Valerie K Sullivan1, Emily A Johnston2, Melanie J Firestone3, Stella S Yi4, Jeannette M Beasley5. 1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: vsulliv5@jhu.edu. 2. Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania. 3. Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota. 4. Department of Population Health, NYU Grossman School of Medicine, New York, New York. 5. Department of Medicine, NYU Grossman School of Medicine, New York, New York.
Abstract
INTRODUCTION: Self-rated health has been extensively studied, but the utility of a similarly structured question to rate diet quality is not well characterized. This study aims to assess the relative validity of self-rated diet quality, compared with that of a validated diet quality measure (Healthy Eating Index-2015) and to examine the associations with cardiometabolic risk factors. METHODS: Analyses were conducted in 2020-2021 using cross-sectional data from the National Health and Nutrition Examination Survey, 2011-2018. Nonpregnant adults who responded to the question: How healthy is your overall diet? and provided 2 dietary recalls were eligible (n=16,913). Associations between self-rated diet quality (modeled as a 5-point continuous variable, poor=1 to excellent=5) and Healthy Eating Index-2015 scores and cardiometabolic risk factors were assessed by linear regression, accounting for the complex survey design and adjusting for demographic and lifestyle characteristics. RESULTS: Self-rated diet quality was positively associated with total Healthy Eating Index-2015 scores (p < 0.001) and with all components except with Dairy (p=0.94) and Sodium (p=0.66). Higher self-rated diet quality was associated with lower BMI, waist circumference, glucose, insulin, triglycerides, and HbA1c and with higher high-density lipoprotein cholesterol (all p<0.01). Positive associations with total diet quality persisted across all racial/ethnic groups, although the associations with individual dietary components varied. Higher self-ratings were most consistently associated with better-scored diet quality among individuals with BMI <30 kg/m2. CONCLUSIONS: Self-rated diet quality was associated with Healthy Eating Index-2015 scores and cardiometabolic disease risk factors. This single-item assessment may be useful in time-limited settings to quickly and easily identify patients in need of dietary counseling to improve cardiometabolic health.
INTRODUCTION: Self-rated health has been extensively studied, but the utility of a similarly structured question to rate diet quality is not well characterized. This study aims to assess the relative validity of self-rated diet quality, compared with that of a validated diet quality measure (Healthy Eating Index-2015) and to examine the associations with cardiometabolic risk factors. METHODS: Analyses were conducted in 2020-2021 using cross-sectional data from the National Health and Nutrition Examination Survey, 2011-2018. Nonpregnant adults who responded to the question: How healthy is your overall diet? and provided 2 dietary recalls were eligible (n=16,913). Associations between self-rated diet quality (modeled as a 5-point continuous variable, poor=1 to excellent=5) and Healthy Eating Index-2015 scores and cardiometabolic risk factors were assessed by linear regression, accounting for the complex survey design and adjusting for demographic and lifestyle characteristics. RESULTS: Self-rated diet quality was positively associated with total Healthy Eating Index-2015 scores (p < 0.001) and with all components except with Dairy (p=0.94) and Sodium (p=0.66). Higher self-rated diet quality was associated with lower BMI, waist circumference, glucose, insulin, triglycerides, and HbA1c and with higher high-density lipoprotein cholesterol (all p<0.01). Positive associations with total diet quality persisted across all racial/ethnic groups, although the associations with individual dietary components varied. Higher self-ratings were most consistently associated with better-scored diet quality among individuals with BMI <30 kg/m2. CONCLUSIONS: Self-rated diet quality was associated with Healthy Eating Index-2015 scores and cardiometabolic disease risk factors. This single-item assessment may be useful in time-limited settings to quickly and easily identify patients in need of dietary counseling to improve cardiometabolic health.
Authors: Donna G Rhodes; Theophile Murayi; John C Clemens; David J Baer; Rhonda S Sebastian; Alanna J Moshfegh Journal: Am J Clin Nutr Date: 2013-04-03 Impact factor: 7.045
Authors: Robert H Eckel; Penny Kris-Etherton; Alice H Lichtenstein; Judith Wylie-Rosett; Allison Groom; Kimberly F Stitzel; Shirley Yin-Piazza Journal: J Am Diet Assoc Date: 2009-02
Authors: Zerleen S Quader; Lixia Zhao; Cathleen Gillespie; Mary E Cogswell; Ana L Terry; Alanna Moshfegh; Donna Rhodes Journal: MMWR Morb Mortal Wkly Rep Date: 2017-03-31 Impact factor: 17.586
Authors: Zhilei Shan; Yanping Li; Megu Y Baden; Shilpa N Bhupathiraju; Dong D Wang; Qi Sun; Kathryn M Rexrode; Eric B Rimm; Lu Qi; Walter C Willett; JoAnn E Manson; Qibin Qi; Frank B Hu Journal: JAMA Intern Med Date: 2020-08-01 Impact factor: 21.873