Avaliacao da confiabilidade e validade do Indice de Qualidade da Dieta Revisado

Abstract

OBJECTIVE:Evaluate validity and reliability of the Brazilian Healthy Eating Index Revised according to the psychometric properties. METHODS:Cross-sectional study of a random sample of 2,375 individuals of both sexes, aged 12 or older from the city of São Paulo, Southeastern Brazil, drawn from the Health Survey carried out in 2003. Information on the population characteristics was acquired using a questionnaire. Food intake was obtained using 24h Recall, used to calculate the Brazilian Healthy Eating Index Revised (BHEI-R). The following aspects were evaluated: (1) content validity, by comparing the components with the Dietary Guidelines for the Brazilian Population; (2) construct validity, factor analysis using principal components method and verifying whether the index can measure diet quality regardless of energy intake; (3) discriminating validity; and (4) the reliability of the BHEI-R by analyzing the internal consistency of the items using Cronbach's alpha coefficient. RESULTS:The correlations between the component scores and energy intake were weak (r < 0.30). Principal component analysis indicated the presence of four factors with eigenvalues > 1 that represented 67% of the index variance. The discriminating validity of the BHEI-R was observed by comparing the individuals by sex and smoking habit, and identifying statistically significant differences between the means of the components of the BHEI-R and the final score. The Cronbach's alpha value (α = 0.7) indicated the presence of internal consistency between the components of the BHEI-R. The SoFAAS component followed by the total fruit component and whole fruit component presented greater correlation with the final index scores. CONCLUSIONS:The Brazilian Healthy Eating Index Revised showed itself to be reliable and structurally valid when used to evaluate and monitor the diet quality of Brazilians.

The diet quality index evaluates the adequacy of energy provided by dietary macronutrients

“…Another aspect demonstrated in this study was the higher ability of the BHEI of differentiating diet quality by gender, showing that females adhere more to healthy food recommendations, corroborating Andrade et al 23 , who published similar findings and claimed that this specific ability is an aspect of this index that reinforces its reliability and validity. The individual's age or age group could also reflect better food choices with rising age 1 , and in fact this study found that adults and older adults have healthier diets than adolescents.…”

Social and demographic inequalities in diet quality in a population-based study

“…The BHEI-R is represented by a set of component-based foods, nutrients, and cooking ingredients with proven health implications, such as whole grains, unsaturated fats, fruits, and sodium 14 . The BHEI-R was considered a valid and reliable instrument to asses and monitor the diet quality of the Brazilian population 15 .…”

Diet quality among adolescents has deteriorated: a panel study in Niterói, Rio de Janeiro State, Brazil, 2003-2008

“…Although the scores are estimated according to components' energy density, there is no information on energy intake adequacy, which would be important to prevent an energyunbalanced diet. Nevertheless, the BHEI-R was adapted 12 and validated 13 in Brazil to monitor dietary quality of ≥ 12 year-old individuals.…”

“…Based on the American RHEI 8 and the Brazilian Dietary Guidelines 11 , Previdelli et al 12 proposed the Brazilian Revised Healthy Eating Index (BHEI-R), aimed at characterizing both healthy and harmful aspects of the diet; additionally, Andrade et al 13 evaluated the validity and reliability of this index, concluding that it is reliable and structurally valid to monitor diet quality in Brazil. The BHEI-R has been used to summarize diet quality, highlighting key dietary characteristics, and is considered a useful tool in nutritional epidemiology 14 .…”