Abstract
Background/Objectives:
Diet quality indices are increasingly used in nutrition epidemiology as dietary exposures in relation to health outcomes. However, literature on the long-term stability of these indices is limited. We aimed to assess the stability of the validated Framingham Nutritional Risk Score (FNRS) and its component nutrients over 8 years, as well as the validity of the follow-up FNRS.
Subjects/Methods:
Framingham Offspring/Spouse Study women and men (n=1734) aged 22–76 years were evaluated over 8 years. Individuals’ nutrient intake and nutritional risk scores were assessed using 3-day dietary records administered at baseline (1984–1988) and at follow-up (1992–1996). Agreement between baseline and follow-up FNRS and nutrient intakes was evaluated by Bland–Altman method; stability was assessed using intra-class correlation (ICC) and weighted Kappa statistics. The effect of diet quality (as assessed by the FNRS) on cardiometabolic risk factors was evaluated using analysis of covariance.
Results:
Modest changes from baseline (⩽15%) were observed in nutrient intake. The stability coefficients for the FNRS (ICC: women, 0.49; men, 0.46; P<0.0001) and many nutrients (ICC ⩾0.3) were moderate. Over half of the women and men (58%) remained in the same or contiguous baseline and follow-up quartile of the FNRS and few (3–4%) shifted >1 quartile. The FNRS was directly associated with body mass index in women (P<0.01) and high-density lipoprotein cholesterol among both women (P<0.001) and men (P<0.01).
Conclusions:
The FNRS and its constituent nutrients remained relatively stable over 8 years of follow-up. The stability of diet quality has implications for prospective epidemiological investigations.
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Acknowledgements
This research was supported by the National Institutes of Health/National Heart, Lung and Blood Institute Grant contracts R01-HL-60700, R01-HL-54776 and N01-HC-25195 (Bethesda, MD, USA).
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Kimokoti, R., Newby, P., Gona, P. et al. Stability of the Framingham Nutritional Risk Score and its component nutrients over 8 years: the Framingham Nutrition Studies. Eur J Clin Nutr 66, 336–344 (2012). https://doi.org/10.1038/ejcn.2011.167
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DOI: https://doi.org/10.1038/ejcn.2011.167
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