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Diet Quality Is Associated with Higher Nutrient Intake and Self-Rated Health in Mid-Aged Women

School of Health Sciences (C.E.C.)
Research Centre for Gender and Health (A.F.Y.)
The University of Newcastle, Callaghan, New South Wales, Cancer Epidemiology Centre, Cancer Council of Victoria, Carlton, Victoria (A.H.), AUSTRALIA

Address correspondence to: Clare E. Collins, PhD, BSc, Dip Nutr Diet, Dip Clin Epi, APD, Associate Professor in Nutrition and Dietetics, School of Health Sciences, University of Newcastle, NSW, Australia, HA12 Hunter Building, University Drive, Callaghan, NSW, 2308. AUSTRALIA. E-mail: Clare.Collins{at}newcastle.edu.au

Objective: To develop a diet quality score reflecting adherence to national dietary recommendations for the Australian Longitudinal Study on Women's Health (ALSWH) and to compare this against energy standardized nutrient intakes and indices of health.

Design: Cross-sectional survey in a nationally representative sample of mid-aged women participating in a cohort study.

Subjects: Data from 9,895 women aged 50–55 who participated in the 2001 survey and had four or less missing values on their food frequency questionnaires were used to calculate the Australian Recommended Food Score (ARFS) based on adherence to Australian Dietary Guidelines.

Measure of Outcome: Correlates of ARFS were investigated including, mean nutrient intakes and indices of self-rated health and health service use. Associations were examined using ANOVA for continuous variables and Chi-squared tests for categorical variables. Area of residence and educational attainment were used as covariates in all modeling, to adjust for sampling frame and socioeconomic status.

Results: The maximum ARFS was 74, with a mean of 33.0 ± 9.0 and 21% achieving a score > 40. Higher ARFS was associated with indicators of higher socio-economic status, better self-rated health and lower health service use, p<0.0001, higher intakes of micronutrients and lower percentage of energy as total or saturated fat, p<0.0001.

Conclusions: The Australian Recommended Food Score can be used to rank mid-aged women in terms of diet quality and nutrient intake and is associated with indices of self-rated health and health service use. The ARFS can be used to measure future associations with health outcomes and mortality.

Abbreviations: AHEI = Alternate Healthy Eating Index • ALSWH = Australian longitudinal Study of Women's Health • ARFS = Australian Recommended Food Score • DQES = Dietary Questionnaire for Epidemiological Studies • BMI = body mass index • BMR = basal metabolic rate • EI/BMR = ratio of energy intake to basal metabolic rate • EI = energy intake • ES = energy standardized • FFQ = food frequency questionnaire • RFS = Recommended Food Score