Higher Global Diet Quality Score Is Associated with Less 4-Year Weight Gain in US Women

Teresa T Fung; Yanping Li; Sabri Bromage; Shilpa N Bhupathiraju; Carolina Batis; Wafaie Fawzi; Michelle D Holmes; Meir Stampfer; Frank B Hu; Megan Deitchler; Walter C Willett

doi:10.1093/jn/nxab170

Higher Global Diet Quality Score Is Associated with Less 4-Year Weight Gain in US Women

J Nutr. 2021 Oct 23;151(12 Suppl 2):162S-167S. doi: 10.1093/jn/nxab170.

Authors

Teresa T Fung^{1

2}, Yanping Li², Sabri Bromage², Shilpa N Bhupathiraju^{2

3}, Carolina Batis⁴, Wafaie Fawzi⁵, Michelle D Holmes^{3

6}, Meir Stampfer^{3

6}, Frank B Hu^{2

3}, Megan Deitchler⁷, Walter C Willett^{2

3}

Affiliations

¹ Department of Nutrition, Simmons University, Boston, MA, USA.
² Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
³ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁴ CONACYT-Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico.
⁵ Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.
⁶ Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
⁷ Intake-Center for Dietary Assessment, FHI Solutions, Washington, DC, USA.

Abstract

Background: We have developed a simple and globally applicable tool, the Global Diet Quality Score (GDQS), to measure diet quality.

Objectives: To test the utility of the GDQS, we examined the associations of the GDQS with weight change and risk of obesity in US women.

Methods: Health, lifestyle, and diet information were collected from women (n = 68,336) in the Nurses' Health Study II (aged 27-44 y in 1991) through repeated questionnaires (1991-2015). The GDQS has 25 food groups (maximum = 49 points) and scoring higher points reflects a healthier diet. The association between GDQS change in 4-y intervals and concurrent weight change was computed with linear models adjusted for confounders.

Results: Mean ± SD weight gain across 4-y periods was 1.68 ± 6.26 kg. A >5-point improvement in GDQS was associated with -1.13 kg (95% CI: -1.19, -0.77 kg) weight gain compared with a score change of <±2 points. For each 5-point increase, weight gain was 0.83 kg less for age <50 y compared with 0.71 kg less for age ≥50 y (P-interaction < 0.05). A >5-point score decrease was associated with 1.13 kg (95% CI: 1.04, 1.22 kg) more weight gain in women aged <50 y and 0.81 kg more (95% CI: 0.63, 0.98 kg) in women aged ≥50 y. Compared with little change in score, obesity RR was 0.77 (95% CI: 0.74, 0.81) for a >5-point increase and 1.32 (95% CI: 1.26, 1.37) for a >5-point decrease. Risk of obesity did not differ by age. Compared with other diet quality scores, the Alternate Healthy Eating Index-2010 had somewhat stronger associations than the GDQS (P < 0.05) but the GDQS had stronger associations than the Minimum Dietary Diversity for Women score (P < 0.05).

Conclusions: Improvement of diet quality as measured by the GDQS was associated with less weight gain and risk of obesity in US women. The association was stronger for women aged <50 y. Associations similar in direction and magnitude were observed between the GDQS and obesity across age groups.

Keywords: diet quality; epidemiology; obesity; weight; women.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Diet*
Diet, Healthy*
Female
Follow-Up Studies
Humans
Life Style
Nurses
Obesity / epidemiology
Risk Factors
Surveys and Questionnaires
United States / epidemiology
Weight Gain*

Abstract

Publication types

MeSH terms

Grants and funding