scholarly journals Diet Quality Index for older adults (DQI-65): development and use in predicting adherence to dietary recommendations and health markers in the UK National Diet and Nutrition Survey

2021 ◽  
pp. 1-39
Author(s):  
Nicole Dorrington ◽  
Rosalind Fallaize ◽  
Ditte A. Hobbs ◽  
Michelle Weech ◽  
Julie A. Lovegrove

Abstract Diet quality indexes (DQIs) are useful tools for assessing diet quality in relation to health and guiding delivery of personalised nutritional advice, however existing DQIs are limited in their applicability to older adults (aged ≥65 years). Therefore, this research aimed to develop a novel evidence-based DQI specific to older adults (DQI-65). Three DQI-65 variations were developed to assess the impacts of different component quantitation methods and inclusion of physical activity. The variations were: Nutrient and Food-based DQI-65 (NFDQI-65), NFDQI-65 with Physical Activity (NFDQI-65+PA) and Food-based DQI-65 with Physical Activity (FDQI-65+PA). To assess their individual efficacy, the NFDQI-65, NFDQI-65+PA and FDQI-65+PA were explored alongside the validated Healthy Eating Index-2015 (HEI-2015) and Alternative Healthy Eating Index-2010 (AHEI-2010) using data from the cross-sectional UK National Diet and Nutrition Survey (NDNS) rolling programme. Scores for DQI-65 variations, the HEI-2015 and AHEI-2010 were calculated for adults ≥65 years from years 2-6 of the NDNS (n=871). Associations with nutrient intake, nutrient status and health markers were analysed using linear and logistic regression. Higher DQI-65s and HEI-2015 scores were associated with increased odds of meeting almost all of our previously proposed age-specific nutritional recommendations, and with health markers of importance for older adults, including lower body mass index, lower medication use and lower C-reactive protein (P<0.01). Few associations were observed for the AHEI-2010. This analysis suggests value of all three DQI-65s as measures of dietary quality in UK older adults. However, methodological limitations mean further investigations are required to assess validity and reliability of the DQI-65s.

2020 ◽  
pp. 1-9
Author(s):  
Amy R Gelfand ◽  
Christy C Tangney

Abstract Objective: To describe diet quality (Healthy Eating Index 2010 (HEI-2010) and Healthy Eating Index 2015 (HEI-2015)) according to self-reported cannabis use among the National Health and Nutrition Examination Survey (NHANES) adult participants. Design: Utilizing cross-sectional data, we assessed diet quality with up to two 24-h diet recalls from NHANES participants. Usual intakes were estimated via the multivariate Markov Chain–Monte Carlo method. Diet quality scores were compared among never users, previous users and current users of cannabis. Setting: NHANES surveys from 2005 to 2016. Participants: Adult NHANES participants (17 855) aged 20–59 years with valid data for dietary recalls and drug use questionnaires. Results: Current adult cannabis users (ages 20–59 years) had significantly lower total diet quality (HEI-2010) scores (51·8 ± 0·7) compared with previous (56·2 ± 0·4) and never users (57·7 ± 0·4). Similar differences in total and individual HEI-2015 scores were observed. For the HEI-2015 scores, cannabis users had a significantly higher (better) sodium scores (4·1 ± 0·2) compared with never users (3·3 ± 0·1) and previous users (3·2 ± 0·1). Cannabis users scored lower compared with never users on total vegetables (3·1 ± 0·1 v. 3·7 ± 0·0), total fruit (2·1 ± 0·1 v. 3·0 ± 0·1) and whole fruit (2·2 ± 0·1 v. 3·3 ± 0·1) for the HEI-2015 index. Conclusions: Current cannabis users’ usual intakes reflect lower diet quality compared with never or previous users, particularly lower subcomponent scores of total vegetables, greens and beans, total fruit and whole fruit. Cannabis users should increase their intake of fruit and vegetables to improve overall diet quality.


2013 ◽  
Vol 26 (4) ◽  
pp. 431-441 ◽  
Author(s):  
Anarlete da Silva Loureiro ◽  
Regina Maria Veras Gonçalves da Silva ◽  
Paulo Rogério Melo Rodrigues ◽  
Rosângela Alves Pereira ◽  
Loiva Lide Wendpap ◽  
...  

OBJECTIVE: To analyze the dietary quality of adults and to identify associated factors. METHODS: Cross-sectional study carried out in a sample of adults (n=195), aged 20-50 years, of both genders, from a population-based study in Cuiabá, Mato Grosso, Brazil. Food consumption data was collected by a food frequency questionnaire. Sociodemographic, lifestyle, anthropometric, and body composition data were also collected. Diet quality was analyzed by the Brazilian Healthy Eating Index-Revised. The associations were estimated by Poisson regression. RESULTS: The mean Brazilian Healthy Eating Index-Revised score was 75.2 points (CI95%=74.2-76.1), which differed significantly between the genders (p=0.03). Women had higher scores for whole fruit and sodium (p<0.01), while men had higher scores for oils, nuts, and fish fat (p=0.02). Individuals aged >30 years had higher total Brazilian Healthy Eating Index-Revised score and higher scores for the groups whole fruit; saturated fat; and calories from solid fats, alcoholic beverages, and added sugar (p<0.01). The Poisson regression between high Brazilian Healthy Eating Index-Revised and the independent variables showed that high Brazilian Healthy Eating Index-Revised was associated with being female, being aged 30 years or more, and being from families whose household head had 8 or more years of formal education. CONCLUSION: The factors associated with high Brazilian Healthy Eating Index-Revised were age, gender, and education level of the household head.


2017 ◽  
Vol 20 (9) ◽  
pp. 1564-1573 ◽  
Author(s):  
Zach Conrad ◽  
Micaela Karlsen ◽  
Kenneth Chui ◽  
Lisa Jahns

AbstractObjectiveTo compare diet quality scores between adult non-meat eaters and meat eaters, and to compare the consumption of diet components across quintiles of diet quality.DesignCross-sectional analysis. The Healthy Eating Index-2010 (HEI-2010) and Alternative Healthy Eating Index-2010 (AHEI-2010) were used to assess mean diet quality. Differences in consumption of diet components between quintiles of diet quality were tested usingpost hocWald tests andztests.SettingThe National Health and Nutrition Examination Survey (NHANES), 2007–2012.SubjectsThe sample consisted of 16810 respondents aged≥18 years, including 280 individuals who reported not consuming meat, poultry, game birds or seafood on two non-consecutive days of dietary recall. Dietary data were obtained from one dietary recall per individual.ResultsNon-meat eaters had substantially greater HEI-2010 and AHEI-2010 scores than meat eaters (P<0·05). Among non-meat eaters, mean consumption across HEI-2010 quintiles demonstrated different (P<0·05) amounts of empty calories and unsaturated:saturated fatty acids. Mean consumption across AHEI-2010 quintiles demonstrated different (P<0·05) amounts of nuts and legumes, vegetables and PUFA.ConclusionsPublic health messages targeted at vegetarians and others who may choose to eat meat-free on certain days should emphasize decreased consumption of empty calories, and increased consumption of nuts and legumes, PUFA and vegetables, as a way to improve overall dietary quality.


2021 ◽  
pp. 1-10
Author(s):  
Yeon Jin Choi ◽  
Eileen M Crimmins ◽  
Jung Ki Kim ◽  
Jennifer A Ailshire

Abstract Objective: A suboptimal diet and nutritional deficiencies can have important influences on health with significant impact among older adults. This study aims to assess the presence of suboptimal dietary intake among older Americans and identify risk and protective factors influencing diet quality. Design: Cross-sectional secondary analysis. Setting: USA. Participants: A nationally representative sample of 5614 community-dwelling older adults over age 54 in the Health and Retirement Study – Health Care and Nutrition Survey. Results: Overall, only 10·7 % of respondents had a good quality diet (Healthy Eating Index score 81 and above); the majority had diets considered poor or needing improvement. Less than 50 % of respondents met dietary guidelines and nutritional goals for most individual food groups and nutrients. Respondents with low socio-economic status, fewer psychosocial resources and those who had limited access to healthy food outlets were more likely to have a diet of suboptimal quality. Conclusions: Efforts to remove identified barriers that put older adults at risk for poor nutrition and to provide resources that increase access to healthy food should be made to encourage healthy eating and enhance diet quality.


Author(s):  
Shahrzad Mirashrafi ◽  
Marzieh Kafeshani ◽  
Akbar Hassanzadeh ◽  
Mohammad Hassan Entezari

Background and Aims: Due to the increasing prevalence of obesity and related disorders, there is an urgent need to examine the relationship between diet quality and public health. The Alternative Healthy Eating Index (AHEI) is one of the indices that is used to assess diet quality. Therefore, we investigated the relationship between AHEI and anthropometric measurements and blood pressure. Methods: In this cross-sectional study, 127 male and female hospital employees were examined. The AHEI was calculated by a 168 items Food Frequency Questionnaire. Body weight, height, Body Mass Index (BMI), Waist Circumference (WC), Waist-to-Hip Ratio (WHR) and blood pressure were measured by skilled nutritionists. Physical activity level was also obtained by International Physical Activity Questionnaire (IPAQ). Results : The mean total AHEI score in participants was reported as 47.1±6.9 (min=31.9, max=60.3). The mean differences of total AHEI score across the obese/non-obese employees were not statistically significant (P>0.05). Furthermore, there was no significant correlation between total AHEI score and BMI (r=0.019), WC (r=0.022), WHR (r=-0.102), systolic (r=-0.133) and diastolic blood pressure (r=-0.040) (P>0.05). The score of nuts and soybeans was inversely related to the WHR (P=0.008) and systolic blood pressure (P=0.030). Cereal fiber score had a negative relationship with BMI (P=0.02), WC (P=0.03), WHR (P=0.004) and systolic (P<0.001) and diastolic blood pressure (P=0.012). Conclusion: Consumption of nuts and soybeans -one serving per day- can be associated with WHR and systolic blood pressure reduction. More studies with a larger scale are needed to examine diet quality.


2016 ◽  
Vol 29 (4) ◽  
pp. 555-565 ◽  
Author(s):  
Daniel dos SANTOS ◽  
Jacqueline Queiroz da SILVEIRA ◽  
Thais Borges CESAR

ABSTRACT Objective: To assess the dietary intake and overall diet quality of female soccer players before the competitive games. Methods: This descriptive and cross-sectional study included 21 women aged 20.8±4.5 years from a professional soccer team. Their nutritional status and dietary adequacy during the training period, before competition season, were assessed. Dietary intake was assessed by three 24-hour recalls, one food frequency questionnaire, and the Healthy Eating Index, an overall diet quality index based on food group intake. Results: The athletes have shown proper nutritional status, but a diet deficient in energy due largely to low carbohydrate intake. On the other hand, the intakes of protein, fatty acids, and sodium were above the recommended intakes, even for athletes. Diet quality assessment by the Healthy Eating Index - 2010 resulted in a mean score of 54.6 points of a maximum of 100, indicating a need of improving the overall diet quality. Conclusion: The study found that the dietary patterns of female football players were both quantitatively and qualitatively inappropriate. A nutritional intervention is indicated to improve diet quality, with the inclusion of various foods, such as whole grains, fruits, vegetables, dairy products, and better protein quality, along with a reduction in saturated fats, sodium, and added sugar.


2010 ◽  
Vol 13 (8) ◽  
pp. 1170-1177 ◽  
Author(s):  
Megan E Grimstvedt ◽  
Kathleen Woolf ◽  
Brandy-Joe Milliron ◽  
Melinda M Manore

AbstractObjectiveTo assess the dietary quality of older women with and without rheumatoid arthritis (RA) using the Healthy Eating Index-2005 (HEI-2005) to identify potential strategies to improve the nutritional status.DesignCross-sectional. Diet was assessed using 7 d food records and analysed for nutrient composition (Food Processor v. 7·11). Diet quality was determined using the HEI-2005, a measure of compliance with 2005 US Dietary Guidelines. Individuals with RA completed a self-reported evaluation of arthritis (pain scale and disability index). Independent two-tailed t tests or Mann–Whitney tests compared the differences between groups and correlations were computed between HEI-2005 and measures of disease reactivity.SettingArizona, USA.SubjectsOlder (≥ 55 years) women (n 108) with RA (n 52) and healthy controls (HC; n 56).ResultsThere were no differences between groups in age, weight, or BMI (kg/m2). HC participants had higher mean HEI-2005 scores for whole fruit (cups; P = 0·02), total fruit (cups; P = 0·05), whole grains (oz; P = 0·004), oil (g; P = 0·05) and total HEI score (P = 0·04) than the RA group. In the RA group, these same HEI components were inversely correlated with disability index (r = −0·20, P = 0·04). Participants with RA reported lower mean intakes of carbohydrate (g; P = 0·02), fibre (g; P = 0·01) and vitamin C (mg; P = 0·04).ConclusionsThis is the first study examining the dietary quality in older women with and without RA using the HEI-2005. Living with RA was associated with significantly lower dietary quality. Since even small changes in dietary quality can translate into better nutritional status, future interventions should focus on increasing dietary quality in this high-risk group.


2020 ◽  
Vol 23 (13) ◽  
pp. 2384-2394 ◽  
Author(s):  
Julia A Wolfson ◽  
Cindy W Leung ◽  
Caroline R Richardson

AbstractObjective:To examine the association between cooking frequency and Healthy Eating Index (HEI)-2015, overall and by income, among US adults.Design:Cross-sectional analysis using multivariable linear regression models to examine the association between cooking frequency and total HEI-2015 score adjusted for sociodemographic variables, overall and stratified by income.Setting:Nationally representative survey data from the USA.Participants:Adults aged ≥20 years (with 2 d of 24 h dietary recall data) obtained from the 2007 to 2010 National Health and Nutrition Examination Survey (n 8668).Results:Compared with cooking dinner 0–2 times/week, greater cooking frequency was associated with higher HEI-2015 score overall (≥7 times/week: +3·57 points, P < 0·001), among lower-income adults (≥7 times/week: +2·55 points, P = 0·001) and among higher-income adults (≥7 times/week: +5·07 points, P < 0·001). Overall, total HEI-2015 score was higher among adults living in households where dinner was cooked ≥7 times/week (54·54 points) compared with adults living in households where dinner was cooked 0–2 times/week (50·57 points). In households in which dinner was cooked ≥7 times/week, total HEI-2015 score differed significantly based on income status (lower-income: 52·51 points; higher-income: 57·35 points; P = 0·003). Cooking frequency was associated with significant differences in HEI-2015 component scores, but associations varied by income.Conclusions:More frequent cooking at home is associated with better diet quality overall and among lower- and higher-income adults, although the association between cooking and better diet quality is stronger among high-income adults. Strategies are needed to help lower-income Americans consume a healthy diet regardless of how frequently they cook at home.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 205-205
Author(s):  
Sharmin Hossain ◽  
May A Beydoun ◽  
Michele K Evans ◽  
Alan B Zonderman ◽  
Marie Fanelli Kuczmarski

Abstract Objectives Prior studies on caregivers have focused mainly on the diet quality of their recipients, especially children. We investigated both cross-sectional and longitudinal associations of caregiver status and diet quality in older adults (mean 53.0 ± 9.0 years). Methods We studied participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (57.7% women, 62% African American) between wave 3 (2009–2013) and wave 4 (2013–2018). Caregiving was assessed at both waves, starting at wave 3. Healthy Eating Index-2010 (HEI2010) score, a measure of diet quality, was assessed from two 24-hour recalls at each wave on both occasions (mean 4.1 years follow-up). Baseline caregiving (at wave 3) was examined in relation to change in HEI between waves 3 and 4. Multivariable linear regression was performed for cross-sectional analysis; mixed-effects regression was performed for longitudinal analyses. Results are expressed as β-coefficients ± standard error of means (β±SE). Results After adjusting for age, sex, race and poverty status, more time spent taking care of grandchildren (N = 2033) was associated with poor diet quality (–1.51 ± 0.55, P = 0.006) in cross-sectional analysis (wave 4 caregiving and wave 4 HEI). However, in a separate cross-sectional analysis (wave 4 only) on dual (caring for both grandchildren and an elderly person) vs. single caregivers (either grandchildren or elderly) (N = 73; 24 men & 49 women) we found no difference in diet quality. The longitudinal analyses (N = 1848) demonstrated that diet quality did not change with caregiving over time for either grandchildren (P = 0.16) or others (not children & grandchildren) (P = 0.88). Overall, women tended to have better quality diet (P &lt; 0.001) than men. Conclusions Among relatively older caregivers, cross-sectional analyses revealed an inverse effect of caregiving with diet quality. Longitudinal research is needed to evaluate the temporal associations of dual caregiving with subsequent diet quality changes over time. Funding Sources The first author is supported by a Postdoctoral Fellowship from the Intramural Research Program (IRP) at the National Institute on Aging (NIA). HANDLS is supported by the Intramural Research Program, National Institute on Aging, National Institutes of Health, grant Z01-AG000513.


2018 ◽  
Vol 11 ◽  
pp. 117863881881884
Author(s):  
Dalila Pinto de Souza Fernandes ◽  
Maria Sônia Lopes Duarte ◽  
Milene Cristine Pessoa ◽  
Sylvia do Carmo Castro Franceschini ◽  
Andréia Queiroz Ribeiro

Background: The food consumption assessment is necessary to monitor elderly’s nutritional status because it allows detecting nutrition deficits and guiding the elaboration of effective conducts. Objective: The objective of this study is to assess the global quality of the elderly’s diet in Viçosa—MG, Brazil. Methods: This is a population-based cross-sectional study, involving noninstitutionalized elderly. Diet quality was assessed through the Brazilian Healthy Eating Index-Revised (BHEI-R) validated to the Brazilian population. Results: The study comprised 620 elderly individuals. The mean total BHEI-R score was 64.28. The worse consumption scores concerned the components Whole grains, Milk and derivatives, Sodium, Total fruit, and Whole fruit. Approximately 82% scored zero (0%) for Whole grains and 67% for Sodium. Men presented significantly lower scores than women, who have presented maximal score in the same items. Women’s scores were not only significantly higher for Total fruit, Whole fruit, Milk and derivatives, but also significantly lower for Saturated fat. Discussion: Most elderly need to improve their diet quality. Strategies heading toward the improvement of diet quality must be priority in policies to health promotion toward the healthy and active aging.


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