Zarrin Rasoul, Ibiebele Torukiri I, Marks Geoffrey C
The University of Queensland, School of Population Health, Australia.
Asia Pac J Clin Nutr. 2013;22(2):177-87. doi: 10.6133/apjcn.2013.22.2.15.
Existing Australian diet quality indices have assumed links to health outcomes but their validity for this has not been reported. We extend the features of existing indices for Australian adults by constructing a new diet quality index (Aussie-DQI) using the national dietary guidelines linked to the Australia National Health Priority Areas. Construct validity was assessed using 24 hour dietary recalls from the 1995 National Nutrition Survey (n=10,851 adults aged 19 years and older). Construct and criterion validity were assessed using food frequency questionnaire data from the Nambour Skin Cancer study (n=1355), a community-based longitudinal study with 16 year follow-up and cause-specific mortality outcomes. Generalised linear regression was used to assess associations between Aussie-DQI scores and socio-economic, demographic, health-behaviour characteristics, and food and nutrient intakes, while Cox proportional-hazards modeling was used to assess associations with cancer and allcause mortality. A high Aussie-DQI score was associated with being female, being older, non-smoking status, and BMI in the normal range in both study populations; and Aussie-DQI scores were inversely associated with cancer mortality among men in multivariable-adjusted analyses (hazard ratio = 0.30, 95% CI: 0.11, 0.83; p for trends = 0.06). In conclusion, Aussie-DQI successfully discriminated diet quality and showed that men, younger adults, current smokers and those overweight/obese were less likely to consume foods that meet dietary recommendations; and that a high diet quality is associated with decreased risk of cancer mortality among men. This study adds further evidence to clarify the role of diet quality in decreasing mortality from chronic diseases.
现有的澳大利亚饮食质量指数已假定与健康结果存在关联，但尚未有关于其有效性的报告。我们通过利用与澳大利亚国家卫生重点领域相关的国家饮食指南构建一个新的饮食质量指数（澳大利亚饮食质量指数，Aussie - DQI），扩展了现有澳大利亚成年人饮食质量指数的特征。使用1995年全国营养调查（n = 10851名19岁及以上成年人）的24小时饮食回顾来评估结构效度。使用楠伯尔皮肤癌研究（n = 1355）的食物频率问卷数据评估结构效度和效标效度，该研究是一项基于社区的纵向研究，随访16年并记录特定病因死亡率结果。使用广义线性回归评估澳大利亚饮食质量指数得分与社会经济、人口统计学、健康行为特征以及食物和营养素摄入量之间的关联，同时使用Cox比例风险模型评估与癌症和全因死亡率的关联。在两个研究人群中，澳大利亚饮食质量指数得分高均与女性、年龄较大、不吸烟状态以及正常范围的体重指数相关；在多变量调整分析中，澳大利亚饮食质量指数得分与男性癌症死亡率呈负相关（风险比 = 0.30，95%置信区间：0.11，0.83；趋势检验p值 = 0.06）。总之，澳大利亚饮食质量指数成功区分了饮食质量，并表明男性、年轻人、当前吸烟者以及超重/肥胖者摄入符合饮食建议食物的可能性较小；且高饮食质量与男性癌症死亡率风险降低相关。本研究进一步证明了饮食质量在降低慢性病死亡率中的作用。
