Validation of self-rated overall diet quality by Healthy Eating Index-2010 score among New York City adults, 2013

• HEI-2010 scores and self-rated diet quality are modestly correlated in our sample.
• Self-rated diet quality may help identify those with poor dietary intake.
• This single-item measure should be further validated against other data sources.

Objective: Chronic conditions such as cardiovascular disease and cancer can result from a number of diet-related environmental and behavioral factors. Screening for poor diet is helpful in developing interventions to prevent chronic disease, but measuring dietary behavior can be costly and time-consuming. The purpose of this study was to test the ability of a self-rated, single-item measure for evaluating diet quality among individuals and populations. Methods: A 24-h dietary recall and single-item self-rated diet quality measure were collected for 485 adults. From dietary recalls, Healthy Eating Index-2010 (HEI) scores were computed and compared with self-rated diet quality. Data were collected in 2013 among adult (18 years and older) New York City residents. Results: The study sample was 57% female, 47% white, 56% college educated, and 45% in the highest income tertile. The mean HEI score was 56.5 out of a possible 100. Women averaged higher HEI scores compared to men (58.1 vs 54.3, p = .01). There was a modest yet significant correlation between HEI scores and self-rated diet quality (ρ = 0.29, p < .01). Overall, mean HEI score increased as self-rated diet quality improved (from 48.2 for “poor” to 63.0 for “excellent”). Conclusions: The single-item measure of self-rated diet quality may provide a simple method of identifying those with the worst diet quality. Further investigation of this measure's validity is needed with alternative measures of dietary intake and with health outcomes.