The Comparative Validity and Reproducibility of a Diet Quality Index for Adults: The Australian Recommended Food Score
Abstract
:1. Introduction
2. Experimental Section
2.1. Subjects
2.2. Australian Eating Survey Food Frequency Questionnaire (AES FFQ)
2.3. Australian Recommended Food Score (ARFS)
2.4. Statistical Methods
2.5. Ethics
3. Results
Round 1 | Round 2 | |||||
---|---|---|---|---|---|---|
Male N = 20 | Female N = 47 | p * | Male N = 20 | Female N = 47 | p * | |
N (%) | N (%) | N (%) | N (%) | |||
Education § | ||||||
Year 10 | 1 (5%) | 3 (6%) | 1 (5%) | 3 (6%) | ||
Year 12 | 1 (5%) | 7 (15%) | 1 (5%) | 7 (15%) | ||
Trade | 3 (15%) | 1 (2%) | 5 (25%) | 1 (2%) | ||
Certificate | 4 (20%) | 11 (23%) | 2 (10%) | 11 (23%) | ||
Degree | 5 (25%) | 13 (28%) | 3 (15%) | 14 (30%) | ||
Postgrad | 6 (30%) | 12 (26%) | 8 (40%) | 11 (23%) | ||
Total | 20 | 47 | 0.44 | 20 | 47 | 0.03 |
Smoked within 10yrs § | ||||||
Yes | 2 (10%) | 2 (4%) | 3 (15%) | 3 (6%) | ||
No | 18 (90%) | 45 (96%) | 17 (85%) | 44 (94%) | ||
Total | 20 | 47 | 0.58 | 20 | 47 | 0.35 |
Current Smoker § | ||||||
Yes | 1 (5%) | 0 (0%) | 1 (5%) | 0 (0%) | ||
No | 19 (95%) | 47 (100%) | 19 (95%) | 47 (100%) | ||
Total | 20 | 47 | 0.30 | 20 | 47 | 0.30 |
General Health § | ||||||
Excellent | 3 (33%) | 6 (29%) | 1 (14%) | 8 (35%) | ||
Very Good | 2 (22%) | 11 (52%) | 5 (71%) | 11 (48%) | ||
Good | 4 (44%) | 4 (19%) | 1 (14%) | 4 (17%) | ||
Fair/Poor | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | ||
Total | 9 | 21 | 0.25 | 7 | 23 | 0.62 |
Median (IQR) | Median (IQR) | p † | Median (IQR) | Median (IQR) | p † | |
Age (years) | 43.6 (41–47) | 41.3 (38–45) | 0.03 | 44.2 (41–47) | 41.9 (39–46) | 0.07 |
Height (cm) ** | 179 (174–182) | 165 (162–170) | <0.01 | 179 (172–183) | 164 (162–169) | <0.01 |
Weight (kg) ** | 81.7 (74–89) | 64.9 (60–72) | <0.01 | 81.6 (74–91) | 65.0 (60–73) | <0.01 |
BMI (kg/m2) ** | 25.7 (24–28) | 23.5 (22–26) | 0.06 | 26.8 (23–28) | 23.5 (22–26) | 0.12 |
Waist (cm) ** | 90.3 (84–98) | 80.8 (74–86) | <0.01 | 91.4 (85–99) | 80.4 (75–87) | <0.01 |
Intake per day | Male (N = 31) | Female (N = 65) | ||||
---|---|---|---|---|---|---|
Meeting | RDI/AI | Median | Meeting RDI | RDI/AI | Median | Meeting RDI |
Protein (g) | 64 | 124.54 | 96% | 46 | 92.25 | 95% |
Fiber (g) AI | 30 | 37.95 | 73% | 25 | 28.41 | 70% |
Vitamin A (µg) | 900 | 1323.77 | 88% | 700 | 1198.36 | 87% |
Thiamine (mg) | 1.2 | 2.27 | 90% | 1.1 | 1.6 | 84% |
Riboflavin (mg) | 1.3 | 3.24 | 100% | 1.1 | 2.42 | 97% |
Niacin equiv. (mg) | 16 | 56.95 | 100% | 14 | 43.28 | 100% |
Folate (µg) | 420 | 468.17 | 65% | 420 | 341.22 | 31% |
Vitamin C (mg) | 45 | 198.1 | 100% | 45 | 174.38 | 98% |
Calcium (mg) | 1000 | 1375.59 | 71% | 1000 | 1172.81 | 70% |
Iron (mg) | 8 | 19.09 | 100% | 18 | 13.95 | 37% |
Magnesium (mg) | 420 | 540.95 | 75% | 320 | 411.14 | 80% |
Phosphorus(mg) | 1000 | 2132.67 | 100% | 1000 | 1642.88 | 95% |
Potassium(mg) AI | 3800 | 4447.83 | 73% | 2800 | 3681.6 | 79% |
Zinc (mg) | 14 | 16.44 | 67% | 8 | 13.14 | 82% |
Exceeding | Upper Limit | Median | Exceeding Upper limit | Upper Limit | Median | Exceeding Upper limit |
Sodium(mg) | 920 | 2768.22 | 100% | 920 | 2161.33 | 97% |
% E Saturated fat | 10 | 11 | 71% | 10 | 13 | 79% |
3.1. FFQ Reproducibility
Round 1 N = 96 | Round 2 N = 67 | Correlation N = 67 | ICC N = 163 | |||||
---|---|---|---|---|---|---|---|---|
Nutrients/day | Median | IQR | Median | IQR | ρ | 95% CI | ICC | 95% CI |
Energy | ||||||||
Energy (kJ) | 9601 | (8024–11501) | 8938 | (7298–11085) | 0.81 | (0.67, 0.96) | 0.85 | (0.80, 0.89) |
Protein (g) | 101 | (82–125) | 96.5 | (77.3–124.8) | 0.65 | (0.46, 0.84) | 0.70 | (0.62, 0.77) |
Total fat (g) | 75.5 | (62.6–85.2) | 73.6 | (53.5–89.8) | 0.71 | (0.49, 0.93) | 0.69 | (0.61, 0.78) |
Saturated fat (g) | 30.1 | (25.0–35.9) | 30.6 | (20.7–34.8) | 0.67 | (0.43, 0.90) | 0.65 | (0.55, 0.76) |
Polyunsat. Fat (g) | 9.7 | (7.52–10.98) | 9.15 | (7.26–11.91) | 0.76 | (0.58, 0.94) | 0.69 | (0.63, 0.76) |
Monounsat. Fat (g) | 27.8 | (22.9–31.7) | 27.3 | (19.6–35.5) | 0.73 | (0.52, 0.93) | 0.72 | (0.65, 0.79) |
Cholesterol (mg) | 283 | (224–360) | 252 | (211–329) | 0.66 | (0.45, 0.87) | 0.70 | (0.60, 0.80) |
Carbohydrate (g) | 262 | (217–341) | 243 | (192–337) | 0.83 | (0.68, 0.98) | 0.85 | (0.81, 0.89) |
Sugars (g) | 141 | (100–182) | 119 | (97–168) | 0.82 | (0.68, 0.95) | 0.83 | (0.77, 0.90) |
Alcohol (g) | 12 | (1.6–20.3) | 8.14 | (1.58–14.29) | 0.79 | (0.64, 0.95) | 0.82 | (0.75, 0.90) |
Nutrients | ||||||||
Fiber (g) | 30.5 | (23.8–37.4) | 29.7 | (23.9–35.6) | 0.76 | (0.65, 0.87) | 0.79 | (0.70, 0.87) |
Vitamin A (µg) | 1228 | (1004–1511) | 1225 | (970–1667) | 0.62 | (0.36, 0.87) | 0.69 | (0.55, 0.83) |
Retinol (µg) | 297 | (227–410) | 317 | (214–480) | 0.69 | (0.42, 0.97) | 0.67 | (0.57, 0.76) |
Beta-carotene(µg) | 5316 | (3997–6581) | 5122 | (3824–6959) | 0.61 | (0.35, 0.88) | 0.72 | (0.54, 0.89) |
Thiamin (mg) | 1.77 | (1.41–2.21) | 1.74 | (1.38–2.16) | 0.72 | (0.52, 0.92) | 0.73 | (0.66, 0.80) |
Riboflavin (mg) | 2.59 | (2.10–3.19) | 2.54 | (2.06–3.34) | 0.72 | (0.51, 0.92) | 0.72 | (0.66, 0.78) |
Niacin (mg) | 45.3 | (38.8–55.7) | 43.8 | (36.4–54.7) | 0.70 | (0.51, 0.88) | 0.74 | (0.67, 0.81) |
Vitamin C (mg) | 184 | (140–235) | 167 | (133–213) | 0.81 | (0.61, 0.101) | 0.88 | (0.82, 0.93) |
Folate (µg) | 372 | (288–455) | 357 | (279–459) | 0.78 | (0.62, 0.93) | 0.80 | (0.74, 0.85) |
Calcium (mg) | 1200 | (949–1413) | 1205 | (903–1603) | 0.72 | (0.55, 0.89) | 0.71 | (0.63, 0.79) |
Iron (mg) | 15.1 | (11.5–18.1) | 14.3 | (11.2–17.7) | 0.75 | (0.60, 0.91) | 0.76 | (0.70, 0.83) |
Magnesium (mg) | 450 | (371–531) | 430 | (344–541) | 0.83 | (0.70, 0.95) | 0.85 | (0.80, 0.90) |
Phosphorus(mg) | 1743 | (1421–2148) | 1704 | (1273–2256) | 0.73 | (0.57, 0.89) | 0.75 | (0.68, 0.82) |
Potassium(mg) | 3881 | (3247–4610) | 3730 | (3093–4580) | 0.73 | (0.58, 0.88) | 0.78 | (0.72, 0.83) |
Sodium(mg) | 2272 | (1783–2846) | 2313 | (1765–2865) | 0.76 | (0.58, 0.93) | 0.80 | (0.75, 0.85) |
Zinc (mg) | 13.9 | (11.3–17.2) | 13.5 | (11.1–16.4) | 0.71 | (0.54, 0.87) | 0.75 | (0.68, 0.81) |
Water (mL) | 3469 | (2977–4024) | 3388 | (2987–3837) | 0.80 | (0.64, 0.96) | 0.87 | (0.83, 0.91) |
Percent Energy | ||||||||
Protein | 18 | (16.0–20.0) | 18 | (16.0–20.0) | 0.49 | (0.19, 0.78) | 0.50 | (0.33, 0.68) |
Carbohydrate | 47.5 | (44.0–52.5) | 48 | (43.0–52.0) | 0.68 | (0.50, 0.87) | 0.66 | (0.58, 0.74) |
Total Fats | 30 | (27.0–33.0) | 30 | (28.0–34.0) | 0.64 | (0.47, 0.81) | 0.60 | (0.50, 0.69) |
Saturated Fat | 12 | (11.0–14.0) | 12 | (11.0–14.0) | 0.64 | (0.42, 0.85) | 0.63 | (0.55, 0.72) |
Alcohol | 4 | (0.50–6.00) | 2 | (1.00–5.00) | 0.77 | (0.63, 0.91) | 0.78 | (0.71, 0.85) |
Percent Fat | ||||||||
Saturated | 45 | (42.0–49.0) | 45 | (42.0–48.0) | 0.72 | (0.56, 0.89) | 0.73 | (0.64, 0.81) |
Polyunsaturated | 14 | (12.0–15.5) | 15 | (13.0–16.0) | 0.80 | (0.59, 0.102) | 0.76 | (0.68, 0.84) |
Monounsaturated | 41 | (39.0–43.0) | 41 | (39.0–42.0) | 0.57 | (0.36, 0.79) | 0.64 | (0.51, 0.76) |
3.2. ARFS Reproducibility
Scores | Round 1 N = 96 | Round 2 N = 67 | Correlation N = 67 | ICC N = 163 | ||||
---|---|---|---|---|---|---|---|---|
ARFS (max avail. score) | Median | IQR | Median | IQR | ρ | 95% CI | ICC | 95% CI |
ARFS total(73) | 36 | (32.0–42.5) | 35 | (31.0–41.0) | 0.83 | (0.68, 0.98) | 0.87 | (0.83, 0.90) |
Vegetables(21) | 14 | (12.0–16.0) | 13 | (11.0–15.0) | 0.59 | (0.34, 0.83) | 0.69 | (0.58, 0.80) |
Fruit(12) | 7 | (4.0–8.0) | 6 | (4.0–8.0) | 0.64 | (0.47, 0.81) | 0.68 | (0.61, 0.75) |
Meat(7) | 2 | (2.0–3.0) | 2 | (1.0–3.0) | 0.66 | (0.48, 0.84) | 0.62 | (0.51, 0.73) |
Meat alternatives(6) | 2 | (1.0–3.0) | 2 | (1.0–3.0) | 0.78 | (0.62,0. 93) | 0.79 | (0.72, 0.86) |
Grains(13) | 6 | (4.0–7.0) | 6 | (5.0–7.0) | 0.64 | (0.48, 0.80) | 0.68 | (0.59, 0.77) |
Dairy(11) | 5 | (3.0–6.0) | 5 | (4.0–6.0) | 0.77 | (0.63, 0.91) | 0.79 | (0.73, 0.84) |
Extras(2) | 1 | (0.0–1.0) | 1 | (0.0–1.0) | 0.65 | (0.44, 0.85) | 0.66 | (0.56, 0.76) |
%E from food groups | ||||||||
FFQ CORE | 67.5 | (58.0–76.0) | 69 | (60.0–75.0) | 0.71 | (0.51, 0.91) | 0.76 | (0.68, 0.85) |
Vegetables | 8 | (6.0–11.0) | 8 | (6.0–10.0) | 0.79 | (0.66, 0.93) | 0.84 | (0.79, 0.89) |
Fruit | 8 | (5.0–11.5) | 8 | (5.0–11.0) | 0.60 | (0.46, 0.74) | 0.57 | (0.39, 0.74) |
Meat | 11.5 | (8.0–15.0) | 11 | (7.0–14.0) | 0.53 | (0.15, 0.91) | 0.52 | (0.31, 0.74) |
Meat alternatives | 4 | (2.0–7.0) | 5 | (2.0–7.0) | 0.53 | (0.26, 0.80) | 0.57 | (0.42, 0.71) |
Grains | 22 | (15.0–27.0) | 22 | (18.0–25.0) | 0.60 | (0.45, 0.76) | 0.62 | (0.53, 0.70) |
Dairy | 9 | (7.0–14.0) | 11 | (7.0–16.0) | 0.54 | (0.32, 0.76) | 0.52 | (0.39, 0.64) |
FFQ NON-CORE | 32.5 | (24.0–42.0) | 31 | (25.0–40.0) | 0.71 | (0.51, 0.91) | 0.77 | (0.69, 0.84) |
Sweet drinks, fruit juice | 1 | (0.0–4.0) | 1 | (0.0–4.0) | 0.78 | (0.59, 0.97) | 0.78 | (0.70, 0.87) |
Packaged snacks | 1 | (0.5–3.5) | 1 | (0.0–3.0) | 0.52 | (0.32, 0.72) | 0.56 | (0.38, 0.74) |
Confectionary | 4 | (2.0–7.0) | 3 | (1.0–6.0) | 0.63 | (0.47, 0.78) | 0.54 | (0.41, 0.67) |
Baked sweet products | 4 | (2.0–7.0) | 3 | (2.0–7.0) | 0.76 | (0.62, 0.90) | 0.72 | (0.58, 0.85) |
Take-away | 6 | (4.0–8.0) | 6 | (4.0–8.0) | 0.77 | (0.53, 0.100) | 0.76 | (0.69, 0.84) |
Condiments | 2 | (1.0–3.5) | 2 | (1.0–5.0) | 0.60 | (0.38, 0.82) | 0.44 | (0.28, 0.61) |
Processed fatty meats | 2 | (1.0–3.0) | 2 | (1.0–3.0) | 0.69 | (0.50, 0.88) | 0.57 | (0.39, 0.76) |
Breakfast cereal | 7 | (4.0–10.0) | 8 | (5.0–11.0) | 0.83 | (0.57, 0.100) | 0.70 | (0.58, 0.82) |
Meat meals with veg. | 7 | (4.5–10.0) | 6 | (4.0–9.0) | 0.52 | (0.19, 0.85) | 0.54 | (0.36, 0.71) |
Meat meals no veg. | 1 | (0.0–2.0) | 1 | (0.0–1.0) | 0.53 | (0.26, 0.79) | 0.54 | (0.43, 0.65) |
3.3. Validity between ARFS and FFQ
ARFS Total | ARFS Veg | ARFS Fruit | ARFS Meat | ARFS Meat Alt | ARFS Grains | ARFS Dairy | ARFS Extra | |
---|---|---|---|---|---|---|---|---|
Protein (g) | 0.19 | 0.10 | 0.22 | |||||
Saturated fat (g) | −0.09 | −0.13 | 0.14 | |||||
Cholesterol (mg) | 0.26 | 0.21 | ||||||
Carbohydrate (g) | −0.09 | −0.09 | −0.07 | |||||
Sugars (g) | 0.15 | −0.14 | ||||||
Fiber (g) | 0.38 | 0.31 | 0.37 | 0.25 | 0.16 | |||
Vitamin A (µg) | 0.45 | 0.38 | 0.37 | 0.29 | ||||
Retinol (µg) | ||||||||
Beta-carotene(µg) | 0.51 | 0.43 | 0.47 | 0.30 | ||||
Thiamine (mg) | 0.17 | |||||||
Riboflavin (mg) | 0.16 | 0.14 | 0.24 | |||||
Niacin equiv. (mg) | 0.12 | 0.20 | 0.09 | 0.12 | ||||
Folate (µg) | 0.27 | 0.20 | 0.19 | 0.15 | 0.17 | |||
Vitamin C (mg) | 0.53 | 0.49 | 0.51 | 0.16 | 0.22 | |||
Calcium (mg) | 0.23 | 0.15 | 0.40 | |||||
Iron (mg) | 0.12 | 0.13 | ||||||
Magnesium (mg) | 0.30 | 0.20 | 0.22 | 0.19 | 0.18 | 0.15 | −0.10 | |
Phosphorus (mg) | 0.32 | 0.24 | 0.28 | 0.15 | 0.13 | 0.12 | 0.20 | −0.13 |
Potassium(mg) | 0.32 | 0.09 | 0.14 | 0.27 | −0.07 | |||
Sodium(mg) | −0.12 | 0.13 | ||||||
Zinc (mg) | 0.13 | 0.17 | ||||||
% E Saturated Fat | −0.23 | −0.22 | −0.29 | −0.20 | 0.18 |
Percentage of Energy From | ARFS Total | ARFS Veg | ARFS Fruit | ARFS Meat | ARFS Meat Alt | ARFS Grains | ARFS Dairy | ARFS Extra |
---|---|---|---|---|---|---|---|---|
CORE | 0.31 | 0.30 | 0.32 | 0.25 | −0.26 | |||
Vegetables | 0.22 | 0.50 | 0.20 | |||||
Fruit | 0.37 | 0.33 | 0.68 | |||||
Meat | 0.42 | −0.30 | ||||||
Meat alternatives | 0.31 | 0.28 | 0.23 | 0.56 | ||||
Grains | 0.28 | |||||||
Dairy | 0.23 | 0.21 | 0.46 | |||||
NON-CORE | −0.31 | −0.30 | −0.32 | −0.25 | 0.26 | |||
Sweet drinks, fruit juice | −0.25 | −0.27 | −0.18 | −0.19 | ||||
Packaged snacks | −0.20 | −0.17 | ||||||
Confectionary | −0.25 | −0.23 | ||||||
Baked sweet products | −0.24 | −0.26 | 0.19 | |||||
Take-away | −0.29 | −0.26 | −0.25 | −0.26 | ||||
Condiments | 0.21 | 0.40 | ||||||
Processed fatty meats | −0.26 | −0.27 | ||||||
Breakfast cereal | 0.23 | −0.21 | ||||||
Meat meals with vegetables | 0.32 | −0.26 | ||||||
Meat meals without vegetables | 0.15 |
4. Discussion
5. Conclusions
Supplementary Files
Supplementary File 1Acknowledgments
Author Contributions
Conflicts of Interest
References
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Collins, C.E.; Burrows, T.L.; Rollo, M.E.; Boggess, M.M.; Watson, J.F.; Guest, M.; Duncanson, K.; Pezdirc, K.; Hutchesson, M.J. The Comparative Validity and Reproducibility of a Diet Quality Index for Adults: The Australian Recommended Food Score. Nutrients 2015, 7, 785-798. https://doi.org/10.3390/nu7020785
Collins CE, Burrows TL, Rollo ME, Boggess MM, Watson JF, Guest M, Duncanson K, Pezdirc K, Hutchesson MJ. The Comparative Validity and Reproducibility of a Diet Quality Index for Adults: The Australian Recommended Food Score. Nutrients. 2015; 7(2):785-798. https://doi.org/10.3390/nu7020785
Chicago/Turabian StyleCollins, Clare E., Tracy L. Burrows, Megan E. Rollo, May M. Boggess, Jane F. Watson, Maya Guest, Kerith Duncanson, Kristine Pezdirc, and Melinda J. Hutchesson. 2015. "The Comparative Validity and Reproducibility of a Diet Quality Index for Adults: The Australian Recommended Food Score" Nutrients 7, no. 2: 785-798. https://doi.org/10.3390/nu7020785
APA StyleCollins, C. E., Burrows, T. L., Rollo, M. E., Boggess, M. M., Watson, J. F., Guest, M., Duncanson, K., Pezdirc, K., & Hutchesson, M. J. (2015). The Comparative Validity and Reproducibility of a Diet Quality Index for Adults: The Australian Recommended Food Score. Nutrients, 7(2), 785-798. https://doi.org/10.3390/nu7020785