Abstract
The overall pattern of a diet (diet quality) is recognized as more important to health and chronic disease risk than single foods or food groups. Indexes of diet quality can be derived theoretically from evidence-based recommendations, empirically from existing datasets, or a combination of the two. We used these methods to derive diet quality indexes (DQI), generated from a novel dietary assessment, and to evaluate relationships with cardiometabolic risk factors in young adults with (n = 106) or without (n = 106) diagnosed depression (62% female, mean age = 21). Participants completed a liking survey (proxy for usual dietary consumption). Principle component analysis of plasma (insulin, glucose, lipids) and adiposity (BMI, Waist-to-Hip ratio) measures formed a continuous cardiometabolic risk factor score (CRFS). DQIs were created: theoretically (food/beverages grouped, weighted conceptually), empirically (grouping by factor analysis, weights empirically-derived by ridge regression analysis of CRFS), and hybrid (food/beverages conceptually-grouped, weights empirically-derived). The out-of-sample CRFS predictability for the DQI was assessed by two-fold and five-fold cross validations. While moderate consistencies between theoretically- and empirically-generated weights existed, the hybrid outperformed theoretical and empirical DQIs in cross validations (five-fold showed DQI explained 2.6% theoretical, 2.7% empirical, and 6.5% hybrid of CRFS variance). These pilot data support a liking survey that can generate reliable/valid DQIs that are significantly associated with cardiometabolic risk factors, especially theoretically- plus empirically-derived DQI.
Highlights
Young adults can show risks for type 2 diabetes and cardiovascular disease with a clustering of biological risks including prediabetes and metabolic syndrome
As diet quality indexes should be independent of energy consumed, we have shown that the liking-based diet quality index is independent of energy consumed in studies with preschoolers [39] and adults [30]
We found lower diet quality across all of the diet quality indexes among those with depression, which agrees with previous literature (e.g., [62,63,64])
Summary
Young adults can show risks for type 2 diabetes and cardiovascular disease with a clustering of biological risks including prediabetes and metabolic syndrome. Nutrients 2020, 12, 882 components that comprise the metabolic syndrome differs from young adults to later adulthood [3,4]. The components of the metabolic syndrome tend to correlate, and cardiometabolic risk scores have been suggested as a more sensitive and specific approach to assess cardiometabolic health and chronic disease risk relationships [4,5,6,7]. Greater abdominal or trunk adiposity in young adults results in greater risk of cardiometabolic risk in later adulthood [8,9]. Healthy behaviors, such as physical activity [10] and a healthy overall diet, can decrease the risk of cardiometabolic disorders. The healthiness of the diet or diet quality may provide a better predictor of disease risk [11] than specific nutrients [12] or restricted food patterns [13]
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