British Journal of Nutrition

Full Papers

Validity of dietary patterns to assess nutrient intake adequacy

Blanca Román-Viñasa1, Lourdes Ribas Barbaa1, Joy Ngoa1, Miguel Ángel Martínez-Gonzáleza2, Trudy M. A. Wijnhovena3 and Lluís Serra-Majema1a4 c1

a1 Community Nutrition Research Centre of the Nutrition Research Foundation, University of Barcelona Science Park, Baldiri Reixac 4, 08028 Barcelona, Spain

a2 Department of Epidemiology and Public Health, University of Navarra, Irunlarrea 1, 31080 Pamplona, Spain

a3 Noncommunicable Disease and Environment World Health Organization Regional Office for Europe, Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark

a4 University of Las Palmas de Gran Canaria, PO Box 550, 35080 Las Palmas de Gran Canaria, Spain


The purpose of the present study was to conduct a systematic review of the literature on the value of the methods used to assess dietary patterns for measuring nutrient intake adequacy in the population. Systematic review on Pubmed database up to April 2008. The search included specific key words and MeSH terms. No language limit was set. Only studies that compared food patterns with nutrient intake adequacy or nutrient biomarkers were included in the analysis. The search resulted in 1504 articles. The inclusion and exclusion criteria limited the selection to thirty articles. Nineteen studies evaluated the usefulness of the dietary patterns, either a priori defined (thirteen studies), or defined by factor analysis (four studies) or by cluster analysis (two studies), but only nine of them tested their validity (four a priori defined and four a posteriori defined). Diet indices showed moderate to good validity results for measuring the adequacy of intakes for α-carotene, β-carotene, vitamin C, vitamin B6, Ca, folic acid, Fe and Mg. The factor analysis approach showed moderate to good validity correlations with the adequacy of intake of α-carotene, β-carotene, lutein, lycopene, vitamin C, vitamin B6 and folic acid. Vitamin B12 and vitamin E are the micronutrients with less probability of being adequately assessed with dietary patterns a priori or a posteriori defined. Diet indices are tools with fair to moderate validity to assess micronutrient intake adequacy.

(Received March 05 2009)

(Revised May 06 2009)

(Accepted June 01 2009)


c1 Corresponding author: Lluís Serra-Majem, fax +34 93 4034543, email


On behalf of EURRECA's RA 1.1 ‘Intake Methods’ members: Serra-Majem L (Coordinator), Cavelaars A, Dhonukshe-Rutten R, Doreste JL, Frost-Andersen L, García-Álvarez A, Glibetic M, De Groot L, Henríquez-Sánchez P, Naska A, Ngo J, Novakovic R, Ortiz-Andrellucchi A, Øverby NC, Gurinovic M, Pijls L, Ranic M, Ribas-Barba L, Ristic-Medic D, Román-Viñas B, Ruprich J, Saavedra-Santana P, Sánchez-Villegas A, Tabacchi G, Tepsic J, Trichopoulou A, van't Veer P, Vucic V, Wijnhoven TMA.

Abbreviations: DDS, diet diversity score; DQI-R, diet quality index revised; FVS, food variety score; HEI, healthy eating index; MAR, mean adequacy ratio; MPA, mean probability of adequate; NN, number of nutrients