Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare

Jaana Lindström, Kirsikka Aittola, Auli Pölönen, Katri Hemiö, Kirsti Ahonen, Leila Karhunen, Reija Männikkö, Ulla Siljamäki-Ojansuu, Tanja Tilles-Tirkkonen, Eeva Virtanen, Jussi Pihlajamäki and Ursula Schwab
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Jaana Lindström: Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
Kirsikka Aittola: School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
Auli Pölönen: Division 1, Tampere University Hospital, 33520 Tampere, Finland
Katri Hemiö: Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
Kirsti Ahonen: Clinical Nutrition Unit, Tampere University Hospital, 33520 Tampere, Finland
Leila Karhunen: School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
Reija Männikkö: School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
Ulla Siljamäki-Ojansuu: Clinical Nutrition Unit, Tampere University Hospital, 33520 Tampere, Finland
Tanja Tilles-Tirkkonen: School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
Eeva Virtanen: Department of Public Health and Welfare, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
Jussi Pihlajamäki: School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
Ursula Schwab: School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland

IJERPH, 2021, vol. 18, issue 5, 1-22

Abstract: Lack of tools to evaluate the quality of diet impedes dietary counselling in healthcare. We constructed a scoring for a validated food intake questionnaire, to measure the adherence to a healthy diet that prevents type 2 diabetes (T2D). The Healthy Diet Index (HDI) consists of seven weighted domains (meal pattern, grains, fruit and vegetables, fats, fish and meat, dairy, snacks and treats). We studied the correlations of the HDI with nutrient intakes calculated from 7-day food records among 52 men and 25 women, and associations of HDI with biomarkers and anthropometrics among 645 men and 2455 women. The HDI correlated inversely with total fat (Pearson’s r = ?0.37), saturated fat ( r = ?0.37), monounsaturated fat ( r = ?0.37), and the glycaemic index of diet ( r = ?0.32) and positively with carbohydrates ( r = 0.23), protein ( r = 0.25), fibre ( r = 0.66), magnesium ( r = 0.26), iron ( r = 0.25), and vitamin D ( r = 0.27), ( p < 0.05 for all). In the linear regression model adjusted for BMI and age, HDI is associated inversely with waist circumference, concentrations of fasting and 2-h glucose and triglycerides in men and women, total and LDL cholesterol in women, and fasting insulin in men ( p < 0.05 for all). The HDI proved to be a valid tool to measure adherence to a health-promoting diet and to support individualised dietary counselling.

Keywords: chronic diseases; diet quality; evaluation; prevention; type 2 diabetes; validation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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