title: Development of a diet-lifestyle quality index for young children and its relation to obesity: the Preschoolers Diet-Lifestyle Index.
abstract: OBJECTIVE
  To develop an index that assesses the degree of adherence to existing diet-lifestyle recommendations for preschoolers (Preschoolers Diet-Lifestyle Index (PDL-Index)) and to investigate its association with obesity.
  
  
  METHODS
  The PDL-Index was constructed using eleven components (i.e. questions regarding the frequency of consumption of selected foods/food groups, time spent on television watching and on moderate-to-vigorous physical activities).
  
  
  METHODS
  Scores from 0 to 4 were assigned to all components of the index. The PDL-Index total score ranged from 0 to 44. Higher values of the PDL-Index indicate greater adherence to dietary and lifestyle recommendations for preschoolers or otherwise greater adherence to healthier dietary-lifestyle patterns.
  
  
  METHODS
  As a validation procedure, a sample of 2287 preschoolers from Greece (GENESIS study) was used.
  
  
  RESULTS
  The participants following healthier diet-lifestyle patterns (third tertile of PDL-Index) were less likely to be obese or overweight/obese compared to those following unhealthy diet-lifestyle patterns (first tertile of PDL-Index). It was observed that a 1/44 unit increase in the score of the PDL-Index was associated with approximately 5 % and 3 % lower odds of being obese and overweight/obese, respectively. Statistically significant results were observed after adjusting for potential confounders.
  
  
  CONCLUSIONS
  The suggested PDL-Index could help public health policy makers in identifying vulnerable population subgroups and developing cost-effective, targeted intervention actions both in family and preschool settings. In addition, health-care professionals can use the PDL-Index to evaluate diet quality, lifestyle and risk for overweight/obesity at an individual level and counsel parents accordingly.
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University of Athens, 70 El. Venizelou Avenue, 17671 Kallithea, Greece. manios@hua.gr
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.forename: Georgia
authors.initials: G
authors.lastname: Kourlaba
authors.forename: Evangelia
authors.initials: E
authors.lastname: Grammatikaki
authors.forename: Odysseas
authors.initials: O
authors.lastname: Androutsos
authors.forename: George
authors.initials: G
authors.lastname: Moschonis
authors.forename: Eleytheria
authors.initials: E
authors.lastname: Roma-Giannikou
mesh_terms: D002675:Child, Preschool; D004032:Diet / Q000592:standards* / Q000706:statistics & numerical data; D005247:Feeding Behavior; D005260:Female; D006115:Greece; D019983:Guideline Adherence; D006291:Health Policy; D006801:Humans; D008019:Life Style; D008297:Male; D009749:Nutrition Surveys / Q000295:instrumentation* / Q000592:standards; D009751:Nutritional Requirements; D009765:Obesity / Q000209:etiology*; D011050:Policy Making; D011634:Public Health; D013334:Students / Q000706:statistics & numerical data