The quality of Indian diets: A comparison of two indices to predict risk of dietary inadequacies linked to non-communicable diseases

Nutritional inadequacies lead to various health problems among Indians. Improvements in diets can be addressed when different aspects of diet quality are known. The primary objective of the study was to assess diet quality of Indian adults belonging to the high-income group. The study also wanted to compare the suitability of two diet quality indices for use in the Indian scenario. A cross sectional study design with non-probability purposive sampling was used to collect data from 589 adults (20-40 years) in Delhi, India. Nutrient intake was assessed using the 24- hour dietary recall method. Two internationally recognized diet quality indices - Diet Quality Index- International Score (DQI-I) and the Global Diet Quality Score (GDQS) were selected to measure diet quality. 78% of the participants had poor diet quality using the DQI-I; the average score was 56.4 ± 5.6. The average DQI-I component scores for variety, adequacy, moderation and overall balance were 13.1±2.6, 27.5±2.2, 15.3±2.9, 0.43±0.9 respectively. Females were more likely (OR=2.07, 95% C.I.: 1.26 – 3.401) to have DQI-I scores in the lowest quartile (p=0.04). 88% had a moderate risk of nutritional inadequacy while 11% were at a high risk of nutritional inadequacy on the basis of their GDQS scores, the average of which was 16.9±2.1. There was a positive association between GDQS and DQI- I scores (ρ =0.316, p<0.001). The GDQS is better for assessing nutrient adequacy with healthy and unhealthy food consumption being compared. On the other hand, DQI-I gives a composite score combining the nutrient and food group intake and observes variety, adequacy, moderation and overall balance. Behaviour change communication strategies that encourage healthier food selection and promote dietary diversity may help improve nutritional quality of diets in Indian populations such as this one.