344例正常体型的糖代谢异常孕妇膳食结构和营养状况分析

目的调查分析正常体型妊娠期糖代谢异常患者诊断前的膳食结构和营养摄入状况,为实施膳食干预措施和营养教育提供依据。方法采用简化的半定量食物频率法对344例正常体型孕期糖代谢异常孕妇进行调查,并以中国居民膳食营养素参考摄入量(dietary reference intakes,DRIs)和孕中晚期妇女平衡膳食宝塔为标准,评价膳食能量、各营养素摄入情况及膳食构成。结果糖代谢异常孕妇每日摄入总能量为(2 342.7±194.3)Kcal;各营养素中超过80%推荐摄入量(recommended nutrient intake,RNI)的糖代谢异常孕妇人数所占比例依次为脂肪91.0%,蛋白质87.5%,热能86.9%;各营养素中低于80% RNI的糖代谢异常孕妇人数所占比例依次为锌45.0%,维生素B134.9%和维生素B232.3%;调查对象中43.0%孕妇的热能、31.4%孕妇的脂肪摄入量超过RNI;调查对象水果和烹调油的摄入量超高,白肉类和奶制品类摄入量偏低,蔬菜的摄入量不到RNI的一半。结论糖代谢异常孕妇的总能量满足孕期需要,但膳食结构不合理,应给予及时纠正。临床应重视糖代谢异常孕妇的膳食管...     

344例正常体型的糖代谢异常孕妇膳食结构和营养状况分析

目的调查分析正常体型妊娠期糖代谢异常患者诊断前的膳食结构和营养摄入状况,为实施膳食干预措施和营养教育提供依据。方法采用简化的半定量食物频率法对344例正常体型孕期糖代谢异常孕妇进行调查,并以中国居民膳食营养素参考摄入量(dietary reference intakes,DRIs)和孕中晚期妇女平衡膳食宝塔为标准,评价膳食能量、各营养素摄入情况及膳食构成。结果糖代谢异常孕妇每日摄入总能量为(2 342.7±194.3)Kcal;各营养素中超过80%推荐摄入量(recommended nutrient intake,RNI)的糖代谢异常孕妇人数所占比例依次为脂肪91.0%,蛋白质87.5%,热能86.9%;各营养素中低于80% RNI的糖代谢异常孕妇人数所占比例依次为锌45.0%,维生素B134.9%和维生素B232.3%;调查对象中43.0%孕妇的热能、31.4%孕妇的脂肪摄入量超过RNI;调查对象水果和烹调油的摄入量超高,白肉类和奶制品类摄入量偏低,蔬菜的摄入量不到RNI的一半。结论糖代谢异常孕妇的总能量满足孕期需要,但膳食结构不合理,应给予及时纠正。临床应重视糖代谢异常孕妇的膳食管理,强化营养指导,促使孕...     

贵阳市434例癌症患者膳食营养状况分析

[目的]了解癌症患者的膳食营养状况,为指导患者合理膳食,提高患者对治疗的耐受性和促进康复提供科学依据.[方法]采用分层整群抽样方法对贵阳市癌症患者进行问卷调查.膳食调查采用24h膳食回顾法,将摄食结果录入微机膳食服务系统(CDGSS)获取患者各类食物及营养素的摄入量.[结果]癌症患者热能和主要营养素的摄入量大多偏低.每人每天热能平均摄入量为(1518.68±726.75)kcal,蛋白质平均摄入量为(56.22±28.29)g.患者热能和各种营养素摄入不足的比例在50%～87%之间.热能和各种营养素摄入充足的仅为10%～30%.除维生素A外,热能和其他营养素摄入治疗组均低于非治疗组.蛋白质、脂肪和碳水化合物的供能比适宜.3餐热能比存在晚餐稍高,早餐偏低的问题.膳食中蔬菜、水果摄入较少.[结论]贵阳市癌症患者膳食营养素的摄入不足,膳食结构亦不合理.有必要进行营养指导,以改善他们的营养状况从而促进康复.     

河北省普通高校篮球运动员膳食营养状况调查

目的了解普通高校篮球运动员的膳食状况。方法采用定量食物频率法,于2012年对河北省不同地域4所普通高校的全部137名篮球运动员进行膳食调查。结果谷类、薯类和蛋类的摄入量都达到了中国居民膳食宝塔推荐标准;蔬菜水果类和奶类摄入量低于推荐摄入量的50%;鱼虾类摄入量低于推荐摄入量的20%,摄入频率每周不到1次;能量摄入来源比例不合理。维生素B1摄取严重不足;蛋白质质量较好。以中国运动员食物推荐摄入量为参考,各类食物远低于推荐标准。结论调查对象膳食结构基本符合中国居民平衡膳食宝塔的构成,食物种类合理,但是食物量偏低,饮食行为不合理,应加强营养教育,促进学生膳食均衡。     

湖南某民航空勤人员营养状况调查研究

目的了解湖南某民航空勤人员的营养摄入状况、膳食结构,为引导其合理膳食、建立科学的食物消费观提供依据。方法对湖南某民航的全部空勤人员（369人）进行食物频率调查;膳食调查采用多阶段整群抽样抽取95人,以24 h回顾法连续3 d进行膳食营养素摄入情况的调查。结果膳食调查结果显示,民航空勤人员膳食结构为谷类22.26%、蔬菜水果类40.43%,摄入比例偏低;鱼禽肉蛋类20.24%、油脂类4.90%,摄入比例偏高。膳食纤维摄入量过低,只达到推荐摄入量的50.10%。钙、维生素B2摄入量不足,分别占推荐摄入量的79.29%和75.71%。结论湖南某民航空勤人员营养状况总体良好,食物结构基本合理,营养素摄入存在蛋白质、脂肪摄入过高,碳水化合物、钙、维生素B2和膳食纤维摄入偏低的问题。因此,需对湖南某民航空勤人员加强营养教育,树立正确营养观念,平衡膳食,合理营养。     

济南市部分城市社区老年人膳食中营养素摄入状况调查

[目的 ]探讨不同年龄阶段老年人膳食中营养素摄入状况 ,以便指导合理营养。 [方法 ] 2 0 0 2年 ,在济南市市区抽取历下区某城市社区 60～ 78岁的退休人员 2 14名 ,采用 2 4h回顾法调查 1d膳食中各类食物的摄入量 ,并计算出热能和各种营养素的摄入量 ,与中国营养学会推荐的平衡膳食宝塔、推荐营养素摄入量进行比较。 [结果 ]老年人体质指数≥ 2 5者占 5 1 40 % ,男性高于女性 ,60～ 69岁组高于 70岁以上组 ;膳食中蛋类和油脂的摄入量偏高 ,蔬菜、鱼类、豆类偏低 ;三大营养素供热比例各组均以脂肪热较高 ,碳水化合物热偏低 ;钙、维生素B1、B2 摄入不足。 [结论 ]不同年龄的社区老年人均存在膳食结构不合理和营养素摄入不平衡现象 ,需要加强合理营养指导     

甘肃会宁地区406名2～4岁儿童膳食调查分析

目的:了解会宁地区406名2～4岁儿童的膳食结构及营养素摄入状况,为改善其营养状况提供基础资料。方法:采用24h膳食回顾法、称重法和半定量食物频率法对调查对象进行膳食调查。结果:调查对象膳食构成以粮谷类食物为主,杂粮摄入较多,为42.1g;动物性及豆类摄入较少,鱼虾类摄入量仅为1.4g。能量的摄入基本满足需要,但达到推荐摄入量(RNI)的人数比例较低,碳水化合物供能比偏高,饱和脂肪酸供能比例较高。蛋白质达到RNI的人数比例只有22.7%,来源于动物性及豆类食物的占26.7%。铁的摄入量较高,但主要来源于植物性食物。钙、锌、维生素A及维生素C摄入均不足。结论:调查对象膳食结构不合理,部分营养素供给不足。应加大营养知识普及,改进食物加工方法,改善该人群的营养状况。     

2000～2004年天津市居民膳食营养状况调查

目的研究2000～2004年天津市城市居民膳食营养摄入状况。方法利用天津市统计局2000～2004年天津城市居民各种食物的消费量和人口资料,通过膳食计算和统计分析,研究天津市2000～2004年食物消费状况、各种营养素摄入及营养素的食物来源情况。结果天津市城市居民动物性食物、水果、蔬菜摄入较合理,蛋白质质量较好,谷类、奶类、豆类食物摄入偏低,维生素A、B1、B2、钙摄入量占推荐摄入量（RNIs）或适宜摄入量（AIs）百分比偏低,脂肪占总热量偏高（34%～35%）。结论天津城市居民膳食不均衡,部分微量营养素摄入不足,脂肪摄入偏高。应进一步加强合理营养教育,完善居民饮食结构,以满足平衡饮食和合理营养的要求。     

潍坊市农村居民膳食营养状况调查

目的探讨潍坊市农村居民膳食营养状况及存在的问题。方法采用食物频率问卷方法进行调查。摄入食物中营养素含量的计算参照中国疾病预防控制中心营养与食品卫生研究所的《食物成分表》。结果平均每人每日摄入食物为(1482±92)g,其中蔬菜、水果摄取食量超过中国居民膳食指南建议数值,鱼、肉及奶制品摄入偏低;女性在营养摄入量方面低于男性。结论农村居民热能、蛋白质摄入量都能满足要求,但总体营养水平偏低,食物摄入不平衡使营养过剩和营养不良并存。     

低体重患儿膳食营养调查

目的 调查评价低体重患儿的膳食结构和饮食营养状况,以便提出膳食建议并为营养教育提供依据.方法 采用简化的食物频率询问法对普儿病房142名3～6岁低体重患儿进行膳食调查,并以中国居民膳食营养素参考摄入量(DRIs)为标准,评价膳食能量和各营养素摄入情况.结果 142名低体重息儿各营养素摄入量未达80%推荐摄入量/适宜摄入量(RNI/AI)的有:维生素A为69.2%,碳水化合物为63.3%,维生素C为61.1%,热能为58.8%,钙为54.9%.有34.8%患儿粮谷类提供的能量不到40%.结论 低体重患儿膳食结构不合理,粮谷类和蔬菜类食物的摄入量严重不足,导致患儿能量不足、维生索A、维生素C及钙缺乏.     

U.S. Food Guide Pyramid food group intake by Asian Indian immigrants in the U.S

This study examined the food group intake and the dietary quality of middle-aged and older Gujarati Asian Indian immigrants (45 years or older) living in two urban metropolitan areas in the U.S. Participants (90 men, 99 females) completed a 24-hour dietary recall, which was used to determine if they met the daily food group intake guidelines of the U.S. Food Guide Pyramid. The overall quality of their reported dietary intake was determined using the Healthy Eating Index based on their nutrient and food group intake. Both men and women met the daily number of servings recommendations for the grains (men: 9.3 servings/day; women: 6.9 servings/day) and vegetables (men: 4.5 servings/day; women: 3.6 servings/day) groups, but did not meet the recommendations for fruits, dairy and meats groups. The total score on the Healthy Eating Index of the diets of these participants was 73, indicative of a dietary intake that does not meet the established U.S. dietary guidelines. These immigrants should be educated about appropriate food choices (ethnic and non-ethnic) within each of the U.S. Food Guide Pyramid food groups to improve the overall quality of their dietary intakes.     

Dietary Intake Among Native Hawaiian,Filipino, and White Children and Caregivers in Hawai‘i

Little is published about dietary intake of children of ethnic populations found in Hawai‘i, due to an absence of national statistics collected on Hawai‘i''s population. This information is needed to focus planning of food, agriculture and health programs aimed to prevent obesity and related chronic disease and to improve health. Dietary patterns of 156 Native Hawaiian (n=110), Filipino (n=28) and White (n=18) children and their caregivers were compared using socio-demographic, annual “food season,” and 24 hour dietary recall data from a baseline survey of four lower income communities selected for an intervention program in rural Hawai‘i. Ethnic differences were found in the Healthy Eating Index (HEI) dairy component, and in calcium and vitamin C nutrient intakes among caregivers only (adjusting for food season). Whites always had higher intakes of these foods and nutrients than Filipinos or Native Hawaiians. Vitamin C intake remained significantly different among ethnic groups after further adjusting for dairy food group intake. Dietary patterns showed low intake of fruits and vegetables, fiber and dairy foods among these understudied populations.     

A revised version of the Healthy Eating Index for the Brazilian population

The revised version of the Brazilian Healthy Eating Index is an indicator of dietary quality developed according to current nutritional recommendations. Dietary data were obtained from a population-based survey, the 2003 Inquérito de Saúde e Alimenta??o (ISA - Health and Diet Survey)-Capital. The Revised Index consists of 12 components: nine food groups included in the 2006 Brazilian Dietary Guidelines, in which daily portions are expressed in terms of energy density; two nutrients (sodium and saturated fats), and SoFAAS (calories from solid fat, alcohol and added sugar). The Revised Brazilian Healthy Eating Index allows for the measurement of dietary risk factors for chronic diseases, evaluating and monitoring the diet at both individual and population levels.     

Poverty and food intake in rural America: diet quality is lower in food insecure adults in the Mississippi Delta

OBJECTIVE: To determine if measures of diet quality differ between food insecure and food secure adults in a rural high-risk population. DESIGN: Random digit dialing telephone survey of a cross-section of the population designed to collect data on food intake, household demographics, and food security status. SETTING: A representative sample of adults who live in 36 counties in the Lower Mississippi Delta region of Arkansas, Louisiana, and Mississippi. SUBJECTS: One thousand six hundred seven adults, both white and African American. MAIN OUTCOME MEASURES: Food security status and diet quality, as defined by adherence to the Healthy Eating Index and Dietary Reference Intakes by determinations from self-reported food intake (1 day intake). STATISTICAL ANALYSES: Regression analysis, t tests, Wald statistic, and beta tests were employed. RESULTS: Food secure adults scored higher on Healthy Eating Index than food insecure adults (P=0.0001), but the regression model showed no differences when multiple factors were included. Food secure individuals consistently achieved higher percentages of the Dietary Reference Intakes (specifically Estimated Average Requirements and Adequate Intakes) than food insecure individuals, with the greatest differences seen for vitamin A (P<0.0001), copper (P=0.0009), and zinc (P=0.0022) and very little difference for vitamins C (P=0.68) and E (P=0.32). Both populations consumed diets extremely low in fiber. CONCLUSIONS: Food insecurity is associated with lower quality diets in this population. It is acknowledged that serious limitations are associated with the use of one 24-hour recall and for comparison between food intake and assessment of food security. These findings still suggest a pressing need for nutrition interventions to improve dietary intake in these at-risk impoverished individuals.     

Abstracts of Articles on Nutrition and Cancer

Background: Overall diet quality measurements have been suggested as a useful tool to assess diet-disease relationships. Oxidative stress has been related to the development of obesity and other chronic diseases. Furthermore, antioxidant intake is being considered as protective against cell oxidative damage and related metabolic complications.

Objective: To evaluate potential associations between the dietary total antioxidant capacity of foods (TAC), the energy density of the diet, and other relevant nutritional quality indexes in healthy young adults.

Methods: Several anthropometric variables from 153 healthy participants (20.8 ± 2.7 years) included in this study were measured. Dietary intake was assessed by a validated food-frequency questionnaire, which was also used to calculate the dietary TAC and for daily energy intake adjustment.

Results: Positive significant associations were found between dietary TAC and Mediterranean energy density hypothesis–oriented dietary scores (Mediterranean Diet Score, Alternate Mediterranean Diet Score, Modified Mediterranean Diet Score), non-Mediterranean hypothesis–oriented dietary scores (Healthy Eating Index, Alternate Healthy Eating Index, Diet Quality Index-International, Diet Quality Index-Revised), and diversity of food intake indicators (Recommended Food Score, Quantitative Index for Dietary Diversity in terms of total energy intake). The Mediterranean Diet Quality Index and Diet Quality Index scores (a Mediterranean and a non–Mediterranean hypothesis–oriented dietary score, respectively), whose lower values refer to a higher diet quality, decreased with higher values of dietary TAC. Energy density was also inversely associated with dietary TAC.

Conclusion: These data suggest that dietary TAC, as a measure of antioxidant intake, may also be a potential marker of diet quality in healthy subjects, providing a novel approach to assess the role of antioxidant intake on health promotion and diet-based therapies.     

Relationships Among the Physical and Social Home Food Environments,Dietary Intake,and Diet Quality in Mothers and Children

BackgroundBoth the physical and social home food environment (HFE) are believed to influence dietary intake and diet quality, but few studies have examined both aspects together.ObjectiveThe purpose of this study was to examine the relationships among the physical and social HFE, dietary intake, and diet quality in mothers and children.DesignThis was a cross-sectional substudy of a larger study.Participants/settingThe study included 24 mothers (aged ≥30 years) with a biological child aged 6 to 12 years living in the Newark, DE, area between June and November 2018.Main outcome measuresThe outcome measures of interest included the physical HFE (ie, home food availability); aspects of the social HFE (ie, parenting styles, family meal frequency, and policies); maternal and child intake of fruits, vegetables, sugar-sweetened beverages, and snacks; and diet quality using the 2015 Healthy Eating Index total score.Statistical analysisPearson correlations were used to examine the relationship between physical HFE and dietary intake as well as social HFE and dietary intake in both mothers and children. The relationships were further examined through exploratory regression analyses.ResultsIn mothers, fruit availability in the physical HFE was correlated with fruit intake (r = 0.50; P = 0.02). Fruit and vegetable availability in the physical HFE were correlated with 2015 Healthy Eating Index total score in both the mother and child. Family meals participation was correlated with dietary intake (vegetable intake in children, r = 0.44; P = 0.04; and snack intake in mothers, r = –0.74; P < .001). Exploratory regression analysis showed vegetables in the HFE was associated with vegetable intake and 2015 Healthy Eating Index total score in mothers, and fruits and vegetables in the HFE were associated with child 2015 Healthy Eating Index total score. Family meals participation was negatively associated with maternal snack intake and child sugar-sweetened beverages intake. Authoritative parenting was negatively associated with child snack intake and permissive parenting was negatively associated with mother’s fruit intake.ConclusionsBoth the physical and social HFE are associated with maternal and child dietary intake, but only the physical HFE was associated with dietary quality. Although preliminary, these data indicate the importance of future studies that include measures to assess both the physical and social HFE to better elucidate the influences of the HFE on dietary intake.     

Index-based dietary patterns and risk of colorectal cancer: the NIH-AARP Diet and Health Study

The authors compared how four indexes-the Healthy Eating Index-2005, Alternate Healthy Eating Index, Mediterranean Diet Score, and Recommended Food Score-are associated with colorectal cancer in the National Institutes of Health-AARP Diet and Health Study (n = 492,382). To calculate each score, they merged data from a 124-item food frequency questionnaire completed at study entry (1995-1996) with the MyPyramid Equivalents Database (version 1.0). Other variables included energy, nutrients, multivitamins, and alcohol. Models were stratified by sex and adjusted for age, ethnicity, education, body mass index, smoking, physical activity, and menopausal hormone therapy (in women). During 5 years of follow-up, 3,110 incident colorectal cancer cases were ascertained. Although the indexes differ in design, a similarly decreased risk of colorectal cancer was observed across all indexes for men when comparing the highest scores with the lowest: Healthy Eating Index-2005 (relative risk (RR) = 0.72, 95% confidence interval (CI): 0.62, 0.83); Alternate Healthy Eating Index (RR = 0.70, 95% CI: 0.61, 0.81); Mediterranean Diet Score (RR = 0.72, 95% CI: 0.63, 0.83); and Recommended Food Score (RR = 0.75, 95% CI: 0.65, 0.87). For women, a significantly decreased risk was found with the Healthy Eating Index-2005, although Alternate Healthy Eating Index results were similar. Index-based dietary patterns that are consistent with given dietary guidelines are associated with reduced risk.     

Diet Quality in the United States Improved during the Great Recession and Deteriorated During Economic Recovery

BackgroundMacroeconomic changes are associated with population health outcomes, such as mortality, accidents, and alcohol use. Diet quality is a risk or protective factor that could be influenced by economic conditions.ObjectiveThis study examined the trajectory of diet quality measured by the Healthy Eating Index 2015 before, during, and after the 2008-2009 Great Recession.DesignRepeated cross-sectional survey data from the National Health and Nutrition Examination Survey were analyzed.Participants/settingThe analytic sample included 48,679 adults who completed at least one dietary recall from National Health and Nutrition Examination Survey 1999-2018.Main outcome measuresDiet quality was assessed with a 24-hour dietary recall to calculate the Healthy Eating Index 2015 total scores, a measure of the conformance with the 2015-2020 Dietary Guidelines for Americans.Statistical analyses performedLeast squares regression was used to adjust for demographic changes across waves.ResultsDiet quality improved noticeably during the Great Recession and deteriorated as economic conditions improved.ConclusionsDeteriorating economic circumstances may constrain choices, but that does not necessarily imply a worsening of dietary quality. During the Great Recession, American diets became more consistent with Dietary Guidelines for Americans recommendations, possibly because of a shift toward food prepared at home instead of prepared food bought away from home.     

Association of Employees’ Meal Skipping Patterns with Workplace Food Purchases,Dietary Quality,and Cardiometabolic Risk: A Secondary Analysis from the ChooseWell 365 Trial

BackgroundEmployed adults may skip meals due to time or financial constraints, challenging work schedules, or limited workplace food choices. Little is known about the relationship between employees’ meal skipping patterns and workplace dietary choices and health.ObjectiveTo examine whether hospital employees’ meal skipping patterns were associated with workplace food purchases, dietary quality, and cardiometabolic risk factors (ie, obesity, hypertension, and prediabetes/diabetes).DesignThis is a secondary cross-sectional analysis of baseline data from the ChooseWell 365 randomized controlled trial. Employees reported meal-skipping frequency in a baseline survey. The healthfulness of workplace food purchases was determined with a validated Healthy Purchasing Score (HPS) (range = 0 to 100 where higher scores = healthier purchases) calculated using sales data for participants’ purchases in the 3 months before study enrollment. Dietary quality was measured with the 2015 Healthy Eating Index (range = 0 to 100 where higher score = healthier diet) from two 24-hour recalls. Cardiometabolic risk factors were ascertained from clinic measurements.Participants/settingParticipants were 602 hospital employees who regularly visited workplace cafeterias and enrolled in ChooseWell 365, a workplace health promotion study in Boston, MA, during 2016-2018.Main outcome measuresPrimary outcomes were HPS, 2015 Healthy Eating Index, and cardiometabolic risk factors.Statistical analysesRegression analyses examined differences in HPS, 2015 Healthy Eating Index, and cardiometabolic variables by meal skipping frequency, adjusting for demographic characteristics.ResultsParticipants’ mean (standard deviation) age was 43.6 (12.2) years and 478 (79%) were women. Overall, 45.8% skipped breakfast, 36.2% skipped lunch, and 24.9% skipped dinner ≥ 1 day/week. Employees who skipped breakfast ≥ 3 days/week (n = 102) had lower HPS (65.1 vs 70.4; P < 0.01) and 2015 Healthy Eating Index score (55.9 vs 62.8; P < 0.001) compared with those who never skipped. Skipping lunch ≥ 3 days/week and dinner ≥ 1 day/week were associated with significantly lower HPS compared with never skipping. Employees who worked nonstandard shifts skipped more meals than those who worked standard shifts. Meal skipping was not associated with obesity or other cardiometabolic variables.ConclusionsSkipping meals was associated with less healthy food purchases at work, and skipping breakfast was associated with lower dietary quality. Future research to understand employees’ reasons for skipping meals may inform how employers could support healthier dietary intake at work.     

Modifying the Healthy Eating Index to assess diet quality in children and adolescents

OBJECTIVE: The Healthy Eating Index (HEI) is a scoring system used by the US government to assess adherence to the Dietary Guidelines for Americans. We examined the ability of the HEI to monitor diet quality among youth. DESIGN: We modified and simplified the HEI for use by older children and adolescents. The new Youth Healthy Eating Index (YHEI) focuses on food quality and assesses both healthful and unhealthful foods and eating behaviors. Both HEI and YHEI scores were calculated from a food frequency questionnaire that was mailed to participants in the Growing Up Today Study in 1996. SUBJECTS/SETTING: Girls (n=8,807) and boys (n=7,645) 9 to 14 years of age who are children of participants in the Nurses Health Study II cohort and who reside across the United States. STATISTICAL ANALYSIS: Mean HEI and YHEI scores were calculated by sex and age, and associations with age, body mass index, activity, inactivity, energy intake, and several nutrients were assessed with Pearson correlations. Linear regression was used to examine the contributions of the individual HEI and YHEI components toward the total scores. RESULTS: The HEI score was highly correlated with total energy intake ( r =0.67), indicating a strong association with quantity of food consumption. In contrast, the YHEI was not strongly correlated with energy intake ( r =0.12) but was inversely associated with time spent in inactive pursuits ( r =-0.27). The HEI component for variety in food selection accounted for 60% of the variation in the total score and several HEI components were highly correlated with each other, particularly those for total and saturated fat ( r =0.78). CONCLUSIONS: To successfully monitor diet in a population of children and adolescents, the HEI may benefit from modifications that focus on food quality and include assessments of unhealthful foods. Further research is needed to determine the dietary elements that are most related to health in diverse populations of youth.