A global overall dietary index: ODI-R revised to emphasize quality over quantity

[[abstract]]Incorporating the Healthy Eating Index concept, we have developed a global dietary quality index, the Overall Dietary Index (ODI). We have evaluated the relationships between ODI and chronic disease in a 1998 Taiwanese Health Screening program with over 46,000 members (51.2% females) aged 19-84. However, it could not predict health status adequately. Therefore, we revised this ODI which became ODI-R (Revised). The revision added a quality evaluation for staples (whole grains) and protein-rich foods (fish and soy) and reduced the impact of dietary fat quantity. ODI-R comprises nine items with a maximal score of 100. It has 5 food categories: dairy products, protein rich foods (eggs/legumes/fish/meats), vegetables, fruits and cereals; 2 dietary fat qualities (P/S ratio and cholesterol); and 2 descriptors: dietary moderation (alcohol, salt and sugar as one item) and dietary variety. The mean ODI-R was lower than ODI (64.4 vs. 68.1 in men and 65.5 vs. 69.0 in women) and the distribution. The correlations between macronutrients and ODI-R were weaker than for ODI, especially for fat (from -0.52 to -0.07) as well as for cholesterol and all fatty acid types by degree of saturation. For dietary fiber and micronutrients, the correlations became either less negative or more positive, signaling that the ODI-R reflects food quality more appropriately than ODI in regard to micronutrients. Empirically, a subtraction scoring approach for the overeating of protein rich foods, did not meaningfully decrease ODI-R in Taiwanese elderly or children. ODI-R provides an effective measure of dietary quality over quantity