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Open AccessArticle

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

1
Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
2
School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
3
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)
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 chronic diseases; diet quality; evaluation; prevention; type 2 diabetes; validation
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; Aittola, Kirsikka; Pölönen, Auli; Hemiö, Katri; Ahonen, Kirsti; Karhunen, Leila; Männikkö, Reija; Siljamäki-Ojansuu, Ulla; Tilles-Tirkkonen, Tanja; Virtanen, Eeva; Pihlajamäki, Jussi; Schwab, Ursula. 2021. "Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare" Int. J. Environ. Res. Public Health 18, no. 5: 2362. https://doi.org/10.3390/ijerph18052362

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