Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study

Rosalind Fallaize, Katherine M. Livingstone, Carlos Celis-Morales, Anna L. Macready, Rodrigo San-Cristobal, Santiago Navas-Carretero, Cyril F M Marsaux, Clare B. O'Donovan, Silvia Kolossa, George Moschonis, Marianne C. Walsh, Eileen R. Gibney, Lorraine Brennan, Jildau Bouwman, Yannis Manios, Miroslaw Jarosz, J. Alfredo Martinez, Hannelore Daniel, Wim H. Saris, Thomas E. GundersenChristian A. Drevon, Michael J. Gibney, John C. Mathers, Julie A Lovegrove

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Diet-quality scores (DQS), which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI) and markers of metabolic health (anthropometry, objective physical activity levels (PAL), and dried blood spot total cholesterol (TC), total carotenoids, and omega-3 index) in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants (n = 1480) were adults recruited from seven European Union (EU) countries. Overall, women had higher HEI and AHEI than men (p < 0.05), and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index (p trends < 0.05). Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour (p trend < 0.05). We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health.

Original languageEnglish
Article number49
Number of pages15
Issue number1
Publication statusPublished - 6 Jan 2018


  • Diet scores
  • Dried blood spots
  • Dutch healthy diet index
  • Healthy eating index
  • Mediterranean diet score
  • Metabolic health
  • Nutritional biomarkers
  • Personalized nutrition
  • Health Status Disparities
  • Nutritive Value
  • Anthropometry
  • Healthy Diet
  • Humans
  • Middle Aged
  • Male
  • Nutrition Assessment
  • Young Adult
  • Adiposity
  • Cholesterol/blood
  • Adult
  • Biomarkers/blood
  • Female
  • Surveys and Questionnaires
  • Nutritional Status
  • Europe
  • Feeding Behavior
  • Health Knowledge, Attitudes, Practice
  • Health Behavior
  • Adolescent
  • Aged


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