A composite measure of diet has been preferred to an index of a single nutrient or food in the area of dietary assessment. However, the lack of such a tool for cross-national comparisons has restricted the ability to compare diet quality between countries using an overall measure of diet. In this study, we created a tool called the Diet Quality Index-International (DQI-I) for global monitoring and exploration of diet quality across countries. The major categories of the index components are variety, adequacy, moderation and overall balance. Using the tool, this research presents a cross-national comparison of diet quality between China and the United States, incorporating comparable national in-depth diet data. The mean of the DQI-I score was slightly higher in China than in the United States. By major categories of the DQI-I, dietary variety was better achieved in the U.S. diet; moderation and overall balance of intakes were better accomplished in China. The DQI-I was successful in capturing variability in intakes of food and nutrients in both countries. Some distinct patterns of poor quality diet in each country were also identified. As demonstrated in this study, the DQI-I provides an effective means of cross-national comparative work for global understanding of diet quality. Furthermore, the dietary problem areas identified by the DQI-I may be useful in guiding the development of programs to improve public health.

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Results: This study's results indicate that statistically significant dietary intake differences occur for different days of the week but not for all age groups-nor for all nutrients. The average American, 2 years and older, consumes 82 kcal more per day on each weekend day (Friday through Sunday) than they do on weekdays (Monday through Thursday). These overall increases in dietary intake are significant for the overall sample and are largest for the 19-to 50-year-old age group; among this age group, the weekend day increase (vs. weekday) is 115 kcal/d. The increased proportions of energy from fat and alcohol consumed on weekends are greater for this adult age group by 0.7% and 1.4%, respectively, whereas the proportion of energy from carbohydrate decreases 1.6%. Discussion: The effects of weekend days on nutrient intake are substantial and should be considered in future clinical and population-based interventions and in dietary monitoring and research in the U.S.

In 1965, there were large differences among groups in dietary quality, with whites of high socioeconomic status eating the least healthful diet, as measured by the index, and blacks of low socioeconomic status the most healthful. By the 1989-1991 survey, the diets of all groups had improved and were relatively similar.

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