Comparisons of Four Diet Quality Indexes to Define Single Meal Healthfulness.

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Publisher: Elsevier Science Publishers
Document Type: Report
Length: 553 words

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Keywords Diet quality; Meal quality; Diet index; Nutrition assessment; Nutrition surveys Abstract Background Many dietary indexes exist to evaluate nutrition quality, but few specifically assess the quality of a single meal. Objective Our aim was to compare 4 different diet quality indexes in their ability to assess the nutrition quality of single meals. Design This was a secondary analysis of data from the PACE (Effects of Physical Activity Calorie Expenditure) food labeling study (2015-2017). Data were collected in business cafeterias in North Carolina and included photos of lunch trays before consumption from an adult population and serving sizes of each food item. Additional nutrient analysis was conducted to compile macro- and micronutrient data for each food item, in addition to servings provided from each food group. Main outcome measures The main outcome was individual meal nutrition quality. Data from the PACE study were used to calculate the scores of the following diet quality indexes: Healthy Eating Index 2015, Dietary Approaches to Stop Hypertension accordance score, Main Meal Quality Index, and Nutrient Rich Foods Index. Statistical analysis performed To score the meals, algorithms were created in SAS software, version 9.4, to combine individual foods and beverages into meals and calculate scores according to the individual index components. The total scores for each of the indexes were compared using Spearman correlation coefficients. Results A total of 8,070 observations or "meals" from 379 participants were scored for this study. The scores for each observation varied by index. The Spearman correlation coefficients between the indexes for the total score for all observations ranged from 0.26 to 0.68. The correlation coefficients did not change equally among the indexes when observations were excluded based on predefined criteria for what constitutes a meal. Conclusions There is wide variability in scores of the 4 diet quality indexes analyzed in this study. In addition, the indexes show weak to moderate correlation, indicating that the appropriateness of the index will depend greatly on the study questions and objectives. Author Affiliation: (1) Department of Public Health, Davidson College, Davidson, NC (2) Duke University School of Medicine, Durham, NC (3) Department of Nutrition, Gillings School of Global Public Health, and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC (4) Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC * Address correspondence to: Sally L. Bullock, PhD, MPH, Davidson College, Box 7135, Davidson, NC 28035. Article History: Received 3 November 2020; Accepted 10 June 2021 (footnote) STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors. (footnote) FUNDING/SUPPORT The PACE study was funded by R01 CA184473-01A1 from the National Cancer Institute, National Institutes of Health. The funding body played no role in study design, data collection, analysis, interpretation of data, or writing the manuscript. (footnote) AUTHOR CONTRIBUTIONS S. L. Bullock, H. M. Miller, and A. J. Viera conceived of the study; S. L. Bullock and H. M. Miller conducted literature review and meal index calculations; S. L. Bullock and H. M. Miller drafted manuscript. A. J. Viera and Alice S. Ammerman provided important intellectual content and critical revisions of manuscript. Byline: Sally L. Bullock, PhD, MPH [sabullock@davidson.edu] (1,*), Hilary M. Miller, MS, RD, LDN (2), Alice S. Ammerman, DrPH (3), Anthony J. Viera, MD, MPH (4)

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Gale Document Number: GALE|A686979909