Performance of the Global Diet Quality Score with Nutrition and Health Outcomes in Mexico with 24-h Recall and FFQ Data

Abstract

Background The Global Diet Quality Score (GDQS) is intended as a simple global diet quality metric feasible in low- and middle-income countries facing the double burden of malnutrition. Objective The aim of this study was to evaluate the performance of the GDQS with markers of nutrient adequacy and chronic disease in nonpregnant nonlactating (NPNL) Mexican women of reproductive age and to compare it with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Minimum Dietary Diversity for Women (MDD-W). Methods We included NPNL women aged 15 to 49 y from the Mexican National Health and Nutrition Surveys (2012 and 2016) with 24-h recall (n = 2542) or a FFQ (n = 4975) (separate samples). We evaluated the correlation of the GDQS with the energy-adjusted intake of several nutrients and evaluated its association with health parameters using covariate-adjusted linear regression models. Results The GDQS was positively correlated with the intake of calcium, folate, iron, vitamin A, vitamin B-12, zinc, fiber, protein, and total fat (rho = 0.09 to 0.38, P < 0.05) and was inversely correlated with the intake of added sugar (rho = −0.37 and −0.38, P < 0.05) using both instruments, and with total fat, SFA, and MUFA only with 24-h recall data (rho = −0.06 to −0.16, P < 0.05). The GDQS was inversely associated with serum ferritin, BMI, waist circumference, and serum total and LDL cholesterol using FFQ data (P < 0.05), and was positively associated with serum folate using 24-h recall data (P < 0.05). Similar correlations and associations were observed with the MDD-W (only with micronutrients) and the AHEI-2010 (only with chronic disease-related nutrients and health markers). Conclusions In comparison to other diet metrics, the GDQS can capture both dimensions of nutrient adequacy and health markers related to the risk of chronic disease. The performance of the GDQS was satisfactory with either 24-h recall or FFQ.

Effect of an action‐research nutrition intervention on the Global Diet Quality Score of Colombian adolescents

“…It is also instructive to compare the GDQS scores obtained in this study with those from other locations. The mean total GDQS scores in this study were lower than those reported from the Mexican National Health and Nutrition Survey 2012–2016 35 (total GDQS = 15.8) which included 1411 women aged 15–29 years; and substantially lower than a study in India, 36 which observed 3041 women of reproductive age (total GDQS = 23.0). Unlike these studies, our sample consisted of a specific group of adolescent women living in the poorest barrios of Medellín who may have been singularly disfavored economically and socially compared to the participants in the other studies.…”

The Global Diet Quality Score is associated with nutrient adequacy and depression among Vietnamese youths

“…Overall, the mean GDQS was low in this sample (18 out of 49 possible points), lower than the GDQS among WRA in neighboring China (20.8 points) 7 or other LMICs (23 and 28 points for WRA in India 6 and Mexico, 5 respectively). The GDQS+ submetric was nearly five times less than the possible score (6.9 vs. 32), with a low consumption of most subgroups in the healthy category (deep orange fruits, deep orange vegetables, orange tubers, dark green leafy vegetables, whole grains, and low‐fat dairy).…”

“…6 Higher GDQS was also found in SSA to be inversely associated with underweight, body mass index (BMI), mid-upper arm circumference (MUAC), waist circumference, and weight gain. [3][4][5][6]9 For NCDs, higher GDQS was associated with a lower risk of diabetes in US women, 10 hypertension in Ethiopian men, 8 and metabolic syndrome in China. 7 Among females, the GDQS has been used mainly on nonpregnant, nonlactating women of reproductive age (WRA, 15-49 years) [11][12][13][14] but no work, to our knowledge, has yet examined the usefulness of the GDQS in examining its association with depression symptoms among young women.…”

“…1 Notwithstanding such large negative effects, important gaps remain in the collection of dietary data, particularly in low-and middle-income countries (LMICs) due to bottlenecks such as high cost, time burden, and low capacity. 2 anemia 4 ) in SSA and with lipid profiles in Mexico 5 and India. 6 Higher GDQS was also found in SSA to be inversely associated with underweight, body mass index (BMI), mid-upper arm circumference (MUAC), waist circumference, and weight gain.…”

“…The GDQS metric has been associated with a range of outcomes related to nutritional status and noncommunicable disease (NCD) risk in various settings. For example, the GDQS was positively associated with individual micronutrient intakes and overall nutrient adequacy in 10 sub‐Saharan African (SSA) countries, 4 Mexico, 5 India, 6 and China 7 . The GDQS was also associated with hematological indicators (including hemoglobin, 8 serum ferritin, 5 serum folate, 5,8 and anemia 4 ) in SSA and with lipid profiles in Mexico 5 and India 6 .…”