Abstract
BackgroundIn India, there is a need to monitor population-level trends in changes in diet quality in relation to both undernutrition and noncommunicable diseases. ObjectivesWe conducted a study to validate a novel diet quality score in southern India. MethodsWe included data from 3041 nonpregnant women of reproductive age (15–49 years) from 2 studies in India. Diet was assessed using a validated food frequency questionnaire (FFQ). The Global Diet Quality Score (GDQS) was calculated from 25 food groups (16 healthy; 9 unhealthy), with points for each group based on the frequency and quantity of items consumed in each group. We used Spearman correlations to examine correlations between the GDQS and several nutrient intakes of concern. We examined associations between the GDQS [overall, healthy (GDQS+), and unhealthy (GDQS−) submetrics] and overall nutrient adequacy, micro- and macronutrients, body mass index (BMI), midupper arm circumference, hemoglobin, blood pressure, high density lipoprotein (HDL), and total cholesterol (TC). ResultsThe mean GDQS was 23 points (SD, 3.6; maximum, 46.5). In energy-adjusted models, positive associations were found between the overall GDQS and GDQS+ and intakes of calcium, fiber, folate, iron, monounsaturated fatty acid (MUFA), protein, polyunsaturated fatty acid (PUFA), saturated fatty acid (SFA), total fat, and zinc (ρ = 0.12–0.39; P < 0.001). Quintile analyses showed that the GDQS was associated with better nutrient adequacy. At the same time, the GDQS was associated with higher TC, lower HDL, and higher BMI. We found no associations between the GDQS and hypertension. ConclusionsThe GDQS was a useful tool for reflecting overall nutrient adequacy and some lipid measures. Future studies are needed to refine the GDQS for populations who consume large amounts of unhealthy foods, like refined grains, along with healthy foods included in the GDQS.
Highlights
In recent decades, India has witnessed an exponential increase in the burden of cardiometabolic diseases, with cardiovascular diseases contributing to 28.1% of total deaths and 14.1% of the total disability-adjusted life years in 2016 [1]
In this cross-sectional analysis of an urbanizing South Indian population, we found that a global metric of diet quality was very strongly associated with measures of nutrient adequacy but less so with cardiometabolic outcomes
The Global Diet Quality Score (GDQS) and the GDQS+ submetric were positively associated with the macronutrients protein and fat and several micronutrients that are of nutritional concern in low- and middle-income countries (LMIC), such as folate, fiber, and iron
Summary
India has witnessed an exponential increase in the burden of cardiometabolic diseases, with cardiovascular diseases contributing to 28.1% of total deaths and 14.1% of the total disability-adjusted life years in 2016 [1]. In India, there is a need to monitor population-level trends in changes in diet quality in relation to both undernutrition and noncommunicable diseases. Objectives: We conducted a study to validate a novel diet quality score in southern India. Methods: We included data from 3041 nonpregnant women of reproductive age (15–49 years) from 2 studies in India. The Global Diet Quality Score (GDQS) was calculated from 25 food groups (16 healthy; 9 unhealthy), with points for each group based on the frequency and quantity of items consumed in each group. We examined associations between the GDQS [overall, healthy (GDQS+), and unhealthy (GDQS−) submetrics] and overall nutrient adequacy, micro- and macronutrients, body mass index (BMI), midupper arm circumference, hemoglobin, blood pressure, high density lipoprotein (HDL), and total cholesterol (TC). Quintile analyses showed that the GDQS was associated with better nutrient adequacy.
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