Establishment and validation of NQICD: a new nutrient profiling model for evaluating Chinese dishes

With the increase in dining out, high consumption of salt, oil, and sugar has led to deteriorating diet quality in China. We developed and validated the Nutritional Quality Index of Chinese Dishes (NQICD), a new nutrient profiling model for Chinese composite dishes, addressing a gap not covered by existing models. NQICD was based on seven domains. Its content validity was confirmed against the Dietary Guidelines for Chinese Residents (DGCR), and convergent validity against existing NP models. Criterion validity was assessed using a population-based cohort (n = 3629) with 12-year follow-up, linking i.NQICD to dietary quality, biomarkers, and health outcomes. In content validity, i.NQICD scores (range: 1-10) showed weak-to-moderate correlations with the DGCR (r: -0.39 to -0.21). In criterion validation, each 1-SD increase (≈1.8 points) was associated with lower body mass index (BMI) (-0.13 kg/m²), SBP (-1.69 mmHg), DBP (-1.05 mmHg), and HbA1c (-0.12%). Prospectively, after adjusting for key variables, a higher baseline i.NQICD score was associated with reduced risks of diabetes (HR 0.93, p = 0.024) and all‑cause mortality (HR 0.88, p = 0.011) over 12 years. The NQICD aligns with DGCR goals, demonstrates adequate validity for evaluating Chinese dishes, and can serve as a public health tool to assess their healthiness.