A narrative review of nutrient based indexes to assess diet quality and the proposed total nutrient index that reflects total dietary exposures. Issue 12 (7th May 2023)

• Record Type: Journal Article
• Authors: Cowan, Alexandra E.; Jun, Shinyoung; Tooze, Janet A.; Dodd, Kevin W.; Gahche, Jaime J.; Eicher-Miller, Heather A.; Guenther, Patricia M.; Dwyer, Johanna T.; Potischman, Nancy; Bhadra, Anindya; Carroll, Raymond J.; Bailey, Regan L.
• Is Part Of: Critical reviews in food science and nutrition. Volume 63:Issue 12(2023)
• Page Start: 1722
• Page End: 1732
• Publication Date: 2023-05-07
• Subjects: Total nutrient intake -- dietary supplements -- dietary assessment methods -- diet quality index -- NHANES -- U.S. adults; Food industry and trade -- Periodicals; Nutrition -- Periodicals; Nutrition -- Periodicals; Food -- Periodicals; Diet -- Periodicals; Review Literature -- Periodicals; Nutrition; Food; Diet; Review Literature; 664
• DOI: 10.1080/10408398.2021.1967872
• Languages: English
• ISSNs: 1040-8398

Abstract

Abstract: A priori dietary indices provide a standardized, reproducible way to evaluate adherence to dietary recommendations across different populations. Existing nutrient-based indices were developed to reflect food/beverage intake; however, given the high prevalence of dietary supplement (DS) use and its potentially large contribution to nutrient intakes for those that use them, exposure classification without accounting for DS is incomplete. The purpose of this article is to review existing nutrient-based indices and describe the development of the Total Nutrient Index (TNI), an index developed to capture usual intakes from all sources of under-consumed micronutrients among the U.S. population. The TNI assesses U.S. adults' total nutrient intakes relative to recommended nutrient standards for eight under-consumed micronutrients identified by the Dietary Guidelines for Americans: calcium, magnesium, potassium, choline, and vitamins A, C, D, E. The TNI is scored from 0 to 100 (truncated at 100). The mean TNI score of U.S. adults (≥19 y; n = 9, 954) based on dietary data from NHANES 2011-2014, was 75.4; the mean score for the index ignoring DS contributions was only 69.0 (t-test; p < 0.001). The TNI extends existing measures of diet quality by including nutrient intakes from all sources and was developed for research, monitoring, and policy purposes. Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.1967872.