Abstract
Because diet quality (DQ) is associated with risk of chronic disease and is a common construct assessed in health-related research, validated tools to assess DQ are needed that have low respondent and researcher burden. Thus, content experts develop the Short Healthy Eating Index (sHEI) tool and an associated scoring system. The sHEI scoring system was then refined using a classification and regression tree (CRT) algorithm methodology with an iterative feedback process with expert review and input. The sHEI scoring system was then validated using a concurrent criterion validation process that included the sHEI DQ scores (calculated from responses from 50 participants) being compared to the participants’ Healthy Eating Index scores derived from 24 h recalls. The total HEI score from the CRT algorithm highly correlated with the 24 h recall HEI score (0.79). For individual food group items, the correlation between the CRT algorithm scoring and the 24 h recall data scoring ranged from 0.44 for refined grains to 0.64 for whole fruits. The sHEI appears to be a valid tool for estimating overall dietary quality and individual items (with correlations > 0.49) for fruits, vegetables, dairy, added sugar, sugar from sugar-sweetened beverages, and calcium.
Highlights
The impact of what an individual eats on health outcomes is rarely influenced by any one eating event or single food [1]
A confirmatory analysis process was conducted to confirm the correlation of the Short Healthy Eating Index (sHEI) and the Dietary Screener Questionnaires (DSQs) with a larger sample
Pearson’s correlation in the DSQ items between the sHEI and the actual DSQ instrument from the training data (n = 50) can be found in Table 3, Column (a). These results showed that these food group intake amounts estimated using the sHEI had a moderate to high correlation with the DSQ
Summary
The impact of what an individual eats on health outcomes is rarely influenced by any one eating event or single food [1]. Health outcomes related to diet are a result of complex combinations of foods eaten together over time, which is referred to as dietary quality (DQ) [1,2]. High DQ has been suggested to reduce the risk and be a protective factor against chronic diseases, such as Type 2. A review conducted by Wirt and colleagues found that higher DQ was inversely associated with chronic disease risk and served as a protective factor against adverse health outcomes such as all-cause mortality, CVD mortality, CVD risk, cancer mortality, and all-cancer risk [2]. Diets high in dietary fiber may reduce the risk of some cancers, such as colorectal and breast cancer [8,9]. Greater intake of leafy greens was associated with a 14% reduced risk of DM [10], and leafy greens and berry intake has been associated with a decreased risk of cognitive decline or developing dementia [11]
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