Validation of a Brief Vegetable Variety Questionnaire to Assess Diet Quality

Background Obtaining estimates of food intake is laborious and expensive via the 24-hour dietary recall. Simpler methods for estimating dietary quality are needed for clinic settings and evaluating nutrition education interventions. Objective To validate a simple, pictorial tool for assessing diet quality using vegetable variety as the indicator. Methods The My Veggies tool, containing 28 pictures of vegetables and items about food preparation, eating at home, and eating fast food, was administered to 258 healthy adults, aged 18 to 65 years. To assess convergent validity, three dietary recalls were used to calculate the Healthy Eating Index-2015 (HEI) and dietary energy density (DED), both serving as measures of diet quality. To determine criterion validity, height, weight and body composition (DEXA) were measured. Using cluster analysis, responses to My Veggies generated three vegetable variety groups: high (HV, n=84), medium (MV, n=107), and low (LV, n=67). Values for HEI, DED, BMI, and body composition were compared between variety groups to determine if differences existed. Results Demographic characteristics were not different between variety groups. The LV group had a median total HEI score (interquartile range) that was lower, 54.4 (15.6), compared to HV 62.1 (17.3) and MV 68.0 (18.6) groups (p