Development of a Food-Based Diet Quality Score from a Short FFQ and Associations with Obesity Measures, Eating Styles and Nutrient Intakes in Finnish Twins

Abstract

We constructed a food-based diet quality score (DQS) and examined its association with obesity measures, eating styles and nutrient intakes. Participants were 3592 individuals (764 dizygotic [DZ] and 430 monozygotic [MZ] twin pairs) from the FinnTwin16 study. The DQS (0–12 points) was constructed from a short 14 item food frequency questionnaire. Anthropometric measures and eating styles were self-reported. Nutrient intakes were calculated from food diaries completed in a subsample of 249 individuals (45 same-sex DZ and 60 MZ twin pairs). Twins were analyzed both as individuals and as twin pairs. The DQS was inversely associated with body mass index (β = −0.12, per one-unit increase in DQS, p < 0.001), waist circumference (β = −0.34, p < 0.001), obesity (odds ratio [OR]: 0.95, p = 0.004) and abdominal obesity (OR: 0.88, p < 0.001), independent of sex, age, physical activity and education. A higher DQS was associated with health-conscious eating, having breakfast, less snacking, fewer evening meals, and a higher frequency and regularity of eating. The DQS was positively correlated with the intakes of protein, fiber and magnesium and negatively correlated with the intakes of total fat, saturated fat and sucrose. Within twin pairs, most of the associations between the DQS with eating styles and some nutrients remained, but the DQS was not associated with obesity measures within twin pairs. The DQS is an easy-to-use tool for ranking adults according to diet quality and shows an association with obesity measures, eating styles and key nutrients in the expected direction.

The genetic architecture of the association between eating behaviors and obesity: combining genetic twin modeling and polygenic risk scores

“…In that study, the indirect association had a β coefficient of 0.02, and the total effect was β = 0.14 and 0.17 for BMI and WC, respectively, which are similar in the present study, although our results were not significant for WC. Previous studies, including that by Konttinen et al, mainly assessed eating behaviors with different versions of the Three-Factor Eating Questionnaire ( 28 , 29 ), whereas we used a questionnaire that was specifically developed for the FT16 study ( 27 , 32 ). Another feature specific to our study is that, in addition to eating behaviors, we also included information about diet quality, which was assessed by a previously validated questionnaire ( 32 ).…”

“…Previous studies, including that by Konttinen et al, mainly assessed eating behaviors with different versions of the Three-Factor Eating Questionnaire ( 28 , 29 ), whereas we used a questionnaire that was specifically developed for the FT16 study ( 27 , 32 ). Another feature specific to our study is that, in addition to eating behaviors, we also included information about diet quality, which was assessed by a previously validated questionnaire ( 32 ). Furthermore, all of the previous studies used a PRS BMI with <100 loci to capture genetic susceptibility to obesity, whereas we used the latest PRS by incorporating all available information regardless of the significance level ( 24 ).…”

“…The participants were asked to select the option that best described their overall eating style (2 items for assessing meal frequency and 2 items for regular eating styles). Another 3 items inquired about health-conscious eating, 1 item about night eating, 1 item about external eating, 2 items about emotional eating, and 5 items about snacking styles with 4 different alternatives: “usually,” “often,” “sometimes,” or “seldom” ( 32 ). The item about night eating style was excluded due to a lack of variability in participants’ responses.…”

“…The item about night eating style was excluded due to a lack of variability in participants’ responses. Dietary intake was assessed by a short FFQ, from which a diet quality score (DQS) was calculated, as previously described ( 32 ). The DQS had been previously validated and is associated with obesity measures and eating styles in this cohort ( 32 ).…”

“…Dietary intake was assessed by a short FFQ, from which a diet quality score (DQS) was calculated, as previously described ( 32 ). The DQS had been previously validated and is associated with obesity measures and eating styles in this cohort ( 32 ). The DQS ranges from 0 to 12 points, with a higher score indicating a better diet quality.…”