Development of a Healthy Dietary Habits Index for New Zealand Adults.

Jyh Wong,Paula Skidmore,Anna Howe,Jillian Haszard,Winsome Parnell

doi:10.3390/nu9050454

Abstract

Healthful dietary habits are individually associated with better nutrient intake and positive health outcomes; however, this information is rarely examined together to validate an indicator of diet quality. This study developed a 15-item Healthy Dietary Habits Index (HDHI) based on self-reported dietary habits information collected in the 2008/09 New Zealand Adult Nutrition Survey. The validity of HDHI as a diet quality index was examined in relation to sociodemographic factors, 24-diet recall derived nutrient intakes, and nutritional biomarkers in a representative sample of adults aged 19 years and above. Linear regression models were employed to determine associations between HDHI quintiles and energy-adjusted nutrient data and nutritional biomarkers. Significantly higher HDHI scores were found among women, older age groups, Non-Māori or Pacific ethnic groups, and less socioeconomically-deprived groups (all p < 0.001). Increasing quintiles of HDHI were associated with higher intakes of dietary fibre and seven micronutrients including calcium, iron, and vitamin C, and lower intakes of energy, macronutrients, sodium, zinc, vitamins B6 and B12. Associations in the expected directions were also found for urinary sodium, whole blood folate, serum and red blood cell folate, and plasma selenium (all p < 0.001). The present findings suggest that the HDHI is a valid measure of diet quality as it is capable of discerning quality of diets of subgroups and ranking nutrient intakes among NZ adults.

Highlights

Dietary quality, as a global marker of food choices, has received much attention in terms of how it relates to health, with regard to chronic diseases, such as cardiovascular disease (CVD)and cancer [1]
We have previously developed a diet quality indices (DQI) for New Zealand (NZ) adolescents based on aggregated information from a dietary habits questionnaire and assessed its validity in a nationally representative sample of 15–18-year-old taking part in the NZ Adults Nutrition Survey (2008/09 NZANS)
We developed a 15-item diet index namely Healthy Dietary Habits Index (HDHI) based on dietary habits information and validated the index against information from 24-h diet recall and nutritional biomarkers in a representative sample of NZ adults

Summary

Introduction

As a global marker of food choices, has received much attention in terms of how it relates to health, with regard to chronic diseases, such as cardiovascular disease (CVD)and cancer [1]. HEI, Mediterranean Diet and Dietary Approaches to Stop Hypertension (DASH) scores) have all been shown to be associated with significant reduced risk of all-cause, CVD and cancer mortality [1,2,3]. Food Frequency Questionnaire (FFQ) or other questionnaires While this is the case in some studies [5,6,7], a large proportion of research involving dietary indices is based on nutrients and/or food components [1,8]. This requires the collection of comprehensive food intake data such as 24 h diet recalls or diet records. The collection of such in-depth dietary data is not feasible, financially or Nutrients 2017, 9, 454; doi:10.3390/nu9050454 www.mdpi.com/journal/nutrients

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