scholarly journals Examining the Validity of the Total Nutrient Index for Assessing Intakes of Nutrients From Foods, Beverages, and Dietary Supplements

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 871-871
Author(s):  
Alexandra Cowan ◽  
Shinyoung Jun ◽  
Janet Tooze ◽  
Kevin Dodd ◽  
Jaime Gahche ◽  
...  
Keyword(s):  
Dietary Supplements ◽  
Diet Quality ◽  
Pearson Correlation ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Data Availability ◽  
Biomarker Analysis ◽  
Usual Intake ◽  
Nutrient Index ◽  
Component Scores

Abstract Objectives To develop and validate the total nutrient index (TNI), a nutrient-based scoring system that assesses nutrient exposures from foods/beverages and dietary supplements (DS). Methods The TNI includes 8 shortfall micronutrients identified in the Dietary Guidelines for Americans: calcium, magnesium, potassium, choline, and vitamins A, C, D, E. Predicted usual intake is expressed as a percentage of the appropriate Recommended Dietary Allowance or Adequate Intake and truncated at 100 to compute component scores. The average of the component scores yields the total TNI score (range 0–100). Usual intakes from foods/beverages and DS of U.S. adults (≥19y) were estimated using a multivariate extension of the National Cancer Institute method. Data sources were two 24-hour recalls and a questionnaire/in-home inventory on DS use, collected in the 2011–2014 National Health and Nutrition Examination Survey (NHANES) (n = 9,954). Concurrent criterion validity was evaluated by comparing TNI scores between subpopulations with known differences in diet quality and by correlating component scores for vitamins A, C, D, and E with biomarker data. Due to data availability, biomarker analysis for vitamins A, C, and E used data from 2003–2006 NHANES (N = 8,861). Convergent validity was determined by correlating the TNI with the Healthy Eating Index (HEI-2015). Results The estimated mean total TNI score was 75.4; the same index calculated using foods/beverages only was 69.0. The TNI scores were significantly different (p < 0.001) for DS-users (83.5) vs. non-users (67.1), non-smokers (76.8) vs. smokers (70.3), and by food security status (food-secure: 76.6 vs. food-insecure: 69.1). The Pearson correlation of the TNI and HEI-2015 total score was 0.48, suggesting that the TNI captures dimensions of nutrient intake that are correlated with but distinct from those captured with the HEI-2015. Correlations of component scores with the available biomarkers ranged from 0.12 (α-tocopherol) to 0.36 (25(OH)D) and were all < 0.10 when DS were not included. Conclusions The TNI identifies total usual intake of shortfall nutrients and extends existing measures of diet quality by including nutrients obtained from DS. Tests of validity suggest the TNI is an effective tool in assessing total nutrient exposures of shortfall nutrients among U.S. adults. Funding Sources National Institutes of Health.

scholarly journals Dietary Restraint in Adolescence Predicts Diet Quality in Young Adulthood

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1323-1323
Author(s):  
Megan Lawless ◽  
Lenka Shriver ◽  
Jessica Dollar ◽  
Susan Calkins ◽  
Susan Keane ◽  
...  
Keyword(s):  
Young Adulthood ◽  
Diet Quality ◽  
Weight Control ◽  
Dietary Restraint ◽  
Poor Quality ◽  
Mean Value ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Health Study ◽  
Component Scores

Abstract Objectives Establishing a diet that follows the Dietary Guidelines for Americans has been associated with lower risk of mortality from cardiovascular disease and cancer. Some research has shown that individuals’ desire for weight control is an important factor in determining food choices. The aims of this study were to 1) examine dietary restraint in adolescence as a predictor of overall diet quality in young adulthood and 2) compare selected dietary components by levels of restraint. Methods Data were collected from participants enrolled in a longitudinal study in NC, the Right Track Health Study (n = 112). Dietary restraint was assessed using the 21-item subscale of the Three Factor Eating Questionnaire. Three 24-hour dietary recalls were collected to estimate dietary intake and Healthy Eating Index 2015 (HEI-2015) scores were calculated to determine diet quality. Multiple linear regression tested the association between restraint and diet quality, adjusting for sex, race, Body Mass Index-for-age percentiles and disinhibition in adolescence. Using the mean value for restraint (score of 6.64), “high restraint” and “low restraint” groups were created, and the specific HEI-2015 component scores were compared using t-tests. Level of significance was set at P < 0.05. Results Overall, participants consumed a poor-quality diet (HEI-2015 score = 50.24 ± 13.56). Higher restraint in adolescence (mean age 16.59 ± 0.39 years) was associated with higher total HEI-2015 score in young adulthood (mean age 18.74 ± 0.51) (β = 15.39 (95% CI: 3.44, 27.34) P = 0.01). The high restraint group had significantly higher HEI-component scores for total vegetables, greens and beans, total fruit, whole fruit, seafood and plant proteins, and added sugars. There were no differences between the two groups in the remaining HEI-2015 component scores (e.g., whole grains, fatty acids, sodium). Conclusions Higher dietary restraint in adolescence predicts better overall diet quality in young adulthood. Nevertheless, young adults in our sample failed to meet the federal dietary guidelines. Interventions aimed at improving diet quality should consider an individual's level of dietary restraint to better tailor nutrition advice. Funding Sources This research was supported by funding from NIH-NICHD and NIH-NIDDK.

scholarly journals Food and beverage choices contributing to dietary guidelines adherence in the Lower Mississippi Delta

2011 ◽  
Vol 14 (12) ◽  
pp. 2099-2109 ◽  
Author(s):  
Jessica L Thomson ◽  
Stephen J Onufrak ◽  
Carol L Connell ◽  
Jamie M Zoellner ◽  
Lisa M Tussing-Humphreys ◽  
...  
Keyword(s):  
Diet Quality ◽  
Mississippi Delta ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Alcoholic Beverages ◽  
Demographic Differences ◽  
Homogeneous Population ◽  
Added Sugars ◽  
Food And Beverage ◽  
Component Scores

AbstractObjectivesThe objectives of the present study were to evaluate diet quality among Lower Mississippi Delta (LMD) residents using the Healthy Eating Index-2005 (HEI-2005) and to identify the top five dietary sources contributing to HEI-2005 components. Demographic differences in HEI-2005 scores were also explored.DesignDiet quality was evaluated using HEI-2005. Demographic differences in HEI-2005 scores were investigated using multivariable regression models adjusting for multiple comparisons. The top five dietary sources contributing to HEI-2005 components were identified by estimating and ranking mean MyPyramid equivalents overall and by demographic characteristics.SettingDietary data, based on a single 24 h recall, from the Foods of Our Delta Study 2000 (FOODS 2000) were used in the analyses.SubjectsFOODS 2000 adult participants 18 years of age or older.ResultsYounger age was the largest determinant of low diet quality in the LMD with HEI-2005 total and seven component scores declining with decreasing age. Income was not a significant factor for HEI-2005 total or component scores. The top five dietary sources differed by all five of the demographic variables, particularly for total vegetables and energy from solid fats, alcoholic beverages and added sugars (SoFAAS). Soft drinks were the leading source of SoFAAS energy intake for all demographic groups.ConclusionsThe assessment of diet quality and identification of top dietary sources revealed the presence of demographic differences for selected HEI-2005 components. These findings allow identification of food patterns and culturally appropriate messaging and highlight the difficulties of treating this region as a homogeneous population.

scholarly journals Diet Quality and Inflammatory Index Score Among Women's Cancer Survivors

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 976-976
Author(s):  
Faten Hasan ◽  
Erin Kennedy ◽  
Kristin Guertin ◽  
Roger Anderson ◽  
Wendy Cohn ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Diet Quality ◽  
Pearson Correlation ◽  
Linear Regression Analysis ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Cancer Center ◽  
Inflammatory Index ◽  
Anti Inflammatory

Abstract Objectives In 2018, women's cancers accounted for 38.6% of new cases and 26.9% of cancer deaths in females worldwide. The risk of recurrence is partially attributed to lifestyle factors linked to inflammation, including diet quality. Adherence to U.S Department of Agriculture Dietary Guidelines, measured with the Healthy Eating Index (HEI-2015), and consuming an anti-inflammatory diet, measured with the Energy-adjusted Dietary Inflammatory Index (E-DII), are found to improve quality of life and reduce recurrence risk. The purpose of this study was to investigate HEI-2015 and E-DII scores in women's cancer survivors. Methods Survivors of women's cancers (N = 52, 65 ± 12 yrs) were recruited to complete a demographic questionnaire and three 24-hour dietary recalls using the Nutrient Data System for Research (NDSR). HEI-2015 and E-DII scores were calculated from average intakes. Linear regression analysis was used to examine the association between demographic factors (age, BMI, education, rurality, income, financial security, years since active treatment, and weight goals) and HEI-2015 and E-DII scores. Pearson Correlation was used to examine correlation between the two. Results On average, HEI-2015 score was 55 ± 13.5 (29.7–84.6), lower than the national average, and E-DII score was -1.14 ± 2.24 (−5.66–3.22). 54% of women had anti- inflammatory (<−1), 17% had pro-inflammatory (>1), and 29% women had relatively neutral (−1 to 1) diets. Women with a graduate degree (P = 0.03) and who completed treatment more than 4 years prior (P = 0.01) had higher HEI-2015 scores. There were no associations between SES and E-DII scores. Most notably, higher diet quality was associated with more anti-inflammatory diets (r = −0.67, P < 0.001). Conclusions While diet quality of women cancer survivors is comparatively low, the association with its inflammatory potential is a promising avenue for preventing recurrence. Higher E-DII scores are correlated with increased inflammatory markers, cardiovascular disease and metabolic syndrome risk, greater risk ratio and 75% increased mortality for several cancers. Guidelines for reducing inflammation will allow Registered Dietitians to provide specific, evidence-based oncology nutrition services, such as education, counseling, and medical nutrition therapy (MNT). Funding Sources This was funded by the University of Virginia Cancer Center.

scholarly journals Dietary intake and diet quality by weight category among a racially diverse sample of women in Birmingham, Alabama, USA

2020 ◽  
Vol 9 ◽  
Author(s):  
Rebecca B. Little ◽  
Renee Desmond ◽  
Tiffany L. Carson
Keyword(s):  
Diet Quality ◽  
Weight Status ◽  
Vegetable Intake ◽  
The United States ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Rank Test ◽  
Deep South ◽  
Weight Category ◽  
Maximum Score

Abstract Diet is a modifiable contributor to health. The lack of adherence to recommended dietary guidelines may contribute to the disproportionate burden of obesity and other chronic conditions observed in the Deep South region of the United States. The objective of this cross-sectional study was to describe food group intake and diet quality by race and weight status of women in the Deep South. Study participants were eighty-nine healthy female volunteers (56 % black, 44 % white, mean age 39⋅7 ± 1⋅4 years) recruited from Birmingham, AL, USA. Body Mass Index (BMI) determined weight status (non-obese/obese). Healthy Eating Index-2010 (HEI-2010) calculated from dietary recalls assessed diet quality. Wilcoxon sum-rank test compared HEI-2010 scores by race and weight status. χ2 analysis compared the percentage of women who achieved maximum points for HEI-2010 index food components by subgroup. Caloric and macronutrient intake did not differ by race or weight status (mean kcal 1863⋅0 ± 62⋅0). Median Total HEI-2010 Score for the sample was 51⋅9 (IQR: 39⋅1–63⋅4). Although there was no statistical difference in diet quality by race, more whites achieved the maximum score for vegetable intake compared to blacks, while blacks reported higher total fruit intake. Non-obese women reported better diet quality (56⋅9 v. 46⋅1; P = 0⋅04) and eating more whole fruits, and more achieved the maximum score for protein from plant and seafood sources. In summary, differences in diet quality were observed by weight status, but not race among this sample. These results point to tailored dietary interventions for women in metropolitan areas of Alabama, USA.

Abstract P108: Metabolic Profile Of Diet Quality In The Multi-Ethnic Study Of Atherosclerosis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Meghana Gadgil ◽  
Alexis F Wood ◽  
Ibrahim Karaman ◽  
Goncalo Gomes Da Graca ◽  
Ioanna Tzoulaki ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Diet Quality ◽  
Spectral Feature ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Elastic Net ◽  
Dietary Quality ◽  
Spectral Features ◽  
Ethnic Study ◽  
Diet Score

Introduction: Poor dietary quality is a well-known risk factor for diabetes and cardiovascular disease (CVD), however metabolites marking adherence to U.S. dietary guidelines are unknown. Our goal was to determine a pattern of metabolites associated with the Healthy Eating Index-2015 (HEI-2015). We hypothesize that there will be metabolites positively and negatively associated with the HEI-2015 score, including those previously linked to diabetes and CVD. Methods: Sample: 2269 adult men and women from the Multi-Ethnic Study of Atherosclerosis (MESA) longitudinal cohort study without known cardiovascular disease or diabetes. Data/specimens: Fasting serum specimens, diet and demographic questionnaires at baseline. Metabolomics: Untargeted 1 H NMR CPMG spectroscopy (600 MHz) annotated by internal and external reference data sets. Statistical analysis: Metabolome-wide association study (MWAS) using linear regression models specifying each spectral feature as the outcome in separate models, HEI-2015 score as the predictor, and adjustment for age, sex, race, and study site, accounting for multiple comparisons. Elastic net regularized regression was used to select an optimal subset of features associated with HEI-2015 score. Separately, hierarchical clustering defined discrete groups of correlated NMR features also tested for association with HEI-2015 score. Results: MWAS identified 1914 spectral features significantly associated with the HEI-2015 diet score. After elastic net regression, 35 metabolomic spectral features remained associated with HEI-2015 diet score. Cluster analysis identified seven clusters, three of which were significantly associated with HEI-2015 score after Bonferroni correction. (Table) Conclusions: Cholesterol moieties, proline betaine, proline/glutamate and fatty acyls chains were significantly associated with higher diet quality in the MESA cohort. Further analysis may clarify the link between dietary quality, metabolites, and pathogenesis of diabetes and CVD.

scholarly journals An Examination of Demographic and Psychosocial Factors, Barriers to Healthy Eating, and Diet Quality Among African American Adults

Nutrients ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 519 ◽  
Author(s):  
Ingrid Richards Adams ◽  
Wilson Figueroa ◽  
Irene Hatsu ◽  
James Odei ◽  
Mercedes Sotos-Prieto ◽  
...  
Keyword(s):  
Social Support ◽  
African American ◽  
African Americans ◽  
Psychosocial Factors ◽  
Healthy Eating ◽  
Diet Quality ◽  
Self Efficacy ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
African American Adults

A healthy diet is associated with lower risk of chronic disease. African Americans generally have poor diet quality and experience a higher burden of many chronic diseases. We examined the associations of demographic and psychosocial factors and barriers to diet quality among African American adults. This cross-sectional study included 100 African American adults in a southeastern metropolitan area. Psychosocial factors (social support, self-efficacy), and barriers to healthy eating were assessed with validated measures. Diet quality was assessed using the Healthy Eating Index (HEI-2010). Nested linear regressions were used to examine the association between the variables of interest and HEI scores. Participants reported having social support (M (mean) = 2.0, SD (standard deviation) = 0.6, range 0–3), high levels of self-efficacy (M = 3.1, SD = 0.7, range 1–4), and low barriers (M = 1.4, SD = 0.6, range 0–4) to engage in healthy eating but total mean HEI scores needed improvement (M = 54.8, SD = 10.9, range 27.1–70.0). Participants consumed significantly higher empty calories and lower whole fruits, dairy, and total protein foods than the national average. Barriers to healthy eating (b = −12.13, p = 0.01) and the interaction between age and barriers (b = 0.25, p = 0.02) were most strongly associated with lower HEI scores. Younger African Americans with the highest barriers to healthy eating had the lowest HEI scores. Culturally appropriate interventions targeting empty calories, barriers to healthy eating, and knowledge of the Dietary Guidelines for Americans are needed for African Americans.

scholarly journals Defining Diet Quality: A Review of Diet Metrics as Applied to the Double Burden of Malnutrition (OR17-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Victoria Miller ◽  
Patrick Webb ◽  
Renata Micha ◽  
Dariush Mozaffarian
Keyword(s):  
Healthy Eating ◽  
Diet Quality ◽  
Fruits And Vegetables ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Healthy Diet ◽  
Food Groups ◽  
Policy Action ◽  
Double Burden ◽  
Meta Analyses

Abstract Objectives Meeting most of the UN Sustainable Development Goals (SGDs) will require a strong focus on tackling all forms of malnutrition─ addressing maternal and child health (MCH) as well as diet-related non-communicable diseases (NCDs). Yet, the optimal metrics to define a healthy diet remain unclear. Our aim was to comprehensively review diet metrics and assess the evidence on each metric's association with MCH and NCDs. Methods Using comprehensive searches and expert discussions, we identified metrics that i) are used in ≥3 countries to link diet to health, ii) quantify the number of foods/food groups consumed and/or iii) quantify recommended nutrient intakes. We reviewed and summarized each metric's development, components and scoring. For each identified metric, we systematically searched PubMed to identify meta-analyses or narrative reviews evaluating these metrics with nutrient adequacy and health outcomes. We assessed validity by grading the number of studies included and the consistency of the diet metric-disease relationship. Results We identified 6 MCH, 13 NCD and 0 MCH/NCD metrics. Most were developed for describing adherence to dietary guidelines or patterns, and others were developed for predicting micronutrient adequacy. On average, the metrics included 14 food groups/nutrients (range 4–45), with 10 food-group only metrics and 0 nutrient-only metrics. The most frequent metric components were grains/roots/tubers, fruits and vegetables. We identified 16 meta-analyses and 14 narrative reviews representing 102 metric-disease relationships (98 metric-NCD and 4 metric-MCH relationships, respectively). We found 5 metrics that have been consistently validated in meta-analyses and narrative reviews for NCDs, 1 metric with limited evidence for MCH, but 0 metrics for both. Of the metrics, the Alternative Healthy Eating Index (aHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Mediterranean Diet Score (MED) were most commonly validated, especially for all-cause mortality and cardiovascular disease (Figure 1). Conclusions Few diet metrics have been used in multiple countries to define a healthy diet. This suggests a serious gap in global analyses of diet quality relating to malnutrition in all its forms, which hinders effective policy action. Funding Sources Gates Foundation. Supporting Tables, Images and/or Graphs

scholarly journals Diet Quality among Women with Previous Gestational Diabetes Mellitus in Rural Areas of Hunan Province

2020 ◽  
Vol 17 (16) ◽  
pp. 5942
Author(s):  
Mingshu Li ◽  
Jingcheng Shi ◽  
Jing Luo ◽  
Qing Long ◽  
Qiping Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Ethnic Minority ◽  
Diet Quality ◽  
Rural Areas ◽  
Healthy Eating Index ◽  
Dietary Guidelines ◽  
Hunan Province ◽  
Linear Regression Models

Diet quality is critical for postpartum type 2 diabetes mellitus (T2DM) progression among women with a history of gestational diabetes mellitus (GDM). The Chinese Healthy Eating Index (CHEI) is a dietary index developed according to the latest Chinese Dietary Guidelines (CDG-2016). Our study aimed to assess the diet quality of women with previous GDM in rural areas of Hunan Province by applying the CHEI. Women with previous GDM in two counties of Hunan were enrolled. Their food intake data, which were used to calculate their CHEI scores, were collected by a 24-h dietary recall. The association of CHEI with sociodemographic and anthropometric variables was evaluated via linear regression models. 404 women were included in the final analysis. The mean score of the total CHEI was 54.9 (SD 7.9). The components of whole grains and mixed beans, seeds and nuts, tubers, dairy, and poultry scored extremely low. Ethnic minority groups and women younger than 30 years had lower CHEI scores. Our study observed an unsatisfactory diet quality among women with previous GDM in rural areas of Hunan Province. Future dietary education focusing on the CDG is needed to improve their diet quality and help in T2DM prevention among this population, especially young and ethnic minority women.

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 Comparing Healthy Eating Index Scoring Methods and Different Dietary Assessment Instruments: The Interactive Diet and Activity Tracking in AARP (IDATA) Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 573-573
Author(s):  
Edwina Wambogo ◽  
Jill Reedy ◽  
Kirsten Herrick ◽  
Marissa Shams-White ◽  
Jennifer Lerman
Keyword(s):  
Healthy Eating ◽  
Dietary Assessment ◽  
Healthy Eating Index ◽  
Ratio Method ◽  
Plant Proteins ◽  
Scoring Methods ◽  
Activity Tracking ◽  
Usual Intake ◽  
Population Ratio ◽  
Component Scores

Abstract Objectives To compare five Healthy Eating Index-2015 (HEI-2015) scoring methods using 24-hour recalls (24HRs), 4-day food records (4DFRs), and food frequency questionnaires (FFQs). Methods Over 12 months, Interactive Diet and Activity Tracking in AARP (IDATA) study participants (N = 1021) aged 50–74 years completed up to six Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) recalls, 2 4DFRs, and 2 FFQs. Mean HEI-2015 total and component scores were estimated using five methods – two estimating usual intake: the multivariate Markov Chain Monte Carlo (MCMC) and bivariate; and three not estimating usual intake: per day, per person, and population ratio. Sums of squared differences (SSD) were calculated to compare differences among component scores. Results MCMC and bivariate methods estimated similar total mean HEI-2015 scores for men with 24HRs (60 points) and 4DFRs (61 points). The population ratio scores were comparable (63 points), but higher, and the per day was most different for both 24HRs and 4DFRs (57 points). This pattern was similar for women. With 24HR and 4DFRs, the population ratio method had higher component scores compared with MCMC and bivariate for Total Fruits, Whole Fruits, and Seafood and Plant Proteins. For example, among men, in 24HRs (comparing MCMC and population ratio), the SSD for Whole Fruit were 1.44 and those of Seafood and Plant Proteins were 0.49, compared to SSDs for other components which only ranged from 0.01 to 0.16. With FFQs, estimation of mean HEI scores is not recommended due to biases. However, when applying all methods, the total and component scores for FFQs were higher for Total Fruits, Whole Fruits, Greens and Beans, Dairy, Fatty Acids, Refined Grains, Sodium, and Saturated Fats. Conclusions Overall, the two usual intake methods (MCMC and bivariate) yield comparable total and component scores. The population ratio method adjusts for day-to-day variation by averaging data across populations, thus arrives at scores closer to the MCMC and bivariate, hence is the preferred method of estimating a population's mean usual HEI scores on the basis of a single day of data. When distributions are needed, the MCMC and bivariate methods are recommended to adjust for measurement error, consider episodic consumption and skewness, and account for correlation between each and or all constituents and energy. Funding Sources N/A.

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