Evaluation of diet quality indicators in adults
Authors: Fatrcová-Šramková Katarí­na 
Published: November 2013

Several indices evaluate the quality of diet. The indices are based on nutrient requirements and dietary guidelines for the prevention of chronic diseases (to reduce the risk of chronic diseases). The Healthy Eating Index, Healthy Diet Indicator, and Diet Quality Index consist of components, which represent different aspects of a healthy diet. The indicators of diet quality are based on dietary intake data from 24-hour dietary recalls. 
The aim of the research was to evaluate the nutrition of adults according to the selected criteria of three diet quality indicators: Healthy Eating Index, Healthy Diet Indicator, Diet Quality Index. 234 nutrition daily records were evaluated (from 78 probands per 3 days). Nutritional intake and blood biochemical parameters were defined in 56 females and 22 men (72% and 28% respectively) aged from 24 to 62 years. The nutritional software Alimenta 4.3e (Food Research Institute, Bratislava, Slovakia, 2004) was used to calculate the nutrient intake. The evaluation of nutrition intake was focused on four parameters/recommendations of the Healthy Eating Index (to reduce total fat intake to 30% or less of energy, to reduce saturated fatty acid intake to less than 10% of energy, to reduce cholesterol intake to less than 300 mg daily, to limit total daily intake of sodium to 2400 mg or less), on five parameters/recommendations of the Healthy Diet Indicator (saturated fatty acids 0-10% of energy intake, polyunsaturated fatty acids 3-7% of energy intake, protein 10-15% of energy intake, dietary fiber 27-40 g, cholesterol 0-300 mg), on five parameters/recommendations of the Diet Quality Index (to reduce total fat intake to 30% or less of energy,to reduce saturated fatty acid intake to less than 10% of energy, to reduce cholesterol intake to less than 300 mg daily, to limit total daily intake of sodium to 2400 mg or less, to maintain adequate calcium intake – approximately Recommended Dietary Allowance levels, i.e. ³RDA). Blood samples from peripheral blood were taken after all-night starvation and then analyzed by using Reflotron (Roche Diagnostics GmbH, Mannheim, Germany). The data from nutritional intake and biochemical parameters were analyzed using t-test and chi-quadrat-test.
The normal cholesterolaemia occured in 47% (thr first group Without risk), and 53% of the examined participants (the second group Risk) were classified with risky cholesterol values (5 mmol.l-1 and more). Among the subjects with hypercholesterolaemia they had 27% higher values of triglycerides (1.9 mmol.l-1 and more), while in the rest of set there were only 14% characterized with hypertriacylglycerolaemia. The probands with the negative high cholesterol level in blood had significantly higher triacylglycerolaemia (P<0.001) and the age of (P<0.05).
In case of Healthy Eating Index the most participants met the criterion only for one recommendation (41%), and fifth of volunteers fulfilled two recommendation altogether. Taking into account all parameters the probands met cholesterol in diet (56%) best, less saturated fat (35%), total fat (24%), and at least sodium intake (9%). Within Healthy Diet Indicator there were recorded fulfillments: for cholesterol in 56%, for saturated fatty acids in 35%, for protein in 32%, for fiber in 22%, and for polyunsaturated fatty acids in 17%. From five criteria there was met only one recommendation of 36% of subjects, 17% achieved two fulfillments, and other 17% three ones. Evaluation of Diet Quality Index recorded that the following order of recommendation fulfillment was obtained: cholesterol (56 %) > calcium (44 %) > saturated fat (35 %) > total fat (24 %) > natrium (9 %). Only one fulfillment reached 37 %, two recommendations met 27 %, and three 14 %.
From all three considered indicators the recommendation for cholesterol intake was met most (by 56% probands), worst for total fat (24%), fiber (22%), polyunsaturated fat (17%), and  natrium (9%).
In conclusion, this study demonstrated higher saturated fat, polyunsaturated fatty acids, fiber, and significantly higher calcium intake (P<0.05) in the examined participants with normal cholesterolaemia in comparison with  the group of  risk cholesterol.