Validation of the Diet Quality Index for Adolescents by Comparison with Biomarkers, Nutrient and Food Intakes: The HELENA Study

Krishna Vyncke, Estefania Cruz Fernandez, Marta Fajó-Pascual, Magdalena Cuenca-García, Wilhelm De Keyzer, Marcela Gonzalez-Gross, Luis A. Moreno, Laurent Beghin, Christina Breidenassel, Mathilde Kersting, Ulrike Albers, Katharina Diethelm, Theodora Mouratidou, Evangelia Grammatikaki, Tineke De Vriendt, Ascensión Marcos, Karin Bammann, Claudia Börnhorst, Carine Vereecken, Lea MaesWencke Gwozdz, Myriam van Winckel, Frédéric Gottrand, Michael Sjöström, Ligia E. Díaz, Anouk Geelen, Lena Hallström, Kurt Widhalm , Anthony Kafatos, Denes Molnar, Stefaan De Henauw, Inge Huybrechts

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    Food-based dietary guidelines (FBDG) aim to address the nutritional requirements at population level in order to prevent diseases and promote a healthy lifestyle. Diet quality indices can be used to assess the compliance with these FBDG. The present study aimed to investigate whether the newly developed Diet Quality Index for Adolescents (DQI-A) is a good surrogate measure for adherence to FBDG, and whether adherence to these FBDG effectively leads to better nutrient intakes and nutritional biomarkers in adolescents. Participants included 1804 European adolescents who were recruited in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. Dietary intake was assessed by two, non-consecutive 24 h recalls. A DQI-A score, considering the components' dietary quality, diversity and equilibrium, was calculated. Associations between the DQI-A and food and nutrient intakes and blood concentration biomarkers were investigated using multilevel regression analysis corrected for centre, age and sex. DQI-A scores were associated with food intake in the expected direction: positive associations with nutrient-dense food items, such as fruits and vegetables, and inverse associations with energy-dense and low-nutritious foods. On the nutrient level, the DQI-A was positively related to the intake of water, fibre and most minerals and vitamins. No association was found between the DQI-A and total fat intake. Furthermore, a positive association was observed with 25-hydroxyvitamin D, holo-transcobalamin and n-3 fatty acid serum levels. The present study has shown good validity of the DQI-A by confirming the expected associations with food and nutrient intakes and some biomarkers in blood.
    Original languageEnglish
    JournalBritish Journal of Nutrition
    Issue number11
    Pages (from-to)2067-2078
    Number of pages12
    Publication statusPublished - 2013

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