Abstract
Adult diet quality indices are shown to predict nutritional adequacy of dietary intake as well as all-cause morbidity and mortality. This study describes the reproducibility and validity of a food-based diet quality index, the Australian Recommended Food Score (ARFS). ARFS was developed to reflect alignment with the Australian Dietary Guidelines and is modelled on the US Recommended Food Score. Dietary intakes of 96 adult participants (31 male, 65 female) age 30 to 75 years were assessed in two rounds, five months apart. Diet was assessed using a 120-question semi-quantitative food frequency questionnaire (FFQ). The ARFS diet quality index was derived using a subset of 70 items from the full FFQ. Reproducibility of the ARFS between round one and round two was confirmed by the overall intraclass correlation coefficient of 0.87 (95% CI 0.83, 0.90), which compared favourably to that for the FFQ at 0.85 (95% CI 0.80, 0.89). ARFS was correlated with FFQ nutrient intakes, particularly fiber, vitamin A, beta-carotene and vitamin C (0.53, 95% CI 0.37–0.67), and with mineral intakes, particularly calcium, magnesium and potassium (0.32, 95% CI 0.23–0.40). ARFS is a suitable brief tool to evaluate diet quality in adults and reliably estimates a range of nutrient intakes.
Highlights
The evaluation of relationships between health and intakes of single nutrients does not address the complexities of food and nutrient interactions in the human diet [1]
The reproducibility and comparative validity of the Australian Recommended Food Score (ARFS) in Australian adults was assessed in the current study by comparing food and nutrient intake data from the Australian Eating Survey (AES) food frequency questionnaire (FFQ) over two administration rounds five months apart, to estimate intra-class correlation coefficients (ICC)
The reproducibility of the ARFS was confirmed as shown by ICCs for each nutrient assessed as being similar to those for the Australian Eating Survey Food Frequency Questionnaire (AES FFQ)
Summary
The evaluation of relationships between health and intakes of single nutrients does not address the complexities of food and nutrient interactions in the human diet [1]. Given the complexity of assessing individual intakes, measurement of overall diet quality and variety by brief indices allows evaluation of several related aspects of dietary intake concurrently [3], and may provide a better measure of usual dietary intake patterns [4]. The relationship between diet quality indices and nutritional adequacy, morbidity and mortality in adults has been reviewed [3,6] This highlights that across these indices the risk for some health outcomes, including biomarkers of disease, incidence and risk of cardiovascular disease, some cancers and both cancer mortality and all-cause mortality can be quantified
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