School of Health Sciences, HA12 Hunter Building, University Drive, University of Newcastle, Callaghan, New South Wales 2308, Australia.
Public Health Nutr. 2009 Dec;12(12):2473-92. doi: 10.1017/S136898000900531X. Epub 2009 Apr 1.
Measures of diet quality have evolved with a number of scoring indices currently in use. They are increasingly being used to examine epidemiological associations between dietary intake and nutrition-related health outcomes. The present review aims to describe current diet quality tools and their applications, and to examine the relationship between diet quality and morbidity and mortality.
A search was conducted of MEDLINE, Cochrane, EMBASE, CINAHL and ProQuest electronic databases. Inclusion criteria were: English language; published from 2004 on; conducted in adult populations; longitudinal/cohort/case-control or cross-sectional study; included a theoretically defined measure of diet quality.
A total of twenty-five indices of overall diet quality and/or variety were found, with components ranging from nutrients only to adherence to recommended food group servings, to variety within healthful food groups. The majority of studies reviewed had methodological weaknesses but demonstrated that higher dietary quality was consistently inversely related to all-cause mortality, with a protective effect of moderate magnitude. The associations were stronger for men and for all-cause and CVD mortality.
The limitations of both the indices and the studies that use them need to be considered when interpreting and comparing results. However, diet quality indices do appear to be able to quantify risk of some health outcomes, including biomarkers of disease and risk of CVD, some cancers and mortality. Further research is needed to improve the validity of these tools and to adapt them for use in clinical dietetic practice.
衡量饮食质量的方法已经发展出了许多评分指数，目前这些指数正在被广泛使用。它们越来越多地被用于研究饮食摄入与营养相关健康结果之间的流行病学关联。本综述旨在描述当前的饮食质量工具及其应用，并探讨饮食质量与发病率和死亡率之间的关系。
对 MEDLINE、Cochrane、EMBASE、CINAHL 和 ProQuest 电子数据库进行了检索。纳入标准为：英语；发表于 2004 年以后；在成年人群中进行；采用纵向/队列/病例对照或横断面研究；包括理论定义的饮食质量衡量方法。
共发现 25 种整体饮食质量和/或多样性指数，其组成部分从营养素到遵守推荐的食物组摄入量，再到健康食物组内的多样性。大多数综述的研究都存在方法学上的弱点，但都表明更高的饮食质量与全因死亡率呈负相关，且具有适度的保护作用。这种关联在男性和全因及心血管疾病死亡率方面更为显著。
在解释和比较结果时，需要考虑到这些指数和使用它们的研究的局限性。然而，饮食质量指数似乎能够量化某些健康结果的风险，包括疾病的生物标志物和心血管疾病、某些癌症以及死亡率的风险。需要进一步的研究来提高这些工具的有效性，并将其应用于临床饮食实践中。
