Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare

Lindström, Jaana; Aittola, Kirsikka; Pölönen, Auli; Hemiö, Katri; Ahonen, Kirsti; Karhunen, Leila; Männikkö, Reija; Siljamäki-Ojansuu, Ulla; Tilles-Tirkkonen, Tanja; Virtanen, Eeva; Pihlajamäki, Jussi; Schwab, Ursula

doi:10.3390/ijerph18052362

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Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare

^1,*

^2,†

^3,†

¹,

⁴,

^2,5,

Ulla Siljamäki-Ojansuu

⁴,

Tanja Tilles-Tirkkonen

Eeva Virtanen

¹,

Jussi Pihlajamäki

^2,5

and

Ursula Schwab

^2,5

Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland

School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland

Division 1, Tampere University Hospital, 33520 Tampere, Finland

⁴

Clinical Nutrition Unit, Tampere University Hospital, 33520 Tampere, Finland

⁵

Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 70029 Kuopio, Finland

Author to whom correspondence should be addressed.

^†

Authors with shared second authorship.

Academic Editor: Paul B. Tchounwou

Int. J. Environ. Res. Public Health 2021, 18(5), 2362; https://doi.org/10.3390/ijerph18052362

Received: 14 January 2021 / Revised: 13 February 2021 / Accepted: 22 February 2021 / Published: 28 February 2021

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Abstract

Lack of tools to evaluate the quality of diet impedes dietary counselling in healthcare. We constructed a scoring for a validated food intake questionnaire, to measure the adherence to a healthy diet that prevents type 2 diabetes (T2D). The Healthy Diet Index (HDI) consists of seven weighted domains (meal pattern, grains, fruit and vegetables, fats, fish and meat, dairy, snacks and treats). We studied the correlations of the HDI with nutrient intakes calculated from 7-day food records among 52 men and 25 women, and associations of HDI with biomarkers and anthropometrics among 645 men and 2455 women. The HDI correlated inversely with total fat (Pearson’s r = −0.37), saturated fat (r = −0.37), monounsaturated fat (r = −0.37), and the glycaemic index of diet (r = −0.32) and positively with carbohydrates (r = 0.23), protein (r = 0.25), fibre (r = 0.66), magnesium (r = 0.26), iron (r = 0.25), and vitamin D (r = 0.27), (p < 0.05 for all). In the linear regression model adjusted for BMI and age, HDI is associated inversely with waist circumference, concentrations of fasting and 2-h glucose and triglycerides in men and women, total and LDL cholesterol in women, and fasting insulin in men (p < 0.05 for all). The HDI proved to be a valid tool to measure adherence to a health-promoting diet and to support individualised dietary counselling. View Full-Text

Keywords: chronic diseases; diet quality; evaluation; prevention; type 2 diabetes; validation

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

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MDPI and ACS Style

Lindström, J.; Aittola, K.; Pölönen, A.; Hemiö, K.; Ahonen, K.; Karhunen, L.; Männikkö, R.; Siljamäki-Ojansuu, U.; Tilles-Tirkkonen, T.; Virtanen, E.; Pihlajamäki, J.; Schwab, U. Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare. Int. J. Environ. Res. Public Health 2021, 18, 2362. https://doi.org/10.3390/ijerph18052362

AMA Style

Lindström J, Aittola K, Pölönen A, Hemiö K, Ahonen K, Karhunen L, Männikkö R, Siljamäki-Ojansuu U, Tilles-Tirkkonen T, Virtanen E, Pihlajamäki J, Schwab U. Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare. International Journal of Environmental Research and Public Health. 2021; 18(5):2362. https://doi.org/10.3390/ijerph18052362

Chicago/Turabian Style

Lindström, Jaana, Kirsikka Aittola, Auli Pölönen, Katri Hemiö, Kirsti Ahonen, Leila Karhunen, Reija Männikkö, Ulla Siljamäki-Ojansuu, Tanja Tilles-Tirkkonen, Eeva Virtanen, Jussi Pihlajamäki, and Ursula Schwab. 2021. "Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare" International Journal of Environmental Research and Public Health 18, no. 5: 2362. https://doi.org/10.3390/ijerph18052362

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