Abstract

Dietary Quality (DQ) is a term used to describe how well an individual’s diet conforms to a specific set of dietary recommendations. Dietary Quality Indices (DQIs) are tools used to systematically assess dietary quality. DQIs can be very helpful tools in research and practice because they can give quickly translatable insight into the dietary quality of individuals as well as large groups of people. They can also help researchers and practitioners understand how dietary quality is related to certain health or performance outcomes. There are many valid and reliable DQIs, including the Healthy Eating Index (HEI) based on the Dietary Guidelines for Americans. Most existing DQIs, including the HEI, were developed to assess compliance with nutrition recommendations meant for the general population and health rather than athletes and sports nutrition recommendations. There appears to be a gap in research regarding the development and validation of DQIs that are specifically meant to assess athlete dietary quality. In this narrative review, the existing body of literature was explored to address the following two objectives: 1) to determine if there are any DQIs that have been developed and/or validated for an athlete population, 2) to determine the appropriateness of the HEI in assessing athlete dietary quality. Following the review, it is evident that there is a lack of a thoroughly validated athlete-specific DQI. In many performance settings, dietitian accessibility and manpower is limited and a streamlined method of nutritional analysis could more efficiently guide nutrition intervention. The HEI may be a good starting point for the development of an athlete-specific DQI as general health eating is the foundation of performance nutrition recommendations, but some modifications may be warranted due to discrepancies seen between evidence-based recommendations for the general population and athletes.

Keywords: Athlete; Dietary quality index; Performance nutrition; Sports nutrition

Abbreviations: DQ: Dietary Quality; DQI: Dietary Quality Index; HEI: Healthy Eating Index; HDI: Healthy Diet Indicator; MDS: Mediterranean Diet Score; HFI: Healthy Food Index; RFS: Recommended Food Score; DQS: Diet Quality Score; DGA: Dietary Guidelines for Americans; NCAA: National Collegiate Athletic Association; AMDR: Adequate Macronutrient Distribution Range; G: Grams; KG: Kilogram; DRI: Daily Reference Intake; kcal: kilocalorie; AI: Adequate Intake; CDRR: Chronic Disease Risk Reduction Intake; RDA: Recommended Dietary Allowance; MG: Milligram; Mcg: Microgram; IU: International Unit; EAGNZA: Eating and Activity Guidelines for New Zealand Adults; ASDs: Accredited Sports Dietitians; DXA: Dual-Energy X-Ray Absorptiometry; DII: Dietary Inflammatory Index; SFAS: Special Forces Assessment and Selection; APFT: Army Physical Fitness Test; FFQ: Food Frequency Questionnaire; USDA: U.S. Department of Agriculture; NHANES: National Health and Nutrition Examination Survey; PUFAs: Poly Unsaturated Fatty Acids; MUFAs: Monounsaturated Fatty Acids; SFA: Saturated Fatty Acids; REDs: Relative Energy Deficiency in Sport