Abstract
Identifying reliable metrics which measure the quality of a diet to promote nutrient adequacy and long-term health is an important step in the development of a sustainable food system. The Probability of Adequate Nutrient Intake (PANDiet) scoring system has been used as a measure of dietary quality in interdisciplinary research in recent years. The aim of the current study is to apply the PANDiet scoring system, and to assess the validity of the score as a metric of nutritional adequacy, within the Irish population. The Irish National Adult Nutrition Survey is a representative database with detailed data on nutrient intakes (18–90 years; n = 1051 valid-reporters; 2008–2010) and biofluid analytes (blood n = 786; urine n = 778). The PANDiet scoring system was expanded to include seven macronutrients, twelve micronutrients, nine minerals, and total energy using an established methodology. PANDiet scores were assessed against the Alternate Healthy Eating Index (AHEI) and Alternate Mediterranean Diet (aMED) food-based scores. The average score for the population (μ) was 63.69 ± 0.23 and ranged from 38.27 to 89.74. Higher PANDiet scores were significantly associated with males, higher educated participants, non-smokers, and low-energy-dense diets (p < 0.001). Females between the ages of 18 and 35 had a significantly lower nutrient adequacy score (μ 59.17). PANDiet scores were significantly correlated with serum folate, riboflavin status, serum vitamin D (p < 0.05) and with AHEI and aMED scores (Rs 0.45 and 0.43, p < 0.0001). The nutritional contribution of food groups varied between genders and low, moderate, and high nutritional adequacy groups. The PANDiet scoring system facilitated a detailed analysis of nutritional adequacy across sub-groups of the population, and is a comprehensive and valid diet quality metric in Irish databases.
Highlights
Transforming food systems to be healthier and more sustainable has become a focus of international research and policy in recent years
Two nutrient sub-scores had less than 25% probability of meeting recommendations: vitamin D and saturated fatty acids (SFA)
The remaining ten nutrients had a score over 75%: vitamin A, thiamin, total energy, folate, iron, niacin, protein, zinc, phosphorus, and cobalamin (Figure 1)
Summary
Transforming food systems to be healthier and more sustainable has become a focus of international research and policy in recent years. This transformation has been identified as a complex global challenge, as it requires co-ordination between multiple actors from different disciplines. That said, developing a DQI is complicated and many inconsistencies across DQIs exist, relating to validation and the foods and/or nutrients included [4]. This presents a risk of inadequate nutrition metrics being misleading and misrepresentative of actual diet and nutritional status [7]. It is imperative that scoring systems are critically evaluated before use, and, the comparability, reliability, reproducibility, sensitivity, and specificity of scores and their association with long-term health should be considered [4,8–10]
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