@article {683416,
	title = {The Global Diet Quality Score Is Inversely Associated with Nutrient Inadequacy, Low Midupper Arm Circumference, and Anemia in Rural Adults in Ten Sub-Saharan African Countries},
	journal = {J Nutr},
	volume = {151},
	number = {Supplement_2},
	year = {2021},
	month = {2021 Oct 23},
	pages = {119S-129S},
	abstract = {BACKGROUND: Key nutrient deficits remain widespread throughout sub-Saharan Africa (SSA) whereas noncommunicable diseases (NCDs) now cause one-third of deaths. Easy-to-use metrics are needed to track contributions of diet quality to this double burden. OBJECTIVES: We evaluated comparative performance of a novel food-based Global Diet Quality Score (GDQS) against other diet metrics in capturing nutrient adequacy and undernutrition in rural SSA adults. METHODS: We scored the GDQS, Minimum Dietary Diversity-Women (MDD-W), and Alternative Healthy Eating Index-2010 (AHEI-2010) using FFQ data from rural men and nonpregnant, nonlactating women of reproductive age (15-49 y) in 10 SSA countries. We evaluated Spearman correlations between metrics and energy-adjusted nutrient intakes, and age-adjusted associations with BMI, midupper arm circumference (MUAC), and hemoglobin in regression models. RESULTS: Correlations between the GDQS and an energy-adjusted aggregate measure of dietary protein, fiber, calcium, iron, zinc, vitamin A, folate, and vitamin B-12 adequacy were 0.34 (95\% CI: 0.30, 0.38) in men and 0.37 (95\% CI: 0.32, 0.41) in women. The GDQS was associated (P\&nbsp;\&lt;\&nbsp;0.05) with lower odds of low MUAC [GDQS quintile (Q) 5 compared with Q1 OR in men: 0.44, 95\% CI: 0.22, 0.85; women: 0.57, 95\% CI: 0.31, 1.03] and anemia (Q5/Q1 OR in men: 0.56, 95\% CI: 0.32, 0.98; women: 0.60, 95\% CI: 0.35, 1.01). The MDD-W correlated better with some nutrient intakes, though associated marginally with low MUAC in men (P\&nbsp;=\&nbsp;0.07). The AHEI-2010 correlated better with fatty acid intakes, though associated marginally with low MUAC (P\&nbsp;=\&nbsp;0.06) and anemia (P\&nbsp;=\&nbsp;0.14) in women. Overweight/obesity prevalence was low, and neither the GDQS, MDD-W, nor AHEI-2010 were predictive. CONCLUSIONS: The GDQS performed comparably with the MDD-W in capturing nutrient adequacy-related outcomes in rural SSA. Given limited data on NCD outcomes and the cross-sectional study design, prospective studies are warranted to assess GDQS performance in capturing NCD outcomes in SSA.},
	issn = {1541-6100},
	doi = {10.1093/jn/nxab161},
	url = {https://academic.oup.com/jn/article/151/Supplement_2/119S/6409543},
	author = {Sabri Bromage and Yiwen Zhang and Michelle D Holmes and Sachs, Sonia E and Fanzo, Jessica and Remans, Roseline and Sachs, Jeffrey D and Batis, Carolina and Bhupathiraju, Shilpa N and Fung, Teresa T and Li, Yanping and Stampfer, Meir J and Megan Deitchler and Willett, Walter C and Fawzi, Wafaie W}
}
