Development and Validity Assessment of a Diet Quality Index for Australians

澳洲飲食品質指標之發展及效度評估

Rasoul Zarrin ； Torukiri I Ibiebele ； Geoffrey C Marks

《Asia Pacific Journal of Clinical Nutrition》 22卷2期 (2013/04) Pp. 177-187

https://doi.org/10.6133/apjcn.2013.22.2.15

摘要

現有的澳洲飲食品質指標，被假設與健康相關，然而他們的效度並未被實際評估過。本研究延伸現有澳洲成人飲食指標之特質，利用澳洲國民健康促進重點（NHPAs）相關的飲食指南，建構新的澳洲飲食品質指標（Aussie-DQI）。建構效度，藉由1995年澳洲國民營養調查的24小時飲食回憶記錄加以評估（計10,851位，年齡大於等於19歲的澳洲成人）。並以Nambour皮膚癌研究之食物頻率問卷資料（樣本數=1355）評估建構與效標效度；Nambour研究是一社區性縱貫研究，追蹤16年的死因別死亡率。以廣義線性迴歸評估Aussie-DQI分數與社經、人口學、健康行為特質、食物及營養素攝取量之相關；Aussie-DQI分數與癌症及全死因死亡率之相關，則以Cox比例風險迴歸評估。澳洲國民營養調查與Nambour皮膚癌研究中，女性、年紀較長、無抽菸者及身體質量指數正常者，飲食品質指標分數較高；經多變項校正後，飲食品質指標分數與男性癌症死亡率呈負相關（風險比=0.30，95% CI：0.11-0.83；趨勢p=0.06）。總結而言，澳洲飲食品質指標成功地辨別飲食品質，且顯示男性、年輕成人、抽菸者、以及過重／肥胖者，較少攝取飲食建議的食物；此外，高飲食品質與男性較低癌症死亡風險相關。本研究提增進一步的證據，闡明飲食品質於降低慢性疾病死亡率的角色。

關鍵字

飲食品質指標 ； 建構效度 ； 效標效度 ； 癌症死亡率 ； 膳食評估

並列摘要

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.

並列關鍵字

diet quality index ； construct validity ； criterion validity ； cancer mortality ； dietary assessment

參考文獻

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