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Research Original Research| Volume 118, ISSUE 1, P62-73.e4, January 2018

Development and Evaluation of a Dietary Approaches to Stop Hypertension Dietary Index with Calorie-Based Standards in Equivalent Units: A Cross-Sectional Study with 24-Hour Dietary Recalls from Adult Participants in the National Health and Nutrition Examination Survey 2007-2010

Published:May 04, 2017DOI:https://doi.org/10.1016/j.jand.2017.03.010
Development and Evaluation of a Dietary Approaches to Stop Hypertension Dietary Index with Calorie-Based Standards in Equivalent Units: A Cross-Sectional Study with 24-Hour Dietary Recalls from Adult Participants in the National Health and Nutrition Examination Survey 2007-2010
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Next ArticleDiet Quality as Assessed by the Healthy Eating Index, Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension Score, and Health Outcomes: An Updated Systematic Review and Meta-Analysis of Cohort Studies

      Abstract

      Background

      Dietary indexes to assess accordance with the Dietary Approaches to Stop Hypertension (DASH) dietary pattern are useful tools in studies with health-related outcomes. However, scoring algorithms of the dietary index can affect the range of its applications.

      Objective

      The purposes of this study were to develop a DASH dietary index with calorie-based standards in equivalent units and to evaluate the validity and reliability of the index.

      Methods

      Calorie-based standards for nine components were determined based on recommended intakes in the DASH eating plan and dietary intakes estimated from two 24-hour dietary recalls of adult participants in the National Health and Nutrition Examination Survey 2007-2008, 2009-2010 (n=9,720). Evaluation tests included descriptive analyses of index scores among US adults stratified by sex and smoking status. Spearman’s rank correlations were used to examine the relationships among components and total scores. The developed index was compared with two DASH dietary indexes that use different scoring algorithms to examine the association between total scores and blood pressure status through multivariable regression models.

      Results

      The newly developed index consisted of seven food group and two nutrient components. The mean and median of total scores among US adults were 42.3 (95% CI 41.6 to 43.0) and 41.6 of 90 points, respectively. The mean total scores among adult women and non–current smokers were higher than their counterparts (P<0.001). The absolute correlation coefficients among the components and between each component and the sum of other components were ≤0.33 and ≤0.35, respectively. After adjusting for age and race/ethnicity, an association between total scores and blood pressure status was found in adult women (P<0.001), but not in adult men. The same pattern was found when the two indexes were used, but the strength of the association varied across the three indexes.

      Conclusions

      The developed index appeared to measure accordance with the DASH dietary pattern based on the dietary data from US adults. Further studies are warranted for various applications of the index.

      Keywords

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      Biography

      M. Matsunaga is a postdoctoral researcher, Office of Public Health Studies, University of Hawai‘i at Mãnoa, Honolulu.

      Biography

      E. L. Hurwitz is a professor, Office of Public Health Studies, University of Hawai‘i at Mãnoa, Honolulu.

      Biography

      D. Li is an associate professor, University of Rochester School of Medicine and Dentistry, Rochester, NY.

      Article info

      Publication history

      Published online: May 04, 2017
      Accepted: March 7, 2017
      Received: May 4, 2016

      Footnotes

      Supplementary materials: Tables 3, 5, 6, and 7 are available at www.jandonline.org

      STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

      FUNDING/SUPPORT There is no funding to disclose.

      Identification

      DOI: https://doi.org/10.1016/j.jand.2017.03.010

      Copyright

      © 2018 by the Academy of Nutrition and Dietetics.

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