title: Development of a Dietary Index to Assess Overall Diet Quality for Chinese School-Aged Children: The Chinese Children Dietary Index.
abstract: BACKGROUND
  A composite measure of diet quality is preferable to an index of nutrients, food groups, or health-promoting behaviors in dietary assessment. However, to date, such a tool for Chinese children is lacking.
  
  
  OBJECTIVE
  Based on the current Chinese Dietary Guidelines and Dietary Reference Intakes, a dietary index for Chinese school-aged children, the Chinese Children Dietary Index was developed to assess overall diet quality among children in South China.
  
  
  METHODS
  Dietary data were recorded using 24-hour recalls among 1,719 children aged 7 to 15 years between March and June 2013. Inactivity data and sociodemographic information were also collected. The Chinese Children Dietary Index included 16 components, which incorporated nutrients, foods/food groups, and health-promoting behaviors. The range of possible Chinese Children Dietary Index scores was 0 to 160, with a higher score indicating better diet quality.
  
  
  METHODS
  Pearson/Spearman correlation was used to assess relative validity using correlations between total Chinese Children Dietary Index score and age, body mass index (BMI; calculated as kg/m(2)), inactivity, whole-grain intake, frequency of fried-foods intake, nutrient adequacy ratios for energy intake and 12 nutrients not included in the Chinese Children Dietary Index, and the mean adequacy ratio. Finally, a stepwise multiple regression analysis was performed to indicate the factors correlated with Chinese Children Dietary Index.
  
  
  RESULTS
  Mean Chinese Children Dietary Index score of this sample was 88.1 points (range=34.2 to 137.8), the Chinese Children Dietary Index score of girls was higher than that of boys and decreased with higher age. Children with higher Chinese Children Dietary Index had lower body mass index and spent less time being inactive. Positive associations were observed between Chinese Children Dietary Index and the majority of nutrient adequacy ratios and the mean adequacy ratio. Age, paternal educational level, and family size were correlated with Chinese Children Dietary Index.
  
  
  CONCLUSIONS
  The Chinese Children Dietary Index successfully differentiated diets and, therefore, it can be used to rank-order overall diet quality among Chinese children. As the results showed, diet quality among Chinese children needs to be improved, especially in adolescents.
authors.forename: Guo
authors.initials: G
authors.lastname: Cheng
authors.forename: Ruonan
authors.initials: R
authors.lastname: Duan
authors.forename: Sibylle
authors.initials: S
authors.lastname: Kranz
authors.forename: Lars
authors.initials: L
authors.lastname: Libuda
authors.forename: Lishi
authors.initials: L
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002681:China; D004032:Diet; D015930:Diet Records; D004522:Educational Status; D015444:Exercise; D005191:Family Characteristics; D005220:Fathers; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D011939:Mental Recall; D018673:Nutrition Policy; D012737:Sex Factors
keywords: Adolescent; Child; China; Diet quality; Dietary index