Relative validity and reproducibility of dietary quality scores from a short diet screener in a multi-ethnic Asian population

Objective: Short screeners for assessing dietary quality are lacking in Asia. We recently developed a short thirty-seven-item diet screener (DS). The present study aimed to evaluate reproducibility and relative validity of the DS in assessing a priori dietary quality indices (DQI; i.e. the Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean Diet (aMed) and Dietary Approaches to Stop Hypertension (DASH) diet) and intakes of selected foods. Design: DS administration and biomarker measurement took place twice within a 4-month interval. A 163-item FFQ was administered one month after the second DS administration. Setting: Singapore, a multi-ethnic urban Asian country. Subjects: Singapore residents (n 161) aged 18-79 years, of Chinese, Malay and Indian ethnicity. Results: Reproducibility coefficients for the two DS were 0.71 (DQI) and 0.65 (food groups). Correlations (p) between mean DS and FFQ DQI scores were 0.51 (AHEI-2010), 0.50 (aMed) and 0.61 (DASH; all P<0.05). Cohen's weighted kappa indicated moderate agreement between the two measures (kappa(w) = 0-48-0-58). DS DQI scores were associated with concentrations of beta-cryptoxanthin (AHEI-2010, rho = 0.26; P< 0.05), odd-chain SFA (aMed, rho = 0.24; DASH, rho = 0.25; both P < and enterolactone, total carotenoids, PUFA and alpha-linolenic acid (all scores, rho = 01.7-0.30; all P< 0.05). Scores were not associated with isoflavone or long-chain n-3 PUFA concentrations. Conclusions: A short screener can be used to assess DQI with good reproducibility and relative validity compared with a longer FFQ in an Asian population.