Development of the Eating Choices Index (ECI): a four-item index to measure healthiness of diet.
OBJECTIVE
Current indices of diet quality generally include intakes of specific foods or nutrients. We sought to develop an index that discriminates healthy and unhealthy eating choices for use in large surveys as a short questionnaire and as a measure in existing studies with adequate dietary data.


METHODS
The Eating Choices Index (ECI) score included four components: (i) consumption of breakfast, (ii) consumption of two portions of fruit per day, (iii) type of milk consumed and (iv) type of bread consumed, each providing a score from 1 to 5. In analysis of 5 d food records, the ECI score was examined in relation to macronutrients, fibre, vitamin C, Fe, Ca and folate using Pearson correlations. Variation with sex, BMI, socio-economic status, marital status, smoking status and physical activity were also investigated.


METHODS
Medical Research Council National Survey of Health and Development.


METHODS
Individuals (n 2256) aged 43 years.


RESULTS
The ECI score (mean 12·3 (sd 3·5)) was significantly positively associated with protein, carbohydrate, fibre, vitamin C, Fe, Ca and folate (r = 0·2-0·5; P < 0·001) and significantly negatively associated with fat intake (r = -0·2; P < 0·001); ECI scores were not correlated with total energy intake. Individuals with a lower ECI score were more likely to be men (P < 0·001), overweight or obese (P < 0·001), have lower socio-economic status (P < 0·001), smoke more (P < 0·001) and be less physically active (P < 0·001).


CONCLUSIONS
ECI scores correlated with nutrient profiles consistent with a healthy diet. It provides a simple method to rank diet healthiness in large observational studies.
1MRC Human Nutrition Research,Elsie Widdowson Laboratory,Cambridge,UK.
Gerda K
GK
Pot
3MRC Unit for Lifelong Health and Ageing at UCL,London,UK.
Marcus
M
Richards
1MRC Human Nutrition Research,Elsie Widdowson Laboratory,Cambridge,UK.
Celia J
CJ
Prynne
1MRC Human Nutrition Research,Elsie Widdowson Laboratory,Cambridge,UK.
Alison M
AM
Stephen
D000328:Adult; D000818:Animals; D001939:Bread; D062408:Breakfast; D002755:Choice Behavior; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D004043:Dietary Fiber / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D005502:Food; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D008892:Milk; D009765:Obesity / Q000209:etiology; D012737:Sex Factors; D012923:Social Class; D011795:Surveys and Questionnaires