scholarly journals Quality and Validity of Diet Quality Indices for Use in Australian Contexts: A Systematic Review

2021 ◽  
pp. 1-55
Author(s):  
Mui Siew Tan ◽  
Ho Ching Cheung ◽  
Erynn McAuley ◽  
Lynda J. Ross ◽  
Helen L. MacLaughlin
Keyword(s):  
Measurement Error ◽  
Construct Validity ◽  
Diet Quality ◽  
Disease Risk ◽  
Dietary Guidelines ◽  
Future Research ◽  
Quality Indices ◽  
Validation Process ◽  
Multiple Dimensions ◽  
Validity Criterion

Abstract Diet quality indices (DQIs) are tools used to evaluate the overall diet quality against dietary guidelines or known healthy dietary patterns. This review aimed to evaluate DQIs and their validation processes to facilitate decision-making in the selection of appropriate DQIs for use in Australian contexts. A search of CINAHL, PubMed and Scopus electronic databases was conducted for studies published between January 2010 – May 2020, which validated a DQI, measuring >1 dimension of diet quality (adequacy, balance, moderation, variety) and was applicable to the Australian context. Data on constructs, scoring, weighting and validation methods (construct validity, criterion validity, reliability and reproducibility) were extracted and summarised. The quality of the validation process was evaluated using COSMIN Risk of Bias and Joanna Briggs Appraisal checklists. The review identified 27 indices measuring adherence to: national dietary guidelines (n=13), Mediterranean diet (n=8), and specific population recommendations and chronic disease risk (n=6). Extensiveness of the validation process varied widely across and within categories. Construct validity was the most strongly assessed measurement property, while evaluation of measurement error was frequently inadequate. DQIs should capture multiple dimensions of diet quality, possess a reliable scoring system, and demonstrate adequate evidence in their validation framework to support use in the intended context. Researchers need to understand the limitations of newly developed DQIs and interpret results in view of the validation evidence. Future research on DQIs is indicated to improve evaluation of measurement error, reproducibility and reliability.

scholarly journals A comparison of diet quality indices in a nationally representative cross-sectional study of Iranian households

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara Ebrahimi ◽  
Sarah A. McNaughton ◽  
Rebecca M. Leech ◽  
Morteza Abdollahi ◽  
Anahita Houshiarrad ◽  
...  
Keyword(s):  
Diet Quality ◽  
Urban Areas ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
World Health ◽  
Future Research ◽  
Quality Indices ◽  
Cross Sectional ◽  
Nutrient Adequacy ◽  
Household Heads

Abstract Background Iranian diet quality has been evaluated using indices that have not been created based on Iranian dietary guidelines. This study aimed to examine the applicability of two diet quality indices by examining their associations with nutrient adequacy, nutrient intakes and sociodemographics. Methods Dietary data were collected using three 24-h dietary recalls from Iranian households. Nutrient adequacy was assessed using World Health Organization/Food and Agriculture Organization 2002 (WHO/FAO) cut points. Household diet quality was calculated using the Healthy Eating Index (HEI) and Diet Quality Index-International (DQI-I). Sociodemographics of the household members were assessed. Regression analyses were used to examine associations between diet quality and nutrient adequacy, and between sociodemographics and diet quality. Results A total of 6935 households were included in the analysis. Higher household diet quality was associated with adequate intake of calcium (HEI: OR 1.11, 95% CI: 1.10, 1.13; DQI-I: OR 1.14, 95% CI: 1.13, 1.16), vitamin C (HEI: OR 1.19, 95% CI: 1.17, 1.20; DQI-I: OR 1.12, 95% CI: 1.11, 1.12) and protein (HEI: OR 1.01, 95% CI: 1.00, 1.02; DQI-I: OR 1.09, 95% CI: 1.08, 1.09). Higher household diet quality was associated with household heads who were older (> 56 years old) (HEI: β 2.06, 95% CI: 1.63, 2.50; DQI-I β 2.90, 95% CI: 2.34, 3.45), higher educated (college/university completed) (HEI: β 4.54, 95% CI: 4.02, 5.06; DQI-I: β 2.11, 95% CI: 1.45, 2.77) and living in urban areas (HEI: β 2.85, 95% CI: 2.54, 3.16; DQI-I: β 0.72, 95% CI: 0.32, 1.12). Conclusions Based on associations with nutrient adequacy and sociodemographics, the applicability of two diet quality indices for assessing the diet quality of Iranian households was demonstrated. Results also indicated DQI-I may be more applicable than HEI for evaluating Iranian nutrient adequacy. Findings have implications for the design and assessment of diet quality in Iranian populations. Future research should examine the link between these diet quality indices and health outcomes.

scholarly journals Diet quality and cognitive function in mid-aged and older men and women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Catherine M. Milte ◽  
Kylie Ball ◽  
David Crawford ◽  
Sarah A. McNaughton
Keyword(s):  
Cognitive Function ◽  
Sex Education ◽  
Diet Quality ◽  
Cognitive Status ◽  
Dietary Guidelines ◽  
Future Research ◽  
Food Level ◽  
Men And Women ◽  
Dietary Variety ◽  
Dietary Behaviours

Abstract Background To date much research into nutrition and cognitive function has been at the nutrient or food level, with inconsistent results. There is increasing interest in the dietary pattern approach to assess whole diet quality and its association with cognitive function. This study investigated if diet quality is associated with cognitive function in men and women aged 55 years and over. Methods Adults aged 55–65 years in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 617) completed a postal survey including a 111-item food frequency questionnaire in 2010 and 2014. Diet quality was assessed via the revised dietary guideline index (DGI-2013) and also by its individual components which assessed key food groups and dietary behaviours from the Australian Dietary Guidelines. The Telephone Interview of Cognitive Status (TICS-m) measured cognitive function in 2014. Associations between past (2010) and recent (2014) diet quality and its components, and cognitive function were assessed by linear regression adjusted for covariates. Results After adjustment for age, sex, education, urban/rural status and physical activity there were no associations between diet quality in 2010 and cognitive function in 2014. However participants who reported higher dietary variety (B = 0.28, 95% CI 0.03, 0.52) and women who reported “sometimes” adding salt to food after cooking (B = 0.98, 95% CI 0.25, 1.71) in 2010 displayed better cognitive function in 2014. In 2014, usual consumption of higher fibre bread choices in the total sample (B = 1.32, 95% CI 0.42, 2.23), and higher diet quality (B = 0.03, 95% CI 0.00, 0.07) and greater fluid consumption (B = 0.14, 95% CI 0.01, 0.27) in men were all associated with better cognitive function. In addition, men who reported “usually” adding salt to their food during cooking displayed poorer cognitive function (B = -1.37, 95% CI -2.39, − 0.35). There were no other associations between dietary intake and cognitive function observed in the adjusted models. Conclusion An association between dietary variety and some limited dietary behaviours and cognitive function was observed, with variation by gender. Future research should consider trajectories of dietary change over longer time periods as determinants of health and function in older age.

scholarly journals Diet quality indices for research in low- and middle-income countries: a systematic review

2019 ◽  
Vol 77 (8) ◽  
pp. 515-540 ◽  
Author(s):  
Laura Trijsburg ◽  
Elise F Talsma ◽  
Jeanne H M de Vries ◽  
Gina Kennedy ◽  
Anneleen Kuijsten ◽  
...  
Keyword(s):  
Diet Quality ◽  
Food System ◽  
Data Extraction ◽  
High Income ◽  
Dietary Guidelines ◽  
Food Groups ◽  
Quality Indices ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Context Dietary intake research has increasingly focused on improving diet quality in low- and middle-income countries (LMICs). Accompanying this is the need for sound metrics to assess diet quality. Objective This systematic literature review aims to describe existing diet quality indices for general populations and highlights recommendations for developing such indices for food system research in LMICs. Data sources Three electronic databases were searched for papers published between January 2008 and December 2017. Data extraction Articles published in English and describing the development of an index to measure overall diet quality, irrespective of whether they were for high-income countries or LMICs, were included. Data analysis Eighty-one indices were identified, over two thirds were based on national dietary guidelines from high-income countries. Of the 3 key diet quality dimensions, “diversity” was included in all 18 indices developed for LMICs, “moderation” was captured by most, and “nutrient adequacy” was included 4 times. Conclusions Indices need to be developed that include all dimensions, include foods and/or food groups rather than nutrients, use an optimal range for individual components in the score, and express the intake of healthy and unhealthy components separately. Importantly, validation of the index should be part of its development.

scholarly journals Cross-comparison of diet quality indices for predicting chronic disease risk: findings from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study

2014 ◽  
Vol 113 (2) ◽  
pp. 259-269 ◽  
Author(s):  
Ala'a Alkerwi ◽  
Cédric Vernier ◽  
Georgina E. Crichton ◽  
Nicolas Sauvageot ◽  
Nitin Shivappa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Chronic Disease ◽  
Cardiovascular Risk Factors ◽  
Diet Quality ◽  
Dietary Patterns ◽  
Quality Index ◽  
Disease Risk ◽  
Quality Indices ◽  
Chronic Disease Risk

The scientific community has become increasingly interested in the overall quality of diets rather than in single food-based or single nutrient-based approaches to examine diet–disease relationships. Despite the plethora of indices used to measure diet quality, there still exist questions as to which of these can best predict health outcomes. The present study aimed to compare the ability of five diet quality indices, namely the Recommendation Compliance Index (RCI), Diet Quality Index-International (DQI-I), Dietary Approaches to Stop Hypertension (DASH), Mediterranean Diet Score (MDS), and Dietary Inflammatory Index (DII), to detect changes in chronic disease risk biomarkers. Nutritional data from 1352 participants, aged 18–69 years, of the Luxembourg nationwide cross-sectional ORISCAV-LUX (Observation of Cardiovascular Risk Factors in Luxembourg) study, 2007–8, were used to calculate adherence to the diet quality index. General linear modelling was performed to assess trends in biomarkers according to adherence to different dietary patterns, after adjustment for age, sex, education level, smoking status, physical activity and energy intake. Among the five selected diet quality indices, the MDS exhibited the best ability to detect changes in numerous risk markers and was significantly associated with lower levels of LDL-cholesterol, apo B, diastolic blood pressure, renal function indicators (creatinine and uric acid) and liver enzymes (serum γ-glutamyl-transpeptidase and glutamate-pyruvate transaminase). Compared with other dietary patterns, higher adherence to the Mediterranean diet is associated with a favourable cardiometabolic, hepatic and renal risk profile. Diets congruent with current universally accepted guidelines may be insufficient to prevent chronic diseases. Clinicians and public health decision makers should be aware of needs to improve the current dietary guidelines.

scholarly journals Dietary Practices Among US Immigrants: Energy Density as a Marker for Acculturation and Diet Quality

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 441-441
Author(s):  
Sofia Pendley ◽  
Melanie Reyes ◽  
Jacqueline Vernarelli
Keyword(s):  
Energy Density ◽  
Diet Quality ◽  
Disease Risk ◽  
Survey Design ◽  
Past Research ◽  
Dietary Guidelines ◽  
Dietary Energy ◽  
Dietary Practices ◽  
The Us ◽  
Dietary Energy Density

Abstract Objectives The Dietary Guidelines Advisory Committee (DGAC) 2020 report indicates a need for examining the association between acculturation, dietary behaviors and disease risk. Dietary energy density (ED, kcal/g) is an established indicator of diet quality and a risk factor for chronic disease. Because ED is calculated using the whole diet, it is culturally relevant for use in a variety of populations. Past research on acculturation and diet indicates a need for more research using indicators that measure diet quality. The objective of the present study was to examine the relationship between acculturation, dietary intake, and dietary energy density. Methods Dietary data was collected using 24hour-recall in a nationally representative sample of 10 622 adults who participated in the 2013–2016 NHANES. Specific questions about acculturation were asked of participants. All data were analyzed using SAS 9.4 survey procedures to account for the complex survey design of the NHANES. Results A linear relationship between dietary ED and length of time in the US was observed (p-trend < 0.0001). Individuals who were in the US for < 5 years had the lowest dietary ED compared to those who had been in the US for the longest (1.39 vs. 1.84 kcal/g, P < 0.0004) representing ∼450 kcal/day difference after adjusting for relevant cofactors. Despite this difference, there was no difference in the amount of money spent on food compared with length of time in the US. Conclusions This study is consistent with other studies that examine changes in dietary patterns among those who have immigrated to the US. Findings from this study, specifically using ED as an indicator of diet quality, may provide recommendations to developing culturally inclusive efforts to encourage healthy diets. Funding Sources None.

Abstract MP56: Specific Nutrients Associate Better Than Dietary Approaches To Stop Hypertension Score With Adult Cardiovascular Risk Factors Over 25 Years: The Princeton Lipid Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Leah Beck ◽  
Jessica G Woo
Keyword(s):  
Cardiovascular Disease ◽  
Diet Quality ◽  
Dietary Habits ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Dietary Guidelines ◽  
Dash Score ◽  
Initial Visit ◽  
Over Time

Introduction: Diet is a contributing factor to cardiovascular disease risk and is the basis for dietary guidelines such as the Dietary Approaches to Stop Hypertension (DASH) eating plan. However, little is known about how childhood dietary habits are maintained into adulthood or how child to adult, or adult to adult changes in diet may influence disease risk. Hypothesis: Our goal was to examine the relationship between diet quality, cardiovascular disease risk, and changes in diet quality over time. We hypothesized that diets lacking in nutrients for ideal cardiovascular health would be conserved from childhood to adulthood. This would be reflected as increased rates of hypertension, diabetes, dyslipidemia, and obesity. Methods: Diet data was analyzed from the Princeton Lipid Research study (24 hour recall in the 70’s; Block Food Frequency Questionnaire in 1998). Diet quality at each visit was assessed as a ranking of 15 different macro/micronutrients and by a modified DASH index based on 9 nutrient targets and adapted for children. Outcomes in both childhood and adulthood included: glucose intolerance/diabetes, high blood pressure/hypertension, dyslipidemia/hyperlipidemia, and obesity. Linear and logistic regression models were performed with adjustment for age, race, sex, BMI, occupation and education of self or head of household, and marital status. Results: Analysis included 221 total individuals in Generation 1 (parents at initial visit; 39% (86 of 221) male, mean age 38.9 ± 6.5 followed up at 66.6 ± 6.6 years) and 606 individuals in Generation 2 (45% (271 of 606) male, mean age 11.9 ± 3.23 at initial visit and 38.5 ± 3.6 years at follow up). Generation 1 increased in total DASH score from initial visit to follow-up (1.74 ± 0.95 → 2.11 ± 1.33) while Generation 2 decreased (1.91 ± 0.80 → 1.64 ± 1.13). Overall DASH score was not significantly associated with baseline or follow up outcomes in childhood or adulthood. However, in Generation 2 at follow-up, fiber, potassium, iron, niacin, and vitamin A were associated with hypertension; fiber and sugar with hyperlipidemia; cholesterol with obesity; and saturated fat with diabetes in Generation 1. Conclusions: Overall diet quality was poor in both generations and changed little over time. In conclusion, no relationship was detected between DASH diet accordance and disease outcomes, however certain nutrients are associated with higher cardiovascular disease risk.

Abstract P360: Dietary Saturated Fats From Different Food Sources Show Inconsistent Associations With Various Indices of Diet Quality in the Canadian Population

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Stephanie Harrison ◽  
Didier Brassard ◽  
Simone Lemieux ◽  
Benoit Lamarche
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Nutritive Value ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Food Sources ◽  
Dietary Intakes ◽  
Trans Fat ◽  
Quality Indices ◽  
Saturated Fats

Background: Canadian dietary guidelines include a recommendation to limit the consumption of foods high in saturated fats (SFA), regardless of their dietary source. The same guidelines also recommend consumption of lean red meat and low-fat dairy products. Yet, the association between the consumption of SFA from different food sources and diet quality is currently unknown. The objective of this study was to examine associations between SFA from various food sources and different indices of diet quality. Methods: Analyses are based on a sample of 11 106 respondents representative of Canadian adults (19-70 y) from the 2015 Canadian Community Health Survey (CCHS 2015). Dietary intakes and diet quality indices were calculated using a single interview-administered 24-hour recall. Food sources of SFA were classified according to the 2019 Canada’s Food Guide categories: 1) vegetables and whole fruits, 2) whole grain foods and 3) protein foods (including dairy and meat, among others). Foods not included in these three categories were grouped as All other foods . The 2010 alternative Healthy eating index (aHEI), the 2015 Healthy eating index (HEI-2015) and the 2007 Canadian Healthy eating index (C-HEI) were calculated. Due to the unreliability of data for trans-fat consumption in the CCHS 2015 database, the trans-fat subscore of the aHEI was removed from the original score. Results: While total SFA intake and SFA from All other foods were inversely correlated with all indices of diet quality (-0.55<r<-0.10, all p<0.001), associations with SFA from dairy and meat were inconsistent. SFA from dairy were inversely correlated (p<0.001) with the aHEI (r=-0.14) and the HEI-2015 (r=-0.16) but showed a weak positive correlation with the C-HEI (r=0.05, p<0.001). SFA from meat were negatively correlated with the aHEI (r=-0.21, p<0.001) and positively correlated with the C-HEI (r=0.11, p<0.001). Removing subscores directly related to SFA intake in diet quality indices yielded positive correlations between SFA from dairy and the HEI-2015 (r=0.13, p<0.001) and the C-HEI (r=0.19, p<0.001). Conclusion: Consumption of SFA from different food sources are inconsistently associated with different indices of overall diet quality. Unsurprisingly, SFA from All other foods , which include low nutritive value foods, showed the strongest negative correlation with all diet quality scores. These results provide further support to the notion that guidance on SFA in future health policies should focus on food sources rather than on total intake of SFA.

scholarly journals Measuring vincristine-induced peripheral neuropathy in children with cancer: validation of the Dutch pediatric–modified Total Neuropathy Score

2019 ◽  
Vol 28 (6) ◽  
pp. 2867-2873 ◽  
Author(s):  
S. M. Schouten ◽  
M. E. van de Velde ◽  
G. J. L. Kaspers ◽  
L. B. Mokkink ◽  
I. M. van der Sluis ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Measurement Error ◽  
Construct Validity ◽  
Pediatric Oncology ◽  
Future Research ◽  
Healthy Controls ◽  
Validity And Reliability ◽  
Dutch Version ◽  
Smallest Detectable Change ◽  
And Gender

Abstract Purpose The aims were to evaluate the construct validity and reliability of the Dutch version of the pediatric-modified Total Neuropathy Score (ped-mTNS) for assessing vincristine-induced peripheral neuropathy (VIPN) in Dutch pediatric oncology patients aged 5–18 years. Methods Construct validity (primary aim) of the ped-mTNS was determined by testing hypotheses about expected correlation between scores of the ped-mTNS (range: 0–32) and the Common Terminology Criteria for Adverse Events (CTCAE) (range: 0–18) for patients and healthy controls and by comparing patients and controls regarding their total ped-mTNS scores and the proportion of children identified with VIPN. Inter-rater and intra-rater reliability and measurement error (secondary aims) were assessed in a subgroup of study participants. Results Among the 112 children (56 patients and 56 age- and gender-matched healthy controls) evaluated, correlation between CTCAE and ped-mTNS scores was as expected (moderate (r = 0.60)). Moreover, as expected, patients had significantly higher ped-mTNS scores and more frequent symptoms of VIPN compared with controls (both p < .001). Reliability as measured within the intra-rater group (n = 10) (intra-class correlation coefficient (ICCagreement) = 0.64, standard error of measurement (SEMagreement) = 2.92, and smallest detectable change (SDCagreement) = 8.1) and within the inter-rater subgroup (n = 10) (ICCagreement = 0.63, SEMagreement = 3.7, and SDCagreement = 10.26) indicates insufficient reliability. Conclusion The Dutch version of the ped-mTNS appears to have good construct validity for assessing VIPN in a Dutch pediatric oncology population, whereas reliability appears to be insufficient and measurement error high. To improve standardization of VIPN assessment in children, future research aimed at evaluating and further optimizing the psychometric characteristics of the ped-mTNS is needed.

scholarly journals Food Waste and Nutrition Quality in the Context of Public Health: A Scoping Review

2021 ◽  
Vol 18 (10) ◽  
pp. 5379
Author(s):  
Aoife Brennan ◽  
Sarah Browne
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
Food Waste ◽  
Diet Quality ◽  
Scoping Review ◽  
Plastic Waste ◽  
Dietary Guidelines ◽  
Future Research ◽  
Nutrition Quality ◽  
Health And Nutrition

Food waste and nutrition are intrinsically linked in terms of environmental health and public health. Despite this, it is unknown whether these topics have been previously synthesized into a review. The aim was to identify the interdisciplinary parameters that exist in public health and nutrition literature in terms of food waste and plastic waste associated with food, and to identify how these parameters currently contribute to food sustainability messaging and interventions. A rapid scoping review was conducted. Data were mapped into concepts and synthesized in a narrative review. Four main concepts were identified: (1) food waste and diet quality, nutrient losses, and environmental health, (2) food waste reduction interventions and diet quality, (3) food banks/pantries and diet/nutritional quality, and (4) food and plastic waste messaging in nutrition or dietary guidelines. Food waste is associated with nutrient wastage, and interventions to reduce food waste can successfully address food sustainability and nutrition quality. Food redistribution systems do not currently address access to sustainably sourced foods that are also nutrient-dense for lower-income communities. Opportunities for future research and practice include aligning food waste, plastic waste, and nutrition priorities together and developing better food redistribution systems to limit wastage of high-quality foods.

scholarly journals Perspective: The Application of A Priori Diet Quality Scores to Cardiovascular Disease Risk—A Critical Evaluation of Current Scoring Systems

2019 ◽  
Author(s):  
Ghadeer S Aljuraiban ◽  
Rachel Gibson ◽  
Linda M Oude Griep ◽  
Nagako Okuda ◽  
Lyn M Steffen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Diet Quality ◽  
Dietary Habits ◽  
Disease Risk ◽  
A Priori ◽  
Food Groups ◽  
Quality Indices ◽  
Cvd Risk ◽  
Population Groups ◽  
Cvd Prevention

ABSTRACT Healthy dietary habits are the cornerstone of cardiovascular disease (CVD) prevention. Numerous researchers have developed diet quality indices to help evaluate and compare diet quality across and within various populations. The availability of these new indices raises questions regarding the best selection relevant to a given population. In this perspective, we critically evaluate a priori–defined dietary indices commonly applied in epidemiological studies of CVD risk and mortality. A systematic literature search identified 59 observational studies that applied a priori–defined diet quality indices to CVD risk factors and/or CVD incidence and/or CVD mortality. Among 31 different indices, these scores were categorized as follows: 1) those based on country-specific dietary patterns, 2) those adapted from distinct dietary guidelines, and 3) novel scores specific to key diet-related factors associated with CVD risk. The strengths and limitations of these indices are described according to index components, calculation methods, and the application of these indices to different population groups. Also, the importance of identifying methodological challenges faced by researchers when applying an index are considered, such as selection and weighting of food groups within a score, since food groups are not necessarily equivalent in their associations with CVD. The lack of absolute cutoff values, emphasis on increasing healthy food without limiting unhealthy food intake, and absence of validation of scores with biomarkers or other objective diet assessment methods further complicate decisions regarding the best indices to use. Future research should address these limitations, consider cross-cultural and other differences between population groups, and identify translational challenges inherent in attempting to apply a relevant diet quality index for use in CVD prevention at a population level.

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