Development and evaluation of Diet Quality Index for Brazilians based on the updated version of the 2024 Food Pyramid: Nutrition focus House Budget Survey, 2017-18: Development and evaluation of diet quality index

Introduction: In 2024 the Brazilian Food Pyramid was updated based on 7 food groups that meet the current dietary recommendations and appeared to be useful to help population achieve healthy eating behaviours. As many epidemiologic studies use dietary indexes, the current study developed and evaluated the psychometric properties of a dietary index to measure adherence to the updated food pyramid groups recommendations on healthy food choices. Methods: Dietary intake data from the mean of two 24-hour dietary recalls in the Nutrition Focus House Budget Survey, 2017-18 was used for this purpose. Variability among individuals were assessed via distribution of dietary intakes. Mean dietary scores were compared among population subgroups. Pearson’s correlations were used to verify the relationship between each component, overall scores and total energy intake. Finally, multidimensionality was checked with principal components analysis based on the 9 components of the index. Results: Mean Brazilian index score was 65.65/100 (95% CI, 65.55, 65.80) among Brazilians ≥ 10yo. Adolescents (64.36) and males’ adults (63.94)had the lowest and female adults (66.84) had the highest total score. Sodium showed the strongest negative correlation with fruits and vegetables (r = -0.52), while total score the strongest positive correlation with fatty acids (r= 0.52). Energy intake showed a stronger positive correlation for grains (r = 0.71) and a negative for fruits and vegetables (r = -0.21). Principal components analysis revealed at least 4 dimensions (60% total variance). Conclusion: The Brazilian Healthy Eating Index, 2024 showed good psychometric properties supporting the 2024 updated food pyramid recommendation.