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The development and evaluation of a Diet Quality Index for Asian toddlers and its perinatal correlates: the GUSTO cohort study

The development and evaluation of a Diet Quality Index for Asian toddlers and its perinatal correlates: the GUSTO cohort study
The development and evaluation of a Diet Quality Index for Asian toddlers and its perinatal correlates: the GUSTO cohort study
Early childhood diet may have lifelong influences on health outcomes, yet development of indices to assess diet quality is scarce in toddlers, especially in Asian countries. We aimed to develop and evaluate a Diet Quality Index (DQI) in a multi-ethnic Asian mother–offspring cohort and identify perinatal correlates of early childhood diet. Based primarily on the Singapore dietary guidelines, the DQI includes seven food components: rice, bread and alternatives; fruit; vegetables; meat and alternatives; milk and dairy products; whole grains; and foods high in sugar. The DQI was developed using parental report of Food Frequency Questionnaires (FFQ) data for 18-month-old toddlers (n = 561). The mean ± SD of DQI for the study toddlers was 44.2 ± 8.9 (theoretical range: 0–65). A higher DQI (better diet quality) was associated with higher intakes of several nutrients and food groups (e.g., vegetables, dietary fibre, and beta-carotene; all p < 0.001). Further construct validity was demonstrated by substantial agreement between the FFQ-DQI and 24-hour-recall-DQI (Intraclass-correlation-coefficient: 0.70). Independent predictors of lower DQI included higher maternal pre-pregnancy BMI [β(95% CI): −0.23(−0.39, −0.07)], Malay ethnicity [−1.88(−3.67, −0.09)], lower household income [−1.97(−3.91, −0.03)], lower education level [−2.57(−4.85, −0.28)] and never breastfeeding [−6.17(−11.06, −1.28)]. We developed a valid DQI for assessing the overall quality of the diets of Asian toddlers.
Chen, Ling-Wei
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Fung, Si Ming
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Fok, Doris
bb0a659f-fc27-4847-b09c-c64f018dca7d
Leong, Lai Peng
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Toh, Jia Ying
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Lim, Hui Xian
2ec0de11-e025-43ca-b534-9c32a793c66a
Pang, Wei Wei
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Tan, Kok Hian
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Chong, Yap-Seng
e669c2b0-ad78-473e-9e31-636ef30b4dbd
Yap, Fabian
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Godfrey, Keith
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Lee, Yung Seng
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Chong, Mary Foong-Fong
1e188259-b1ab-4448-9e65-5b6a0fd99502
Chen, Ling-Wei
528a58c5-d5ec-4dd8-b3c4-0f2f2a97ea53
Fung, Si Ming
6b3cf503-1007-4b21-954f-020f45912043
Fok, Doris
bb0a659f-fc27-4847-b09c-c64f018dca7d
Leong, Lai Peng
7509dcfa-e324-4d44-bf2a-6f41d714994a
Toh, Jia Ying
bae40ae7-536e-451c-a758-b2b8674681ac
Lim, Hui Xian
2ec0de11-e025-43ca-b534-9c32a793c66a
Pang, Wei Wei
6bfc8a33-62c1-4c3b-81a3-baaa14210f8d
Tan, Kok Hian
672ae6c4-d4c8-4b1b-8512-efec36431503
Chong, Yap-Seng
e669c2b0-ad78-473e-9e31-636ef30b4dbd
Yap, Fabian
22f6b954-31fc-4696-a52b-e985a424b95b
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Lee, Yung Seng
0e28a8d6-3085-4086-9fa1-ac0684783bcf
Chong, Mary Foong-Fong
1e188259-b1ab-4448-9e65-5b6a0fd99502

Chen, Ling-Wei, Fung, Si Ming, Fok, Doris, Leong, Lai Peng, Toh, Jia Ying, Lim, Hui Xian, Pang, Wei Wei, Tan, Kok Hian, Chong, Yap-Seng, Yap, Fabian, Godfrey, Keith, Lee, Yung Seng and Chong, Mary Foong-Fong (2019) The development and evaluation of a Diet Quality Index for Asian toddlers and its perinatal correlates: the GUSTO cohort study. Nutrients, 11 (3). (doi:10.3390/nu11030535).

Record type: Article

Abstract

Early childhood diet may have lifelong influences on health outcomes, yet development of indices to assess diet quality is scarce in toddlers, especially in Asian countries. We aimed to develop and evaluate a Diet Quality Index (DQI) in a multi-ethnic Asian mother–offspring cohort and identify perinatal correlates of early childhood diet. Based primarily on the Singapore dietary guidelines, the DQI includes seven food components: rice, bread and alternatives; fruit; vegetables; meat and alternatives; milk and dairy products; whole grains; and foods high in sugar. The DQI was developed using parental report of Food Frequency Questionnaires (FFQ) data for 18-month-old toddlers (n = 561). The mean ± SD of DQI for the study toddlers was 44.2 ± 8.9 (theoretical range: 0–65). A higher DQI (better diet quality) was associated with higher intakes of several nutrients and food groups (e.g., vegetables, dietary fibre, and beta-carotene; all p < 0.001). Further construct validity was demonstrated by substantial agreement between the FFQ-DQI and 24-hour-recall-DQI (Intraclass-correlation-coefficient: 0.70). Independent predictors of lower DQI included higher maternal pre-pregnancy BMI [β(95% CI): −0.23(−0.39, −0.07)], Malay ethnicity [−1.88(−3.67, −0.09)], lower household income [−1.97(−3.91, −0.03)], lower education level [−2.57(−4.85, −0.28)] and never breastfeeding [−6.17(−11.06, −1.28)]. We developed a valid DQI for assessing the overall quality of the diets of Asian toddlers.

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Accepted/In Press date: 22 February 2019
Published date: 1 March 2019

Identifiers

Local EPrints ID: 428688
URI: https://eprints.soton.ac.uk/id/eprint/428688
PURE UUID: f5f7e3e9-9057-4c88-ae9b-5b3aca0d4267
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 06 Mar 2019 17:30
Last modified: 11 Apr 2019 00:38

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Contributors

Author: Ling-Wei Chen
Author: Si Ming Fung
Author: Doris Fok
Author: Lai Peng Leong
Author: Jia Ying Toh
Author: Hui Xian Lim
Author: Wei Wei Pang
Author: Kok Hian Tan
Author: Yap-Seng Chong
Author: Fabian Yap
Author: Keith Godfrey ORCID iD
Author: Yung Seng Lee
Author: Mary Foong-Fong Chong

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