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Research Project: Interplay of the Physical Environment, Social Domain, and Intrapersonal Factors on Nutrition and Physical Activity Related Health Behaviors in Children and Adolescents

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Title: Diet quality component differences among United States adolescents who misclassified their diet quality

Author
item Thomson, Jessica
item LANDRY, ALICIA - University Of Central Arkansas
item Walls, Tameka

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 2/17/2022
Publication Date: 5/18/2022
Citation: Thomson, J.L., Landry, A.S., Walls, T.I. 2022. Diet quality component differences among United States adolescents who misclassified their diet quality. Meeting Abstract. Paper No.114.

Interpretive Summary:

Technical Abstract: Purpose: Lack of awareness about what constitutes good diet quality may lead adolescents to misclassify the healthfulness of their diet. Whether this misclassification is the result of under- or overrating of diet quality is not clear. Thus, the purpose of this study was to determine percentages of United States (US) adolescents who under- or overrated their diet quality and explore diet quality component differences among rating groups of adolescents who misclassified their diet quality. Methods: Data from two cycles of National Health and Nutrition Examination Survey (NHANES), 2015-2016 and 2017-2018, were used for this study. Self-assessed diet quality was measured by asking adolescents, 16-19 years of age, to rate the healthfulness their diet with responses including excellent, very good, good, fair, and poor. Measured diet quality was assessed using the 2015 Healthy Eating Index (HEI-2015) and based on 24-hour dietary recalls. Correct classification between self-assessed and measured diet quality (100-point scale) included: excellent=90-100, very good=80-100, good=70-89, fair=60-79, and poor=0-59. All others were considered misclassified. Descriptive statistical methods for complex survey designs were used to analyze the data. Results/findings: Out of 1086 adolescents analyzed, 956 adolescents (88%) misclassified their diet quality. All adolescents in the poor rating group correctly classified their diet quality, while over 99% of adolescents in the other four groups overrated their diet quality. Based on 95% confidence intervals, mean total diet quality differed among four rating groups (fair=40.8, good=45.3, very good=48.9, excellent=52.6) as did 9 of 13 component scores. Component scores generally increased as healthfulness of diet ratings increased from fair to excellent. Total dairy, seafood and plant protein, fatty acids, and sodium mean scores were not significantly different and uniformly low across the four rating groups. Conclusions: Although total and most diet quality component scores increased as adolescent ratings of their diet quality increased, total scores were below 59% (failing) for all rating groups. Dietary interventions targeting US adolescents should consider all components of the diet; however, particular attention may need to be directed at total dairy, seafood and plant protein, fatty acids, and sodium intakes given the uniformly low adolescent scores for these dietary components.