A dietary guideline adherence score is positively associated with dietary biomarkers but not lipid profile in healthy children

Background: Whether dietary indexes are associated with biomarkers of children's dietary intake is unclear. Objective: The study aim was to examine the relations between diet quality and selected plasma biomarkers of dietary intake and serum lipid profile. Methods: The study sample consisted of 130 children aged 4-13 y (mean ± SD: 8.6 ± 2.9 y) derived by using baseline data from an intervention study. The Dietary Guideline Index for Children and Adolescents (DGI-CA) comprises the following 11 components with age-specific criteria: 5 core food groups, whole-grain bread, reduced-fat dairy foods, discretionary foods (nutrient poor; high in saturated fat, salt, and added sugar), healthy fats/oils, water, and diet variety (possible score of 100). A higher score reflects greater compliance with dietary guidelines. Venous blood was collected for measurements of serum lipids, fatty acid composition, plasma carotenoids, lutein, lycopene, and α-tocopherol. Linear regression was used to examine the relation between DGI-CA score (independent variable) and concentrations of biomarkers by using the log-transformed variable (outcome), controlling for confounders. Results: DGI-CA score was positively associated (P < 0.05) with plasma concentrations of lutein (standardized ß = 0.17), α-carotene (standardized ß = 0.28), ß-carotene (standardized ß = 0.26), and n-3 (ω-3) fatty acids (standardized ß = 0.51) and inversely associated with plasma concentrations of lycopene (standardized ß = -0.23) and stearic acid (18:0) (standardized ß = -0.22). No association was observed between diet quality and α-tocopherol, n-6 fatty acids, or serum lipid profile (all P > 0.05). Conclusion: Diet quality, conceptualized as adherence to national dietary guidelines, is cross-sectionally associated with plasma biomarkers of dietary exposure but not serum lipid profile. This trial was registered with the Australia New Zealand Clinical Trial Registry (www.anztr.org.au) as ACTRN12609000453280.