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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #195517
Title: THE 2005 DIETARY GUIDELINES FOR AMERICANS ADHERENCE INDEX: DEVELOPMENT AND APPLICATION

Author
item FOGLI-CAWLEY, JEANENE - BI-DEACONESS MEDICAL CTR
item DWYER, JOHANNA - TUFTS-NEMC
item Saltzman, Edward
item MCCULLOUGH, MARJORIE - AMERICAN CANCER SOCIETY
item TROY, LISA - TUFTS/HNRCA
item Jacques, Paul

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/26/2006
Publication Date: 11/1/2006
Citation: Fogli-Cawley, J.J., Dwyer, J.T., Saltzman, E., Mccullough, M.L., Troy, L.M., Jacques, P. 2006. The 2005 dietary guidelines for americans adherence index: development and application. Journal of Nutrition. 136:2908-2915.

Interpretive Summary: In 1980, the United States Departments of Agriculture (USDA) and Health and Human Services issued the first "Dietary Guidelines for Americans" (DGA), federal dietary recommendations intended to decrease major chronic disease risk for healthy American adults. The most recent (sixth) version of the DGA, released in January 2005, represents a significant departure from the guidelines written over the past 20 years. When the DGA was originally developed in 1980, there was no plan in place to evaluate its success. The first evaluation tool created to assess the DGA, the Healthy Eating Index (HEI), was developed by the USDA Center for Nutrition Policy and Promotion based on the 1990 DGA. We developed the Dietary Guidelines Adherence Index (DGAI) as a measure of adherence to the key dietary intake recommendations of the 2005 DGA to reflect the substantial changes in these recommendation. Eleven index items assess adherence to calorie-specific food intake recommendations, and 9 items assess adherence to "healthy choice" nutrient intake recommendations. Each item was scored from a minimum of 0 to a maximum of 1, depending on the degree of adherence to the recommendation. A score of 0.5 was given for partial adherence on most items or for exceeding the recommendation for energy-dense food items. The DGAI was applied to dietary data collected at the 5th examination of the Framingham Heart Study Offspring Cohort. The mean DGAI score was 10.7 (range 3.0-18.0). Those with higher DGAI scores were significantly (P<0.05) more likely to be women, older, multivitamin supplement users and have a lower BMI and less likely to be smokers. The DGAI demonstrated a reasonable variation in this population of adult Americans, and by design this index was independent of energy consumption after accounting for age, sex and BMI. The DGAI also demonstrated face validity based on the observed associations of the index with participant characteristics. Given these attributes, this index should provide a useful measure of diet quality and adherence to the new 2005 Dietary Guidelines for Americans, which can be used to assess the relation between adherence to the 2005 DGA and chronic disease risk and their intermediate risk factors.

Technical Abstract: The sixth edition of the Dietary Guidelines for Americans (DGA) was released in January 2005, with revised healthy eating recommendations for all adult Americans. The 2005 Dietary Guidelines Adherence Index (DGAI) was developed as a measure of adherence to the key dietary intake recommendations. Eleven index items assess adherence to calorie-specific food intake recommendations, and 9 items assess adherence to "healthy choice" nutrient intake recommendations. Each item was scored from a minimum of 0 to a maximum of 1, depending on the degree of adherence to the recommendation. A score of 0.5 was given for partial adherence on most items or for exceeding the recommendation for energy-dense food items. The DGAI was applied to dietary data collected at the 5th examination of the Framingham Heart Study Offspring Cohort. The mean DGAI score was 10.7 (range 3.0-18.0). Those with higher DGAI scores were significantly (P<0.05) more likely to be women, older, multivitamin supplement users and have a lower BMI and less likely to be smokers. The DGAI demonstrated a reasonable variation in this population of adult Americans, and by design this index was independent of energy consumption. The DGAI also demonstrated face validity based on the observed associations of the index with participant characteristics. Given these attributes, this index should provide a useful measure of diet quality and adherence to the new 2005 Dietary Guidelines for Americans.