title: A healthy diet indicator: quantifying compliance with the dietary guidelines using the BRFSS.
abstract: BACKGROUND
  The Behavioral Risk Factor Surveillance System (BRFSS) monitors population prevalence of risk factors related to chronic disease through annual telephone surveys. The purpose of this study was to investigate the feasibility of using the BRFSS to estimate an indicator of overall diet quality among adults.
  
  
  METHODS
  The authors developed a brief set of dietary questions that were included in the 1997 Michigan BRFSS. Responses to these questions were analyzed to calculate the Michigan healthy diet indicator (MI-HDI), which was modeled after the U.S. Department of Agriculture's Healthy Eating Index.
  
  
  RESULTS
  Among 2,532 respondents, the mean MI-HDI was 55.7 points (maximum score = 100). The mean MI-HDI decreased consistently with declining self-rated eating habits, from 61.5 among those with excellent eating habits to 45.2 among those with poor habits. Diet quality, as measured by the MI-HDI, was higher among women than men and improved with age, education, and factors related to certain interactions with health professionals.
  
  
  CONCLUSIONS
  A BRFSS-based indicator can be a feasible and valuable tool for evaluating diet quality among adults using an established state-level surveillance system.
authors.affiliation: Bureau of Epidemiology, Michigan Department of Community Health, Lansing, Michigan 48909, USA. raffertya@state.mi.us
authors.forename: Ann P
authors.initials: AP
authors.lastname: Rafferty
authors.forename: Judith V
authors.initials: JV
authors.lastname: Anderson
authors.forename: Harry B
authors.initials: HB
authors.lastname: McGee
authors.forename: Corinne E
authors.initials: CE
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D004032:Diet / Q000523:psychology / Q000592:standards*; D004034:Diet Surveys; D005240:Feasibility Studies; D005247:Feeding Behavior; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires