Evaluation of a Diet Quality Index Based on the Probability of Adequate Nutrient Intake (PANDiet) Using National French and US Dietary Surveys

Abstract

BackgroundExisting diet quality indices often show theoretical and methodological limitations, especially with regard to validation.ObjectiveTo develop a diet quality index based on the probability of adequate nutrient intake (PANDiet) and evaluate its validity using data from French and US populations.Material and MethodsThe PANDiet is composed of adequacy probabilities for 24 nutrients grouped into two sub-scores. The relationship between the PANDiet score and energy intake were investigated. We evaluated the construct validity of the index by comparing scores for population sub-groups with ‘a priori’ differences in diet quality, according to smoking status, energy density, food intakes, plasma folate and carotenoid concentrations. French and US implementations of the PANDiet were developed and evaluated using national nutritional recommendations and dietary surveys.ResultsThe PANDiet was not correlated with energy for the French implementation (r = −0.02, P>0.05) and correlated at a low level for the US implementation (r = −0.11, P<0.0001). In both implementations, a higher PANDiet score (i.e. a better diet quality) was associated with not smoking, having a lower-energy-dense diet, consuming higher amounts of fruits, vegetables, fish, milk and other dairy products and lower amounts of cheese, pizza, eggs, meat and processed meat, and having higher plasma folate and carotenoid concentrations after controlling for appropriate factors (all P<0.05, carotenoid data for US not available).ConclusionsThe PANDiet provides a single score that measures the adequacy of nutrient intake and reflects diet quality. This index is adaptable for use in different countries and relevant at the individual and population levels.

Changes in diet quality during a 12 month weight loss randomised controlled trial

“…Changes in food choices were consistent with results from other studies in which higher diet quality scores reflected lower consumption of meat [5,65,66], alcohol [33,67] and discretionary food items [29,31]. The observed increased consumption of fruit (found with APDQS and DQT), non-starchy vegetables (found with DQT), tomato and other vegetables (found with APDQS) was also congruent with other studies associating higher intakes of vegetables and fruits associated with high diet quality [65,66].…”

“…The observed increased consumption of fruit (found with APDQS and DQT), non-starchy vegetables (found with DQT), tomato and other vegetables (found with APDQS) was also congruent with other studies associating higher intakes of vegetables and fruits associated with high diet quality [65,66]. Importantly reductions in foods considered 'discretionary' in the DQT were 'negative' foods listed in the APDQS, notably, salty snacks and grain based desserts.…”

Typology of eaters based on conventional and organic food consumption: results from the NutriNet-Santé cohort study

“…As the origin (organic or conventional) of foods was not taken into account, some potential differences in contents reported in the literature resulting from the mode of production were not considered (20)(21)(22) . We also computed two a priori nutritional diet quality scores: the modified Programme National Nutrition Santé Guidelines Score (mPNNS-GS), which is a thirteen·five-point score that reflects adherence to the French nutritional recommendations (23) , and the PANDiet, a 100-point score that reflects the probability of adequate nutrient intake (24) . The prevalence of inadequate intakes of selected nutrients was estimated by the proportion of subjects with intake below the estimated average requirement for the French population (25,26) .…”

Evaluation of a nutrient-based diet quality index in UK young children and investigation into the diet quality of consumers of formula and infant foods

“…Evaluation of the content and construct validity of the PANDiet The strategy to evaluate the content and construct validity of the PANDiet has been described previously in the French and US adult populations (18) . In order to evaluate the content and construct validity of the PANDiet in this new population, we adopted the same strategy as used previously, but using variables linked to diet quality in UK young children.…”