The Diet Quality Index-Revised: A Tool to Promote and Evaluate Dietary Change among Older Cancer Survivors Enrolled in a Home-Based Intervention Trial

• Published in: Journal of the American Dietetic Association 2007-09, Vol.107 (9), p.1519-1529
• Main Authors: Clutter Snyder, Denise, MS, RD, Sloane, Richard, MPH, Haines, Pamela S., DrPH, RD, Miller, Paige, Clipp, Elizabeth C., PhD, RN, Morey, Miriam C., PhD, Pieper, Carl, DrPH, Cohen, Harvey, MD, Demark-Wahnefried, Wendy, PhD, RD
• Format: Article
• Language: English
• Subjects: Aged; behavior change; Biological and medical sciences; breast neoplasms; Breast Neoplasms - diet therapy; Breast Neoplasms - prevention & control; Cancer; Clinical trials; Diet; Diet - standards; diet counseling; Diet Quality Index; dietary fat; disease course; elderly; elderly nutrition; Female; Gastroenterology and Hepatology; Health Behavior; Health Promotion; Humans; Internal Medicine; Life Style; Male; Medical sciences; men; Mental Recall; Metabolic diseases; Neoplasm Recurrence, Local - prevention & control; Nutrition Policy; Nutrition therapy; nutritional adequacy; nutritional intervention; Nutritional Physiological Phenomena - physiology; Nutritional Sciences - education; Physical Fitness; prostatic neoplasms; Prostatic Neoplasms - diet therapy; Prostatic Neoplasms - prevention & control; Quality of Life; Studies; Telephone; United States; women
• ISSN: 0002-8223; 2212-2672; 1878-3570; 2212-2680
• DOI: 10.1016/j.jada.2007.06.014

Abstract Objective To utilize the Diet Quality Index-Revised (DQI-R) as a framework for delivering and evaluating an intervention to improve overall diet quality among older cancer survivors. Design As part of a randomized controlled trial to improve lifestyle behaviors among older cancer survivors, we sought a dietary measure that could serve as both an intervention framework and a means to evaluate global dietary quality. The DQI-R measures overall diet quality by summing 10 subscales that relate to national guidelines. At baseline, DQI-R scores were generated from three multi-pass 24-hour dietary recalls. The 6-month intervention delivered tailored feedback on individual DQI-R subscales. Dietary recalls were repeated at 6 and 12 months. Subjects Elderly (aged ≥65 years) individuals within 18 months of diagnosis of breast or prostate cancer (n=182) were randomized postbaseline measures to intervention vs attention control arms. Results Significant differences in overall diet quality were observed between arms at 6 months, with the intervention arm improving (67.6±12.2 to 69.8±13.9), and controls declining (67.5±12.5 to 64.6±14.7) ( P =0.003). Significant differences were observed between arms over time in dietary diversity subscale scores: baseline and 6-month follow-up means among intervention and control arms were 4.8±1.3 to 4.8±1.4, and 4.7±1.2 to 4.1±1.1, respectively ( P =0.001). Conclusions The DQI-R served as an effective guide and evaluation tool for this diet-related randomized controlled trial. Like many interventions, our effect diminished after the intervention was complete. Future research should consider testing interventions that use the DQI-R, or other global diet-related indexes, as guides and evaluation tools over longer study periods, as well as in other populations.