Can United States Adults Accurately Assess Their Diet Quality?
Jessica L. Thomson, Alicia S. Landry, Tameka I. Walls
Abstract
PURPOSE: To estimate the percentage of United States adults who accurately assessed their diet quality (DQ). DESIGN: Observational, cross-sectional, nationally representative. SETTING: National Health and Nutrition Examination Survey, 2015-2018. SAMPLE: 9757 (86%) of 11 288 adults aged ≥20 years. MEASURES: Perceived DQ was assessed by asking participants, how healthy is your diet? The five responses included excellent, very good, good, fair, and poor. Measured DQ was assessed using 24-hours dietary recalls scored with 2015 Healthy Eating Index; scores were categorized using a 10-point grading scale. ANALYSIS: Matches between perceived and measured DQ that were classified as accurate included: excellent = A, very good = A or B, good = B or C, fair = C or D, and poor = D or F. All others were classified as inaccurate. Analyses included descriptive statistics and multivariable logistic regression for complex survey designs. RESULTS: 63% of adults perceived their DQ as very good or good while 70% scored DQ grades of F. Overall, 15% of adults accurately assessed their DQ with 96% accuracy in the poor perception group and <23% in the other 4 groups. Overall, 75% of adults overrated their DQ. Females, adults with lower educational attainment, and those with low food security were more likely to accurately assess their DQ. CONCLUSION: Adults cannot accurately assess their DQ except for those perceiving their DQ as poor, and the majority overrate their DQ.