Validity of two short screeners for diet quality in time-limited settings

Abstract

Objective: An urgent need in dietary assessment is the development of short tools that provide valid assessments of dietary quality for use in time-limited settings. The present study assessed concurrent and construct validity of the short Diet Quality Screener (sDQS) and brief Mediterranean Diet Screener (bMDSC) questionnaires. Design: Relative validity was measured by comparing three dietary quality indicesthe Diet Quality Index (DQI), the modified Mediterranean Diet Score (mMDS) and the Antioxidant Score (ANTOX-S) -derived from the two questionnaires with those from multiple 24 h recalls over 12 months. Construct validity was demonstrated by correlations between average nutrient intake recorded on multiple 24 h recalls and the DQI, mMDS and ANTOX-S derived by the short screeners. Setting: Both short questionnaires were administered to 102 participants recruited from a population-based survey in Spain. Results: DQI, mMDS and ANTOX-S correlated (P , 0?001) with the corresponding 24 h recall indices (r 5 0?61, 0?40 and 0?45, respectively). Limits of agreement lay between 96 and 126 %, 59 and 144 % and 61 and 118 % for the DQI, ANTOX-S and mMDS, respectively. Dietary intakes of fibre, vitamin C, vitamin E, Mg and K reported on the 24 h recalls were positively associated (P , 0?04) with the DQI, mMDS and ANTOX-S indices. Conclusions: The sDQS and bMDSC provide reasonable approximations to food-based dietary indices and accurately situate subjects within the indices constructed for the present validation study. Keywords Validation Short screener Construct validity Diet quality Mediterranean dietNon-communicable diseases such as CVD and cancer are estimated to be responsible for 60 % of world deaths, and dietary habits appear to be strong determinants for their development (1) . Therefore, analysis of dietary habits in large populations to identify dietary deficiencies is of paramount importance. FFQ are widely used to estimate food intake in large epidemiological settings. However, full-length FFQ are time consuming for participants and thus are unsuitable for routine clinical use and for non-dietary studies incorporating a broad spectrum of measurements. For this reason, several brief screening tools have been developed to assess intakes of major food groups. Most of these short dietary questionnaires focus on one or two dietary components (2)(3)(4)(5)(6)(7) . Only a few brief screeners assess a broader range of dietary intake (8,9) , an approach that might help to identify subjects at nutritional risk by indicating their level of adherence to diet quality recommendations. To address the need for a brief, effective instrument, we designed short dietary screeners for two different settings. The brief Mediterranean Diet Screener (bMDSC) is intended to assess adherence to the healthy Mediterranean dietary pattern. The short Diet Quality Screener (sDQS) was created to estimate overall diet quality in primary-care settings. We calculated a modified Mediterranean Diet Score (mMDS) and an y A full roster of REGIC...

Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity

“…Similar effects on metabolic indicators have been reported for pre-diabetic Mexican adults following a diet with a 50% reduction in carbohydrates and higher fruit, vegetable, and fiber content [47] The fiber consumption in the MSD group was greater than 16 g. This is similar to the value reported for a population on a diet with many food items typical of a Mediterranean diet [48]. The MSD group increased significantly the fiber consumption, this is beneficial, since it has been reported the association between a low fiber diet and higher adiposity and cardiovascular risk factors during childhood and adolescence [49,50].…”

Validity of a short diet-quality index to predict changes in anthropometric and cardiovascular risk factors: a simulation study

“…The simulation of responses can be considered a limitation of the present work. However, data from a previously conducted validation study in 102 men and women 8 revealed a good correlation (r ¼ 0.51) and low crossmisclassification (6.9%) between the DQI derived from the sDQS (actual response) and the DQI derived from a validated full-length FFQ. The sDQS was developed for the estimation of diet quality in a Spanish population.…”

“…The DQI derived from the simulated data was calculated, as described in the validation study. 8 The sDQS asked for the usual food intake of 18 food items grouped in 3 food categories over the past year. The first food category contains major food items such as bread, pasta and vegetables, the second category is devoted to meat and other food items from animal origin and the third category contains fish, legumes and nuts.…”

“…5,6 However, the administration of detailed and time-consuming dietary assessment methods is a burden in time-limited primary care settings and only a few short dietary assessment instruments are available that provide valid information on total diet quality. [7][8][9] Furthermore, the predictive validity (for example, how well the short screener predicts future health outcomes) was not addressed in these validation studies. 3,4,[7][8][9] We recently established the construct and concurrent validity of a short diet-quality index (DQI) derived from the short dietary quality screener (sDQS).…”

“…3,4,[7][8][9] We recently established the construct and concurrent validity of a short diet-quality index (DQI) derived from the short dietary quality screener (sDQS). 8 The objective of the present study was to determine the predictive validity of the DQI in a simulation study using data from a long-term population study.…”