Journal List > J Nutr Health > v.51(4) > 1100555

J Nutr Health. 2018 Aug;51(4):340-356. Korean.
Published online August 31, 2018.  https://doi.org/10.4163/jnh.2018.51.4.340
© 2018 The Korean Nutrition Society
Development of Nutrition Quotient for Korean adults: item selection and validation of factor structure
Jung-Sug Lee,1 Hye-Young Kim,2 Ji-Yun Hwang,3 Sehyug Kwon,4 Hae Rang Chung,5 Tong-Kyung Kwak,6 Myung-Hee Kang,7 and Young-Sun Choi8
1Department of Food & Nutrition, Kookmin University, Seoul 02707, Korea.
2Department of Food & Nutrition, Yong In University, Yongin, Gyeonggi 17092, Korea.
3Department of Foodservice Management & Nutrition, Sangmyung University, Seoul 03016, Korea.
4Department of Statistics, Hannam University, Daejeon 34430, Korea.
5Nutrition for the Future Inc., Seoul 08788, Korea.
6Department of Food & Nutrition, Yonsei University, Seoul 03722, Korea.
7Department of Food & Nutrition, Hannam University, Daejeon 34430, Korea.
8Department of Food & Nutrition, Daegu University, Gyeongsan, Gyeongbuk 38453, Korea.

To whom correspondence should be addressed. tel: +82-53-850-6833, Email: yschoi@daegu.ac.kr
Received July 27, 2018; Revised August 02, 2018; Accepted August 07, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

This study was conducted to develop a nutrition quotient (NQ) to assess overall dietary quality and food behaviors of Korean adults.

Methods

The NQ was developed in three steps: item generation, item reduction, and validation. Candidate items of the NQ checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the Korea National Health and Nutrition Examination Survey (2010 ~ 2013) data, and national nutrition policies and recommendations. A total of 368 adults (19 ~ 64 years) participated in a one-day dietary record survey and responded to 43 items in the food behavior checklist. Pearson's correlation coefficients between responses to the checklist items and nutritional intake status of the adults were calculated. Item reduction was performed, and 24 items were selected for a nationwide survey. A total of 1,053 nationwide adult subjects completed the checklist questionnaires. Exploratory and confirmatory factor analyses were performed to develop a final NQ model.

Results

The 21 checklist items were used as final items for NQ. Checklist items were composed of four factors: nutrition balance (seven items), food diversity (three items), moderation for the amount of food intake (six items), and dietary behavior (five items). The four-factor structure accounted for 41.8% of the total variance. Indicator tests of the NQ model suggested an adequate model fit (GRI = 0.9693, adjusted GFI = 0.9617, RMR = 0.0054, SRMR = 0.0897, p < 0.05), and item loadings were significant for all subscales. Standardized path coefficients were used as weights of the items. The NQ and four-factor scores were calculated according to the obtained weights of the questionnaire items.

Conclusion

NQ for adults would be a useful tool for assessing adult dietary quality and food behavior. Further investigations of adult NQ are needed to reflect changes in their food behavior, environment, and prevalence of chronic diseases.

Keywords: nutrition quotient; adult; food behavior; dietary quality; checklist

Figures


Fig. 1
Process of NQ development. FBC: food behavior checklist
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Fig. 2
Weights and path coefficients of four-factor structure model
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Fig. 3
Comparison of percentage of nutrient intake of the adult to recommended nutrient intake (RNI) or adequate intake (AI) according to NQ score four-grade criterion of samples from the pilot survey. a, b: Different alphabets are significantly different by Duncan's multiple range test (p < 0.05).
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Fig. 4
ROC curve for the NQ model
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Tables


Table 1
Checklist items selected for the pilot survey
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Table 2
Items selected for a nationwide survey checklist and selection rationales
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Table 3
Results of exploratory factor analysis of the 21 items selected by LISREL analysis
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Table 4
NQ score and group score calculation using response point of the checklist
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Table 6
NQ score range by the three-grade criterion
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Notes

This research was supported by a grant (14162MFDS126) from Ministry of Food and Drug Safety in 2014.

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