(P22-080-20) Validation of a New Instrument for Assessing Diet Quality and Its Association with Undernutrition and Non-Communicable Diseases for Women in Reproductive Age in India

Objectives: India has been undergoing a rapid nutrition transition, resulting in the co-existence of undernutrition and nutrition-related non-communicable diseases (NCD). There is a need to develop and validate a diet quality assessment tool to assess risks for the double burden of disease.

Methods: We included 2915 non-pregnant and non-lactating women (15-49 years) from two Indian cohorts: The Andhra Pradesh Children and Parent Study and the Indian Migration Study. Using dietary data collected from FFQs, we developed a novel diet metric, the Global Diet Quality Score (GDQS). We categorized foods into 25 groups based on similarity of nutrient intake and intake patterns. Each category was assigned a positive or negative score based on prior evidence on their associations with undernutrition and NCD. Scores were calculated from the frequency and intake amounts for each category with higher scores corresponding to better diet quality (maximum total points of 49). We evaluated associations between the GDQS (overall, positive submetric, and negative submetric) and overall nutrient adequacy ( >6/12 nutrients intake being adequate), individual micro and macronutrients, BMI, hemoglobin, systolic and diastolic blood pressure (SBP and DBP), high density lipoprotein (HDL), and total cholesterol (TC).

Results: The mean (SD) of the GDQS was 24 (4) points. In energy-adjusted models, positive associations were found between the overall GDQS and intakes of calcium, fiber, folate, iron, MUFA, protein, PUFA, SFA, total fat, and zinc in energy-adjusted models (r=0.15-0.33, p< 0.001). Adjusted for age, GDQS was positively associated with overall nutrient adequacy. Quintile analyses showed that GDQS was positively associated with the odds of being overweight, obese and high SBP. Lower intake of foods in the GDQS negative submetric was associated with lower odds of having BMI ≥30kg/m2 (OR=0.66  (95%CI: 0.56-0.77), TC ≥ 200mg/dL (0.87 (0.78-0.97), and DBP ≥80mmHg (0.82 (0.74-0.92).

Conclusions: Among Indian women, the overall GDQS was positively associated with overall nutrient adequacy. Both the overall and negative submetric were associated with several NCD risk markers. Future studies should validate these metrics against incident diabetes and cardiovascular disease.

Funding Sources: Intake - Center for Dietary Assessment at FHI Solutions