Development of a Food-Based Diet Quality Score from a Short FFQ and Associations with Obesity Measures, Eating Styles and Nutrient Intakes in Finnish Twins

We constructed a food-based diet quality score (DQS) and examined its association with obesity measures, eating styles and nutrient intakes. Participants were 3592 individuals (764 dizygotic [DZ] and 430 monozygotic [MZ] twin pairs) from the FinnTwin16 study. The DQS (0–12 points) was constructed from a short 14 item food frequency questionnaire. Anthropometric measures and eating styles were self-reported. Nutrient intakes were calculated from food diaries completed in a subsample of 249 individuals (45 same-sex DZ and 60 MZ twin pairs). Twins were analyzed both as individuals and as twin pairs. The DQS was inversely associated with body mass index (β = −0.12, per one-unit increase in DQS, p < 0.001), waist circumference (β = −0.34, p < 0.001), obesity (odds ratio [OR]: 0.95, p = 0.004) and abdominal obesity (OR: 0.88, p < 0.001), independent of sex, age, physical activity and education. A higher DQS was associated with health-conscious eating, having breakfast, less snacking, fewer evening meals, and a higher frequency and regularity of eating. The DQS was positively correlated with the intakes of protein, fiber and magnesium and negatively correlated with the intakes of total fat, saturated fat and sucrose. Within twin pairs, most of the associations between the DQS with eating styles and some nutrients remained, but the DQS was not associated with obesity measures within twin pairs. The DQS is an easy-to-use tool for ranking adults according to diet quality and shows an association with obesity measures, eating styles and key nutrients in the expected direction.

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Development of a food-based diet quality score and associations with eating styles and nutrient intakes in Finnish twins

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003675 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Guiomar Masip ◽

Anna Keski-Rahkonen ◽

Kirsi H. Pietiläinen ◽

Urho M. Kujala ◽

Mirva Rottensteiner ◽

...

Keyword(s):

Diet Quality ◽

Fast Food ◽

Large Scale ◽

Low Cost ◽

Dietary Assessment ◽

Saturated Fat ◽

Quality Score ◽

Same Sex ◽

Nutrient Intakes ◽

Eating Styles

AbstractShort dietary assessment instruments are often included to large-scale twin studies that focus on multiple health behaviors and disease outcomes. Due to their feasibility and low cost, food frequency questionnaires (FFQs) are usually employed to provide data on dietary intake and diet quality. Diet quality have been linked with eating styles such as meal and snacking frequency. However, little is known about how diet quality is related with various eating styles. We aimed to construct a food-based diet quality score (DQS) from a short FFQ to estimate diet quality and to examine its association with eating styles and nutrient intakes in Finnish twins. Participants were 3592 twin individuals (764 dizygotic [DZ] pairs and 430 monozygotic [MZ] pairs) aged 31–37 from the wave 5 of the FinnTwin16 study. The DQS (range 0–12 points) was constructed from a short FFQ that included dark bread, white bread, fruits and berries, vegetables, fish, whole grain, fast food, fat free or reduced-fat milk or milk products, sugar-sweetened soft drinks or juices, energy drinks, butter and margarine/vegetable oils. Eating styles were self-reported by questionnaire. Nutrient intakes were calculated from food diaries completed in a subsample of 249 twin individuals (45 same-sex DZ pairs and 60 MZ pairs). Data were analyzed using Pearson correlations and multiple regression models adjusted for covariates in individuals and pairwise analyses. Both in individuals and within twin pairs, a higher diet quality was associated with health-conscious eating, having breakfast, fewer evening meals, and a higher frequency and regularity of eating. No associations were found with night eating styles, food as a reward or food restricting/overeating. Among individuals, the DQS was positively correlated with the intakes of protein, fiber and magnesium and negatively with the intakes of total fat, saturated fat and sucrose (rmax = 0.30 for magnesium). The associations with saturated fat, fiber and magnesium remained significant within same-sex DZ twin pairs (rmax = 0.40 for magnesium) and with sucrose within MZ twin pairs (r = -0.42). The DQS is an easy-to-use short tool for ranking individuals and twin pairs according to overall diet quality. The DQS reflects eating styles and intakes of key nutrients related to diet quality.

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Association of Time-of-Day Energy Intake Patterns with Nutrient Intakes, Diet Quality, and Insulin Resistance

Nutrients ◽

10.3390/nu13030725 ◽

2021 ◽

Vol 13 (3) ◽

pp. 725

Author(s):

Xiaoyun Song ◽

Huijun Wang ◽

Chang Su ◽

Zhihong Wang ◽

Feifei Huang ◽

...

Keyword(s):

Insulin Resistance ◽

Energy Intake ◽

Diet Quality ◽

Latent Class ◽

Asian Population ◽

Time Of Day ◽

Quality Score ◽

Nutrient Intakes ◽

Nutrition Survey ◽

Dominant Pattern

Evidence shows time-of-day of energy intake are associated with health outcomes; however, studies of time-of-day energy patterns and their health implication are still lacking in the Asian population. This study aims to examine the time-of-day energy intake pattern of Chinese adults and to examine its associations with nutrient intakes, diet quality, and insulin resistance. Dietary data from three 24-h recalls collected during the 2015 China Health and Nutrition Survey (CHNS) were analyzed (n = 8726, aged ≥ 18 years). Time-of-day energy intake patterns were determined by latent class analysis (LCA). General Linear Models and Multilevel Mixed-effects Logistic Regression Models were applied to investigate the associations between latent time-of-day energy intake patterns, energy-adjusted nutrient intakes, diet quality score, and insulin resistance. Three time-of-day energy intake patterns were identified. Participants in the “Evening dominant pattern” were younger, had higher proportions of alcohol drinkers and current smokers. The “Evening dominant pattern” was associated with higher daily energy intake and a higher percentage of energy from fat (%) (p < 0.001), as well as higher insulin resistance risk (OR = 1.21; 95% CI: 1.05, 1.40), after adjusting for multivariate covariates. The highest diet quality score was observed in participants with “Noon dominant pattern” (p < 0.001). A higher proportion of energy in the later of the day was associated with insulin resistance in free-living individuals.

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Fresh and Lean Beef Consumption in Relation to Nutrient Intakes and Diet Quality Among U.S. Adults, 2005–2016 (P18-057-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.p18-057-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Ruopeng An ◽

Sharon Nickols-Richardson ◽

Reginald Alston ◽

Sa Shen ◽

Caitlin Clarke

Keyword(s):

Vitamin B12 ◽

Diet Quality ◽

Eating Habits ◽

Sodium Intake ◽

Saturated Fat ◽

Vitamin B3 ◽

Nutrient Intakes ◽

Confounding Bias ◽

Lean Beef ◽

Daily Intakes

Abstract Objectives This study assessed the influence of beef consumption on nutrient intakes and diet quality among U.S. adults. Methods Nationally-representative sample (N = 27,117) from the National Health and Nutrition Examination Survey (NHANES) 2005–2016 waves were analyzed. First-difference estimator addressed confounding bias from time-invariant unobservables (e.g., eating habits, taste preferences) by using within-individual variations in beef consumption between 2 nonconsecutive 24-hour dietary recalls. Results Approximately 53.6%, 11.6%, and 6.7% of American adults consumed beef, fresh beef, lean beef, and fresh lean beef, respectively. An increase in lean beef and fresh lean beef consumption by one ounce-equivalent per day was associated with an increase in the Health Eating Index-2010 score by 0.20 (95% CI = 0.10, 0.29) and 0.29 (95% CI = 0.03, 0.55), respectively. Prevalence of beef, fresh beef, lean beef, and fresh lean beef consumption differed by sex, age, race/ethnicity, education level, and obesity status. An increase in beef, fresh beef, lean beef, and fresh lean beef consumption by one ounce-equivalent per day was found to be associated with an increase in intakes of total energy by 46.1, 39.6, 34.3, and 23.3 kcal, protein by 5.0, 4.1, 4.9, and 4.2 g, sodium by 66.6, 63.4, 35.8, and 39.1 mg, choline by 18.9, 18.1, 19.4, and 18.9 mg, iron by 0.6, 0.6, 0.5, and 0.5 mg, selenium by 3.8, 3.4, 3.6, and 3.8 µg, zinc by 1.4, 1.2, 1.3, and 1.1 mg, phosphorus by 37.1, 37.5, 32.4, and 34.4 mg, vitamin B2 by 0.03, 0.05, 0.02, and 0.04 mg, vitamin B3 by 0.9, 0.6, 0.9, and 0.6 mg, and vitamin B6 by 0.1, 0.06, 0.1, and 0.07 mg, respectively. An increase in beef, fresh beef, and lean beef consumption by one ounce-equivalent per day was found to be associated with an increase in daily intakes of saturated fat by 0.9, 0.8, and 0.6 g, and vitamin B12 by 0.4, 0.3, and 0.4 µg, respectively. No association linking fresh lean beef consumption with daily intakes of saturated fat and vitamin B12 was identified. Conclusions Beef consumers are advised to increase their share of fresh and lean beef over total beef intake in an effort to maximize their nutritional gains from beef consumption while minimize the resultant increase in energy, saturated fat, and sodium intake. Funding Sources National Cattlemen's Beef Association.

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Dietary intakes and anthropometric measures of Indigenous Australian women and their infants in the Gomeroi gaaynggal cohort

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174416000325 ◽

2016 ◽

Vol 7 (5) ◽

pp. 481-497 ◽

Cited By ~ 6

Author(s):

A. M. Ashman ◽

C. E. Collins ◽

L. J. Weatherall ◽

L. Keogh ◽

L. J. Brown ◽

...

Keyword(s):

Small Sample Size ◽

Saturated Fat ◽

Small Sample ◽

Indigenous Australians ◽

Breastfeeding Initiation ◽

Dietary Intakes ◽

Nutrient Intakes ◽

Indigenous Australian ◽

Anthropometric Measures ◽

Cross Sectional

Indigenous Australians continue to experience disparities in chronic diseases, many of which have nutrition-related trajectories. Optimal nutrition throughout the lifespan is protective for a number of adverse health outcomes, however little is known about current dietary intakes and related anthropometric outcomes of Indigenous women and their infants. Research is required to identify nutrition issues to target for health promotion activities. The Gomeroi gaaynggal programme is an ongoing, prospective cohort of pregnant Indigenous Australian women and their children. A cross-sectional examination of postnatal dietary intakes and anthropometric outcomes of mothers and children are reported. To date, 73 mother–child dyads have participatedpostpartum. Breastfeeding initiation was 85.9% and median (interquartile range) duration of any breastfeeding was 1.4 (0.5–4.0) months. Infants were introduced to solid foods at 5.0 months (4.0–6.0) and cow’s milk at 12.0 (10.0–13.0) months. At 12 monthspostpartum, 66.7% of women were overweight or obese, 63.7% at 2 years. Compared with recommendations, reported median maternal nutrient intakes from 24-h recall were low in fibre, folate, iodine, calcium, potassium and vitamin D and high in proportions of energy from total and saturated fat. Limitations of this study include a small sample size and incomplete data for the cohort at each time point. Preliminary data from this ongoing cohort of Indigenous Australian women and children suggest that women may need support to optimize nutrient intakes and to attain a healthy body weight for themselves and their children.

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Calibration of the dietary questionnaire for the Canadian Study of Diet, Lifestyle and Health cohort

Public Health Nutrition ◽

10.1079/phn2002362 ◽

2003 ◽

Vol 6 (1) ◽

pp. 79-86 ◽

Cited By ~ 30

Author(s):

Meera G Jain ◽

Thomas E Rohan ◽

Colin L Soskolne ◽

Nancy Kreiger

Keyword(s):

Saturated Fat ◽

Correlation Coefficients ◽

Epidemiological Studies ◽

Canadian Study ◽

Nutrient Intakes ◽

Food Component ◽

Median Correlation ◽

Calibration Study ◽

Total Fat ◽

The Relationship

AbstractObjective:For proper interpretation of results from epidemiological studies that use food-frequency questionnaires (FFQs), it is necessary to know the relationship between reported intakes from the FFQ and true usual intake. In this paper, we report a calibration study conducted to investigate the performance of the FFQ used in a cohort study, the Canadian Study of Diet, Lifestyle and Health.Methods:Over a 1-year period, 151 men and 159 women completed a full set of questionnaires including a self-administered baseline FFQ, three 24-hour diet recalls administered by telephone, and a second FFQ self-administered subsequently. The association between the nutrient estimates derived from the FFQs and the diet recalls was evaluated by calculating deattenuated Pearson's correlation coefficients.Results:The FFQs estimated mean daily nutrient intakes higher than the diet recalls. When the log-transformed and energy-adjusted nutrient intakes from the average of three 24-hour recalls were compared against the baseline FFQ, the following deattenuated correlations were obtained in men and women, respectively: total energy 0.44 and 0.32, total fat 0.64 and 0.68, saturated fat 0.68 and 0.70, dietary fibre 0.65 and 0.44, vitamin E 0.32 and 0.37, vitamin C 0.40 and 0.37, β-carotene 0.34 and 0.29, alcohol 0.74 and 0.67, caffeine 0.81 and 0.76, with a median correlation of 0.49 and 0.53. Correlations between the second FFQ and diet recalls were similar. The correlations between the two FFQs as a test of reliability had a median value 0.64 for men and 0.63 for women for selected nutrients.Conclusions:The study suggests that the FFQ method gives acceptable levels of nutrients or food component estimates, as assessed by this calibration study against diet recalls, when limited to energy-adjusted and deattenuated values.

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Perceived and objective diet quality in US adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES)

Public Health Nutrition ◽

10.1017/s1368980014000196 ◽

2014 ◽

Vol 17 (12) ◽

pp. 2641-2649 ◽

Cited By ~ 22

Author(s):

Tiffany M Powell-Wiley ◽

Paige E Miller ◽

Priscilla Agyemang ◽

Tanya Agurs-Collins ◽

Jill Reedy

Keyword(s):

National Health ◽

Diet Quality ◽

Mexican Americans ◽

Saturated Fat ◽

Cross Sectional Study ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Dietary Recall ◽

Health And Nutrition ◽

Total Fat

AbstractObjectiveThe Dietary Approaches to Stop Hypertension (DASH) dietary pattern has been shown to reduce cardiometabolic risk. Little is understood about the relationship between objective diet quality and perceived diet quality (PDQ), a potential psychosocial barrier to appropriate dietary intake. We compared PDQ and diet quality measured by a nutrient-based DASH index score in the USA.DesignCross-sectional study. Participants in the 2005–2006 National Health and Nutrition Examination Survey (NHANES) rated diet quality on a 5-point Likert scale and PDQ scores were generated (low, medium, high). A single 24 h dietary recall was used to estimate DASH index scores (range 0–9 points) by assigning 0, 0·5 or 1 point (optimal) for nine target nutrients: total fat, saturated fat, protein, cholesterol, fibre, Ca, Mg, K and Na.SettingNationally representative sample of the US population.SubjectsAdults aged ≥19 years in 2005–2006 NHANES (n 4419).ResultsParticipants with high PDQ (33 %) had higher DASH index scores (mean 3·0 (sd 0·07)) than those with low PDQ (mean 2·5 (sd 0·06), P < 0·001), but average scores did not align with targets for intermediate or optimal DASH accordance. Adults with high PDQ reported higher total fat, saturated fat and Na intakes compared with optimal DASH nutrient goals. Differences between those with high v. low PDQ were similar for Whites and Blacks, but there was no difference between PDQ groups for Mexican Americans.ConclusionsAmong Whites and Blacks, but not Mexican Americans, high PDQ may be associated with higher diet quality, but not necessarily a diet meeting DASH nutrient goals. This disconnect between PDQ and actual diet quality may serve as a target in obesity prevention.

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The impact of food industry reformulation, innovation and consumer preference on dietary intakes in Ireland: a probabilistic intake model

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003651 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Maeve Cushen ◽

Noel Rogers ◽

Rebecca Barron ◽

Jasmin Wonik ◽

Beata Stanek ◽

...

Keyword(s):

Food Industry ◽

Consumer Preferences ◽

Saturated Fat ◽

Consumer Preference ◽

Rank Test ◽

Dietary Intakes ◽

Nutrient Intakes ◽

Increased Risk ◽

Total Fat ◽

The Impact

AbstractStrong evidence exists linking poor diet to increased risk of overweight, obesity and non-communicable diseases. Reformulation initiatives, whereby the food industry gradually reduces energy, sodium, sugar, fat and saturated fat content of their products, are identified as important strategies to improve dietary intakes. The analysis aimed to examine the impact of voluntary reformulation, changes to products on the market and changes in consumer preferences on dietary intakes in Ireland from 2005 to 2017. Data on composition and volume sales (kg/ year) of products available on the market in 2005 and 2017 were collected from 15 Food Drink Ireland (FDI) member companies via online templates. These products were assigned to appropriate food and beverage groups identified in four Irish University Nutrition Alliance (IUNA) surveys of preschool children (1–4 years), children (5–12 years), teenagers (13–17 years) and adults (18–90 years). Assignment of FDI products to IUNA foods and beverages was carried out using weighted distributions for a given group of foods. The weightings were taken from the sales volumes of similar products relative to one another in a given category in a given year. Monte Carlo simulations were used to run the IUNA survey consumption data with both sets of weighted composition data from 2005 and 2017. The Creme Global intake model was used to estimate daily energy and nutrient intakes for all four populations during 2005 and 2017. The Wilcoxon-signed rank test was used to test for differences between the two years. Changes in both the products available on the market and market share of these products were observed from 2005 to 2017. The nutrient with the greatest intake reduction between the two years for all ages was sugar. Children and teens were the most affected, where total sugar intakes reduced by 3.2g/d and 2.7g/d, respectively. This reduction was primarily driven by the beverage category. There were modest saturated fat intake reductions observed for teens and adults (0.2g/d and 0.5g/d, respectively). Energy, total fat and sodium intakes for all ages remained relatively stable between the two years. This analysis highlights the impact of not only food industry efforts but also consumer choices on nutrient intakes in Ireland. It is worth noting that the data collected predates the sugar tax on sugar-sweetened beverages in Ireland. Reductions in sugar intakes were not compensated by total fat or energy increases.

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A healthy dietary pattern with a low inflammatory potential reduces the risk of gestational diabetes mellitus

European Journal of Nutrition ◽

10.1007/s00394-021-02749-z ◽

2021 ◽

Author(s):

Lotta Pajunen ◽

Liisa Korkalo ◽

Ella Koivuniemi ◽

Noora Houttu ◽

Outi Pellonperä ◽

...

Keyword(s):

Diabetes Mellitus ◽

Fatty Acids ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Diet Quality ◽

Dietary Pattern ◽

Trans Fatty Acids ◽

Nutrient Intakes ◽

Eating Frequency ◽

Total Fat

Abstract Purpose An optimal diet for lowering the risk of gestational diabetes mellitus (GDM) is still to be defined, but may comprise of nutrient intakes, dietary patterns, diet quality, and eating frequency. This study was designed to investigate the contribution of diet in developing GDM in a comprehensive way. Methods The dietary intake of overweight or obese women, a risk group for GDM (n = 351), was assessed using 3-day food diaries and diet quality questionnaires in early pregnancy. Eating frequency and nutrient intakes were calculated, and dietary patterns identified using principal component analysis. The inflammatory potential of the diet was determined by calculating the dietary inflammatory index (DII®) and energy-adjusted DII (E-DII™). GDM was diagnosed with an oral glucose tolerance test at 24–28 gestational weeks. Results Higher adherence to ‘healthier dietary pattern’ characterized by consumptions of vegetables and rye bread associated with a reduced risk of GDM (adjusted OR 0.27, 95% CI 0.11–0.70). Higher E-DII score, indicating pro-inflammatory diet, was associated with a 27% higher risk of GDM (adjusted OR 1.27; 95% CI 1.08–1.49) for each E-DII point. In the evaluation of nutrient intakes, total fat, saturated fatty acids (SFAs), and trans fatty acids were higher and fiber lower in women developing GDM compared to women not developing GDM (all p < 0.05). Intakes of total fat, SFAs, and trans fatty acids were also significant predictors for GDM (all p < 0.05). Conclusions The results emphasize the importance of an overall healthy diet and limitation of foods with SFAs, and other nutrients with a high inflammatory potential in reducing the risk of GDM. Trial registration ClinicalTrials.gov Identifier: NCT01922791, August 14, 2013.

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Nutrient intake over time in a multi-ethnic sample of youth

Public Health Nutrition ◽

10.1079/phn2002255 ◽

2002 ◽

Vol 5 (2) ◽

pp. 319-328 ◽

Cited By ~ 38

Author(s):

Leslie A Lytle ◽

John H Himes ◽

Henry Feldman ◽

Michelle Zive ◽

Johanna Dwyer ◽

...

Keyword(s):

African American ◽

Nutrition Education ◽

African American Students ◽

Saturated Fat ◽

Childhood And Adolescence ◽

Nutrient Intakes ◽

American Students ◽

Race Ethnicity ◽

Total Fat ◽

Over Time

AbstractObjectives:The purpose of this paper is to present longitudinal data on nutrient intakes of youth with emphases on differences by sex and race/ethnicity. Nutrients selected for examination are those implicated in chronic disease.Design:24-hour dietary recalls were collected from a cohort of third, fifth and eighth graders (n=1874).Setting and subjects:The sample is drawn from the Child and Adolescent Trial for Cardiovascular Health and includes students from California, Louisiana, Minnesota and Texas.Results:Across the total sample, nutrient intakes met recommended levels except that total fat, saturated fat and sodium consistently exceeded recommendations and calcium and iron intake of girls consistently fell short of recommended levels. Nutrient consumption between third and eighth grade differed by sex and race/ethnicity for a number of nutrients. In particular, females' intake of energy from total fat, calcium, iron, folic acid, vitamin A and vitamin D decreased over time relative to males' intakes, controlling for overall energy intake. Compared with the other ethnic/racial groups, African-American students increased their intake of energy from total fat and saturated fat over time.Conclusions:Our results suggest that the diets of youth change over time, and negative trends are more common in females than in males and in African-American and Hispanics compared with Caucasian students. Nutrition education and intervention are needed throughout childhood and adolescence with an emphasis on choosing healthful foods. In addition, greater attention to differential opportunities and reinforcements for females and males, and Caucasian, Hispanic and African-American students is warranted.

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A Novel Food-Based Diet Quality Score Is Associated with Nutrient Adequacy and Reduced Anemia Among Rural Adults in Ten African Countries

Current Developments in Nutrition ◽

10.1093/cdn/nzaa061_009 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1381-1381

Author(s):

Sabri Bromage ◽

Yiwen Zhang ◽

Michelle Holmes ◽

Wafaie Fawzi ◽

Sonia Sachs ◽

...

Keyword(s):

Diet Quality ◽

Dietary Diversity ◽

Dietary Assessment ◽

Food Group ◽

Quality Score ◽

Food Groups ◽

Nutrient Intakes ◽

African Countries ◽

Novel Food ◽

Nutrient Adequacy

Abstract Objectives We aimed to develop and evaluate an easily-tabulated metric that is sensitive to diet quality in diverse settings. In this analysis, we examined associations between a novel food-based metric – the Global Diet Quality Score (GDQS) - and diet quality using data from rural Africa. Methods The GDQS gives points for higher intake of 16 healthy food groups and lower intake of 9 unhealthy groups, based on 3 intake ranges for each group. We scored the GDQS using food frequency questionnaire (FFQ) data from 1613 men and 1710 nonpregnant nonlactating women ages 15–49 (median: 30) in 12 rural African villages participating in the Millennium Villages Project in 2006 to 2009. We evaluated associations between the GDQS and nutrient intakes calculated from the same FFQ, body mass index (BMI), mid-upper arm circumference (MUAC), hemoglobin, and an overall nutrient adequacy score ranging from 0 to 7 (1 point given for each of 7 nutrients meeting average requirements). Associations were also derived for GDQS submetrics (GDQS+ and GDQS−) computed using only healthy or unhealthy food groups, respectively, and simplified versions of the GDQS and submetrics (scored using 2 intake ranges for each food group). Results Moderate rank correlations were observed between the GDQS+ and energy-adjusted intakes of fiber (women: 0.43, men: 0.33), folate (0.40, 0.30), vitamin A (0.40, 0.34), and zinc (0.38, 0.30), exceeding correlations with the Minimum Dietary Diversity Score for Women (p for difference between metrics <0.05 for fiber and folate in both sexes). The simplified GDQS- correlated moderately with energy-adjusted saturated fat intake (women: 0.35, men: 0.29). Rank correlations between the GDQS+ and overall nutrient adequacy score differed notably by country (range: 0.34–0.75), but not by age or season. Adjusting for age, interview month, and household size, the GDQS and GDQS+ were associated with hemoglobin and anemia (p for difference between metrics >0.05): women and men in the highest GDQS+ quintile had an OR of anemia of 0.25 (95% CI 0.09, 0.68) and 0.16 (95% CI 0.04, 0.46), respectively, relative to those in the lowest. Metrics were not associated with BMI or MUAC in adjusted analyses. Conclusions The GDQS and submetrics were associated with nutrient intakes, hemoglobin, and reduced anemia in rural African adults. Funding Sources Intake - Center for Dietary Assessment at FHI Solutions.

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