J Nutr Health.  2018 Aug;51(4):340-356. 10.4163/jnh.2018.51.4.340.

Development of Nutrition Quotient for Korean adults: item selection and validation of factor structure

• Lee JS
• Kim HY
• Hwang JY
• Kwon S
• Chung HR
• Kwak TK
• Kang MH
• Choi YS

• KMID: 2419505
• DOI: http://doi.org/10.4163/jnh.2018.51.4.340

Abstract

PURPOSE
This study was conducted to develop a nutrition quotient (NQ) to assess overall dietary quality and food behaviors of Korean adults.
METHODS
The NQ was developed in three steps: item generation, item reduction, and validation. Candidate items of the NQ checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the Korea National Health and Nutrition Examination Survey (2010 ~ 2013) data, and national nutrition policies and recommendations. A total of 368 adults (19 ~ 64 years) participated in a one-day dietary record survey and responded to 43 items in the food behavior checklist. Pearson's correlation coefficients between responses to the checklist items and nutritional intake status of the adults were calculated. Item reduction was performed, and 24 items were selected for a nationwide survey. A total of 1,053 nationwide adult subjects completed the checklist questionnaires. Exploratory and confirmatory factor analyses were performed to develop a final NQ model.
RESULTS
The 21 checklist items were used as final items for NQ. Checklist items were composed of four factors: nutrition balance (seven items), food diversity (three items), moderation for the amount of food intake (six items), and dietary behavior (five items). The four-factor structure accounted for 41.8% of the total variance. Indicator tests of the NQ model suggested an adequate model fit (GRI = 0.9693, adjusted GFI = 0.9617, RMR = 0.0054, SRMR = 0.0897, p < 0.05), and item loadings were significant for all subscales. Standardized path coefficients were used as weights of the items. The NQ and four-factor scores were calculated according to the obtained weights of the questionnaire items.
CONCLUSION
NQ for adults would be a useful tool for assessing adult dietary quality and food behavior. Further investigations of adult NQ are needed to reflect changes in their food behavior, environment, and prevalence of chronic diseases.

Keyword

nutrition quotient; adult; food behavior; dietary quality; checklist

MeSH Terms

Adult*
Checklist
Chronic Disease
Diet Records
Eating
Humans
Korea
Nutrition Policy
Nutrition Surveys
Prevalence
Weights and Measures

Figure

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  Fig. 1 Process of NQ development. FBC: food behavior checklist

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  Fig. 2 Weights and path coefficients of four-factor structure model

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  Fig. 3 Comparison of percentage of nutrient intake of the adult to recommended nutrient intake (RNI) or adequate intake (AI) according to NQ score four-grade criterion of samples from the pilot survey. a, b: Different alphabets are significantly different by Duncan's multiple range test (p < 0.05).

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  Fig. 4 ROC curve for the NQ model

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