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

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-M?ori 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.

SUBMITTER: Wong JE

PROVIDER: S-EPMC5452184 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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

Wong Jyh Eiin JE Haszard Jillian J JJ Howe Anna S AS Parnell Winsome R WR Skidmore Paula M L PML

Nutrients 20170503 5

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 d ...[more]

PMID: 28467392

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Project description:BackgroundAs there is no population-specific, simple food-based diet index suitable for examination of diet quality in New Zealand (NZ) adolescents, there is a need to develop such a tool. Therefore, this study aimed to develop an adolescent-specific diet quality index based on dietary information sourced from a Food Questionnaire (FQ) and examine its validity relative to a four-day estimated food record (4DFR) obtained from a group of adolescents aged 14 to 18 years.MethodsA diet quality index for NZ adolescents (NZDQI-A) was developed based on 'Adequacy' and 'Variety' of five food groups reflecting the New Zealand Food and Nutrition Guidelines for Healthy Adolescents. The NZDQI-A was scored from zero to 100, with a higher score reflecting a better diet quality. Forty-one adolescents (16 males, 25 females, aged 14-18 years) each completed the FQ and a 4DFR. The test-retest reliability of the FQ-derived NZDQI-A scores over a two-week period and the relative validity of the scores compared to the 4DFR were estimated using Pearson's correlations. Construct validity was examined by comparing NZDQI-A scores against nutrient intakes obtained from the 4DFR.ResultsThe NZDQI-A derived from the FQ showed good reliability (r = 0.65) and reasonable agreement with 4DFR in ranking participants by scores (r = 0.39). More than half of the participants were classified into the same thirds of scores while 10% were misclassified into the opposite thirds by the two methods. Higher NZDQI-A scores were also associated with lower total fat and saturated fat intakes and higher iron intakes.ConclusionsHigher NZDQI-A scores were associated with more desirable fat and iron intakes. The scores derived from either FQ or 4DFR were comparable and reproducible when repeated within two weeks. The NZDQI-A is relatively valid and reliable in ranking diet quality in adolescents at a group level even in a small sample size. Further studies are required to test the predictive validity of this food-based diet index in larger samples.

Project description:The transition from adolescence to adulthood is a critical period for the development of healthy behaviors. Yet, it is often characterized by unhealthy food choices. Considering the current pandemic scenario, it is also essential to assess the effects of coronavirus disease-19 (COVID-19) on lifestyles and diet, especially among young people. However, the assessment of dietary habits and their determinants is a complex issue that requires innovative approaches and tools, such as those based on the ecological momentary assessment (EMA). Here, we describe the first phases of the "HEALTHY-UNICT" project, which aimed to develop and validate a web-app for the EMA of dietary data among students from the University of Catania, Italy. The pilot study included 138 students (mean age 24 years, SD = 4.2; 75.4% women), who used the web-app for a week before filling out a food frequency questionnaire with validation purposes. Dietary data obtained through the two tools showed moderate correlations, with the lowest value for butter and margarine and the highest for pizza (Spearman's correlation coefficients of 0.202 and 0.699, respectively). According to the cross-classification analysis, the percentage of students classified into the same quartile ranged from 36.9% for vegetable oil to 58.1% for pizza. In line with these findings, the weighted-kappa values ranged from 0.15 for vegetable oil to 0.67 for pizza, and most food categories showed values above 0.4. This web-app showed good usability among students, assessed through a 19-item usability scale. Moreover, the web-app also had the potential to evaluate the effect of the COVID-19 pandemic on students' behaviors and emotions, showing a moderate impact on sedentary activities, level of stress, and depression. These findings, although interesting, might be confirmed by the next phases of the HEALTHY-UNICT project, which aims to characterize lifestyles, dietary habits, and their relationship with anthropometric measures and emotions in a larger sample of students.

Project description:BackgroundThe only available predictive models for the outcome of breast cancer patients in New Zealand (NZ) are based on data in other countries. We aimed to develop and validate a predictive model using NZ data for this population, and compare its performance to a widely used overseas model, the Nottingham Prognostic Index (NPI).MethodsWe developed a model to predict 10-year breast cancer-specific survival, using data collected prospectively in the largest population-based regional breast cancer registry in NZ (Auckland, 9182 patients), and assessed its performance in this data set (internal validation) and in an independent NZ population-based series of 2625 patients in Waikato (external validation). The data included all women with primary invasive breast cancer diagnosed from 1 June 2000 to 30 June 2014, with follow up to death or Dec 31, 2014. We used multivariate Cox proportional hazards regression to assess predictors and to calculate predicted 10-year breast cancer mortality, and therefore survival, probability for each patient. We assessed observed survival by the Kaplan Meier method. We assessed discrimination by the C statistic, and calibration by comparing predicted and observed survival rates for patients in 10 groups ordered by predicted 10-year survival. We compared this NZ model with the Nottingham Prognostic Index (NPI) in this validation data set.ResultsDiscrimination was good: C statistics were 0.84 for internal validity and 0.83 for an independent external validity. For calibration, for both internal and external validity the predicted 10-year survival probabilities in all groups of patients, ordered by predicted survival, were within the 95% confidence intervals (CI) of the observed Kaplan-Meier survival probabilities. The NZ model showed good discrimination even within the prognostic groups defined by the NPI.ConclusionsThese results for the New Zealand model show good internal and external validity, transportability, and potential clinical value of the model, and its clear superiority over the NPI. Further research is needed to assess other potential predictors, to assess the model's performance in specific subgroups of patients, and to compare it to other models, which have been developed in other countries and have not yet been tested in NZ.

Dataset Information

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

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

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