Comparing three summary indices to assess diet quality of Canadian children: a call for consensus

PurposeThe Healthy Eating Index-Canada 2015 (HEI-C 2015), Diet Quality Index-International (DQI-I), and Healthy Eating Food Index 2019 (HEFI-2019) are commonly used to summarize the quality of Canadian diets. This paper sought to compare these three diet quality indices with respect to their ability...

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Main Authors: Seyedehatefeh Panahimoghadam, Paul J. Veugelers, Julia Dabravolskaj, Trudy Tran, Katerina Maximova
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2024.1519829/full
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author Seyedehatefeh Panahimoghadam
Paul J. Veugelers
Julia Dabravolskaj
Trudy Tran
Katerina Maximova
Katerina Maximova
author_facet Seyedehatefeh Panahimoghadam
Paul J. Veugelers
Julia Dabravolskaj
Trudy Tran
Katerina Maximova
Katerina Maximova
author_sort Seyedehatefeh Panahimoghadam
collection DOAJ
description PurposeThe Healthy Eating Index-Canada 2015 (HEI-C 2015), Diet Quality Index-International (DQI-I), and Healthy Eating Food Index 2019 (HEFI-2019) are commonly used to summarize the quality of Canadian diets. This paper sought to compare these three diet quality indices with respect to their ability to capture diets of different quality in Canadian children and to discriminate between population subgroups.MethodsData were collected in school-based surveys from grade 4–6 students (9–12 years old) in western Canada through 24-h dietary recall in 2016 (n = 336), 2018 (n = 454), and 2020/2021 (n = 909). Diet quality was assessed using HEI-C 2015, DQI-I and HEFI-2019. Agreement between the three indices was assessed using weighted Cohen’s kappa. Univariate and multivariable linear regression models assessed diet quality according to student’s sex, grade level, school material/social deprivation, and geographic region.ResultsHEFI-2019 scores had the widest range, while DQI-I had the smallest. Agreement was 0.55 between HEI-C 2015 and DQI-I, 0.38 between HEI-C 2015 and HEFI-2019, and 0.29 between DQI-I and HEFI-2019. Boys and students from materially deprived areas reported diets of lower quality, irrespective of the index. There were no differences in diet quality across grade levels and geographic region. Energy consumption was associated positively with DQI-I and negatively HEFI-2019 scores.ConclusionThe three indices demonstrated fair to moderate agreement and varying ability to discriminate diet quality between different population subgroups of Canadian children. This study shows that the choice of a diet quality index affects the interpretation of results and practical considerations, yielding different conclusions with respect to the determinants of children’s diet quality. Seeking consensus on which diet quality index to use for research, policy and/or practice would help support dietary research and policy development, and promote dietary guidelines implementation.
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spelling doaj-art-8a04d035cc3343a797f45e3448e6cc002025-01-07T05:23:44ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-01-011110.3389/fnut.2024.15198291519829Comparing three summary indices to assess diet quality of Canadian children: a call for consensusSeyedehatefeh Panahimoghadam0Paul J. Veugelers1Julia Dabravolskaj2Trudy Tran3Katerina Maximova4Katerina Maximova5School of Public Health, University of Alberta, Edmonton, AB, CanadaSchool of Public Health, University of Alberta, Edmonton, AB, CanadaMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, CanadaDalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, CanadaDalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaPurposeThe Healthy Eating Index-Canada 2015 (HEI-C 2015), Diet Quality Index-International (DQI-I), and Healthy Eating Food Index 2019 (HEFI-2019) are commonly used to summarize the quality of Canadian diets. This paper sought to compare these three diet quality indices with respect to their ability to capture diets of different quality in Canadian children and to discriminate between population subgroups.MethodsData were collected in school-based surveys from grade 4–6 students (9–12 years old) in western Canada through 24-h dietary recall in 2016 (n = 336), 2018 (n = 454), and 2020/2021 (n = 909). Diet quality was assessed using HEI-C 2015, DQI-I and HEFI-2019. Agreement between the three indices was assessed using weighted Cohen’s kappa. Univariate and multivariable linear regression models assessed diet quality according to student’s sex, grade level, school material/social deprivation, and geographic region.ResultsHEFI-2019 scores had the widest range, while DQI-I had the smallest. Agreement was 0.55 between HEI-C 2015 and DQI-I, 0.38 between HEI-C 2015 and HEFI-2019, and 0.29 between DQI-I and HEFI-2019. Boys and students from materially deprived areas reported diets of lower quality, irrespective of the index. There were no differences in diet quality across grade levels and geographic region. Energy consumption was associated positively with DQI-I and negatively HEFI-2019 scores.ConclusionThe three indices demonstrated fair to moderate agreement and varying ability to discriminate diet quality between different population subgroups of Canadian children. This study shows that the choice of a diet quality index affects the interpretation of results and practical considerations, yielding different conclusions with respect to the determinants of children’s diet quality. Seeking consensus on which diet quality index to use for research, policy and/or practice would help support dietary research and policy development, and promote dietary guidelines implementation.https://www.frontiersin.org/articles/10.3389/fnut.2024.1519829/fulldietary assessmentdiet quality indexchildrenhealthy eatingepidemiologypublic health
spellingShingle Seyedehatefeh Panahimoghadam
Paul J. Veugelers
Julia Dabravolskaj
Trudy Tran
Katerina Maximova
Katerina Maximova
Comparing three summary indices to assess diet quality of Canadian children: a call for consensus
Frontiers in Nutrition
dietary assessment
diet quality index
children
healthy eating
epidemiology
public health
title Comparing three summary indices to assess diet quality of Canadian children: a call for consensus
title_full Comparing three summary indices to assess diet quality of Canadian children: a call for consensus
title_fullStr Comparing three summary indices to assess diet quality of Canadian children: a call for consensus
title_full_unstemmed Comparing three summary indices to assess diet quality of Canadian children: a call for consensus
title_short Comparing three summary indices to assess diet quality of Canadian children: a call for consensus
title_sort comparing three summary indices to assess diet quality of canadian children a call for consensus
topic dietary assessment
diet quality index
children
healthy eating
epidemiology
public health
url https://www.frontiersin.org/articles/10.3389/fnut.2024.1519829/full
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