compared with the Healthy Eating Index (HEI)-2015 calculated from the FFQ (max. score 100). The DRS was moderately correlated with HEI-2015 [(n=126, 87% female; mean HEI-2015: 63.3 (95% CI: 61.1, 65.4); mean DRS: 11.8 (95% CI: 10.8, 12.8); r=-0.6, p<0.001; R 2 =0.36]. Furthermore, the DRS ranked 37% (n=47) of subjects in the same quintile and 41% (n=52) within ± 1 quintile of the HEI-2015 (weighted kappa=0.27). The DRS had high reliability (n=102, ICC: 0.83). Mean completion time was two minutes. The DRS may be useful in clinical or other time-limited settings to quickly identify individuals at high risk of diet-related preventable cardiometabolic mortality.

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Inedible Food Waste Linked to Diet Quality and Food Spending in the Seattle Obesity Study SOS III

Nutrients ◽

10.3390/nu13020479 ◽

2021 ◽

Vol 13 (2) ◽

pp. 479

Author(s):

Shilpi Gupta ◽

Chelsea M. Rose ◽

James Buszkiewicz ◽

Jennifer Otten ◽

Marie L. Spiker ◽

...

Keyword(s):

Food Waste ◽

Diet Quality ◽

Economic Status ◽

Property Values ◽

Healthy Eating Index ◽

Residential Property ◽

Processed Foods ◽

Household Level ◽

Food Expenditures ◽

Residential Property Values

Americans waste about a pound of food per day. Some of this is represented by inedible food waste at the household level. Our objective was to estimate inedible food waste in relation to diet quality and participant socio-economic status (SES). Seattle Obesity Study III participants (n = 747) completed the Fred Hutch Food Frequency Questionnaire (FFQ) and socio-demographic and food expenditure surveys. Education and geo-coded tax-parcel residential property values were measures of SES. Inedible food waste was calculated from diet records. Retail prices of FFQ component foods (n = 378) were used to estimate individual-level diet costs. The NOVA classification was used to identify ultra-processed foods. Multivariable linear regressions tested associations between inedible food waste, SES, food spending, Nutrient Rich Food (NRF9.3) and Healthy Eating Index (HEI-2015) scores. Inedible food waste was estimated at 78.7 g/d, mostly from unprocessed vegetables (32.8 g), fruit (30.5 g) and meat, poultry, and fish (15.4 g). Greater inedible food waste was associated with higher HEI-2015 and NRF9.3 scores, higher food expenditures and lower percent energy from ultra-processed foods. In multivariable models, more inedible food waste was associated with higher food expenditures, education and residential property values. Higher consumption of unprocessed foods were associated with more inedible food waste and higher diet costs. Geo-located estimates of inedible food waste can provide a proxy index of neighborhood diet quality.

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A Novel Diet-Health Index Reveals Worsening Trends and Widening Disparities in the Health Impacts of Diet in the United States

Current Developments in Nutrition ◽

10.1093/cdn/nzab035_009 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 101-101

Author(s):

Yan Bai ◽

Mengxi Du ◽

JIfan Wang ◽

Elena Naumova ◽

Fang Fang Zhang ◽

...

Keyword(s):

Diet Quality ◽

Metabolic Diseases ◽

Total Mortality ◽

The United States ◽

Healthy Eating Index ◽

Dietary Factors ◽

Health Impacts ◽

Health Index ◽

Individual Level ◽

Funding Sources

Abstract Objectives Poor diets are associated with poor health outcomes, but existing metrics of diet quality do not directly include the health effects of diet. Using a novel international diet-health index (IDHI), we can measure diet-related health impacts from multiple dietary factors simultaneously, given a population's health status and most prevalent causes of death and disability. Methods We obtained individual-level data on intake of 12 dietary factors and exposure to 2 metabolic risk factors from the National Health and Nutrition Examination Survey (NHANES), 2003–2014, and computed the IDHI for 12 cardio-metabolic diseases and 15 cancers in the U.S. by sex, race, education, and income. We then compared IDHI to a modified Alternative Healthy Eating Index (mAHEI) using 10 of the 12 dietary factors and validated the indices using the National Center for Health Statistics (NCHS) linked dataset for total mortality through 2015. Results IDHI declined from −0.314 (95% CI: −0.323, −0.305) in 2003/04 to −0.325 (−0.334, −0.316) in 2013/14 (P = 0.007 for trend). Non-Hispanic Black Americans have persistently lower IDHI than other groups, and disparities in IDHI have widened over time by level of income (P = 0.004 for interaction), and education (P = 0.047 for interaction). IDHI was more closely correlated with the mAHEI at higher levels of diet quality, and both indices were strongly associated with total mortality. Conclusions The IDHI is a valid tool for measuring diet-related health impacts in the context of a population's most prevalent diseases, potentially offering tailored guidance regarding how best to reduce diet-related health disparities. Funding Sources No funding.

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Cultural Differences in Diet and Determinants of Diet Quality in Switzerland: Results from the National Nutrition Survey menuCH

Nutrients ◽

10.3390/nu11010126 ◽

2019 ◽

Vol 11 (1) ◽

pp. 126 ◽

Cited By ~ 9

Author(s):

Giulia Pestoni ◽

Jean-Philippe Krieger ◽

Janice Marie Sych ◽

David Faeh ◽

Sabine Rohrmann

Keyword(s):

Diet Quality ◽

Tertiary Education ◽

Healthy Eating Index ◽

Normal Weight ◽

Activity Level ◽

Linear Regression Models ◽

Dietary Recommendations ◽

Nutrition Survey ◽

Targeted Interventions ◽

National Nutrition Survey

Sociodemographic differences in dietary consumption were observed in different populations. The current study aimed to identify sociodemographic and lifestyle determinants of diet quality and to investigate the differences in diet quality between the three main language regions of Switzerland. Using data of the Swiss National Nutrition Survey menuCH (n = 2057), two diet quality scores—Alternate Healthy Eating Index and Mediterranean Diet Score—were computed. Linear regression models were used to investigate the determinants of diet quality and chi-square tests were used to test for differences in single score components between language regions. Significantly higher diet quality scores were observed for individuals who were female, older, normal weight, non-Swiss, with tertiary education or moderate-to-high physical activity level. Additionally, residents of the French- and Italian-speaking parts of Switzerland scored higher than residents of the German-speaking region. More specifically, the higher diet quality observed in the French- and Italian-speaking regions was mediated by higher scores in the components of alcohol, dairy products, fat, fish, sugar-sweetened beverages and whole grains. The present results may help to better characterize population groups requiring specific dietary recommendations, enabling public health authorities to develop targeted interventions.

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