Stability of the Framingham Nutritional Risk Score and its component nutrients over 8 years: the Framingham Nutrition Studies

• Published in: European journal of clinical nutrition Vol. 66; no. 3; pp. 336 - 344
• Main Authors: Kimokoti, R W, Newby, P K, Gona, P, Zhu, L, Campbell, W R, D'Agostino, R B, Millen, B E
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.03.2012; Nature Publishing Group
• Subjects: Adult; Aged; Biological and medical sciences; Body Mass Index; Body size; Body Weight; Cardiovascular Diseases - etiology; Cholesterol; Clinical Nutrition; Diet; Diet - standards; Diet Records; Energy Intake; Epidemiology; Evaluation; Feeding Behavior; Feeding. Feeding behavior; Female; Follow-Up Studies; Food intake; Fundamental and applied biological sciences. Psychology; Health aspects; Health risks; High density lipoprotein; Humans; Internal Medicine; Lipoproteins, HDL - blood; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic Diseases - etiology; Middle Aged; Nutrients; Nutrition; Nutrition Assessment; Nutrition research; Offspring; original-article; Physiological aspects; Public Health; Quality; Quality assessment; Reproducibility of Results; Risk analysis; Risk assessment; Risk Factors; Stability analysis; Statistical analysis; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Women; Young Adult; United States; long-term stability; dietary quality indices; nutrients; Stability; Nutrition; Metabolic diseases; Risk; Long term; Feeding; Diet; Quality; Risk factor; Nutrient
• ISSN: 0954-3007; 1476-5640; 1476-5640
• DOI: 10.1038/ejcn.2011.167

Background/Objectives: Diet quality indices are increasingly used in nutrition epidemiology as dietary exposures in relation to health outcomes. However, literature on the long-term stability of these indices is limited. We aimed to assess the stability of the validated Framingham Nutritional Risk Score (FNRS) and its component nutrients over 8 years, as well as the validity of the follow-up FNRS. Subjects/Methods: Framingham Offspring/Spouse Study women and men ( n =1734) aged 22–76 years were evaluated over 8 years. Individuals’ nutrient intake and nutritional risk scores were assessed using 3-day dietary records administered at baseline (1984–1988) and at follow-up (1992–1996). Agreement between baseline and follow-up FNRS and nutrient intakes was evaluated by Bland–Altman method; stability was assessed using intra-class correlation (ICC) and weighted Kappa statistics. The effect of diet quality (as assessed by the FNRS) on cardiometabolic risk factors was evaluated using analysis of covariance. Results: Modest changes from baseline (⩽15%) were observed in nutrient intake. The stability coefficients for the FNRS (ICC: women, 0.49; men, 0.46; P <0.0001) and many nutrients (ICC ⩾0.3) were moderate. Over half of the women and men (58%) remained in the same or contiguous baseline and follow-up quartile of the FNRS and few (3–4%) shifted >1 quartile. The FNRS was directly associated with body mass index in women ( P <0.01) and high-density lipoprotein cholesterol among both women ( P <0.001) and men ( P <0.01). Conclusions: The FNRS and its constituent nutrients remained relatively stable over 8 years of follow-up. The stability of diet quality has implications for prospective epidemiological investigations.