Development of a diet quality index assessing adherence to the Swedish nutrition recommendations and dietary guidelines in the Malmo Diet and Cancer cohort

Objective: To develop a diet quality index (DQI) that assesses adherence to the Swedish nutrition recommendations (SNR) and the Swedish dietary guidelines (SDG). Design: A cross-sectional study within the Malmo Diet and Cancer (MDC) cohort. A diet history method collected dietary data, a structured questionnaire lifestyle and socio-economic information, and anthropometric data were collected by direct measurements. The index (DQI-SNR) included six components: SFA, PUFA, fish and shellfish, dietary fibre, fruit and vegetables, and sucrose. Setting: Malmo, Sweden. Subjects: Men (n 4525) and women (n 8491) of the MDC cohort enrolled from September 1994 to October 1996. Results: For participants with high DQI-SNR scores, nutrient and food intakes were close to recommendations. However, most of the study population exceeded the recommended intake for SFA (98%) and few reached recommended intakes for dietary fibre (24%), fruit and vegetables (32%), vitamin D (18%) and folate (2%). A high DQI-SNR score was positively associated with age, physical activity, not smoking, past food habit change, education and socio-economic status. Individuals with high scores were more likely to have a diabetes diagnosis or experienced a cardiovascular event. Conclusions: Results suggest that the DQI-SNR is a useful tool for assessing adherence to the SNR 2005 and the SDG in the MDC cohort. No index has previously been developed with the aim of evaluating adherence to the current dietary recommendations in Sweden. Further validation of the DQI-SNR, and evaluation of its utility, is needed.