title: A comparison of three dietary pattern indexes for predicting biomarkers of diet and disease.
abstract: OBJECTIVE
  Examination of dietary indexes in association with objective biomarkers of dietary intake and chronic disease risk is an important step in their validation. We compared three dietary pattern indexes-Healthy Eating Index (HEI), Recommended Foods Score (RFS-24 hour recall), and Dietary Diversity Score for recommended foods (DDS-R)-for their ability to predict biomarkers of dietary intake, obesity, cardiovascular disease, and diabetes.
  
  
  METHODS
  We used dietary and laboratory data from the third National Health and Nutrition Examination Survey to study these associations in 8719 disease-free adults aged > or =20 y. The HEI, developed by the USDA, was a sum of scores on consideration of ten individual components; the RFS was a sum of all recommended foods (lean meat, poultry and fish, whole grains, fruits and juices, low-fat dairy, and vegetables) mentioned in the recall; the DDS-R examined whether or not a recommended food was mentioned from each of the five major food groups. The independent association of the dietary pattern indexes with body mass index (BMI), blood pressure, and serum concentrations of several biomarkers were examined using regression methods to adjust for multiple covariates.
  
  
  RESULTS
  All indexes were strong independent positive predictors of serum concentrations of vitamin C, E, folate, and all carotenoids (p < or = 0.00001), except lycopene, and were negative predictors of BMI, serum homocysteine, C-reactive protein, plasma glucose, and hemoglobin A1C (p < 0.05). The RFS and DDS-R were inversely associated with blood pressure and serum cholesterol (p < or = 0.03).
  
  
  CONCLUSIONS
  The RFS and DDS-R performed as well or better than the HEI for predicting serum concentration of nutrients and biomarkers of disease risk.
authors.affiliation: Department of Family, Nutrition, and Exercise Sciences, Remsen Hall, Room 306E, Queens College of the City University of New York, Flushing, NY 11367, USA. akant@qc.edu
authors.forename: Ashima K
authors.initials: AK
authors.lastname: Kant
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D015992:Body Mass Index; D002908:Chronic Disease; D004032:Diet / Q000639:trends*; D004522:Educational Status; D015444:Exercise / Q000502:physiology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011237:Predictive Value of Tests; D012907:Smoking; D014481:United States; D016885:United States Department of Agriculture
chemical_list: D015415:Biomarkers