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if the objective is to measure all dimensions that encompass the definition of diet quality, using individual level quantitative data from a 24-hour dietary recall or weighed food records is required. a 24-hour dietary recall, for example, provides quantitative information on the individual level, which allows for not only quantification of dietary diversity, but also nutrient adequacy, moderation, and overall balance of the diet. these data also allow for the assessment of nutrient deficiencies and excesses in populations (their primary use). food frequency questionnaires (ffq) can also be can be used to determine some aspects of diet quality (e.g. fruit and vegetable consumption, animal source protein), particularly if they seek to quantify intake. ffqs can be developed to measure moderation (intake of nutrients or foods that should be consumed with restraint), and overall balance (macronutrient composition in the diet). the major drawback of using an ffq is that they are context specific since diets vary from place to place and thus the food list needs to be updated and the ffq validated in each context. d8a7b2ff72
in addition to measuring diet quality, dietary diversity is widely used as an indicator of nutrition-specific dietary adequacy. the indicator is based on the idea that the more different foods an individual eats, the higher the probability of meeting the recommended nutrient intake for micronutrients through the diet. dietary diversity is also a measure of food security and in the context of malnutrition it can also be used as an indicator of the extent to which an individual is exposed to nutritional risks (alkhaher et al. 2007 ). dietary diversity measures by itself are a limited way to assess nutritional adequacy but due to the increased attention that it has been gaining over the last years (klemmensen et al. 2013), new methods of assessing dietary diversity have started to appear (alkhaher et al. 2007).
the consumption of less healthy foods and greater consumption of nutrient-dense foods are combined into the concept of diet quality in diet assessment. the concept may be measured by the consumption distribution index (cdi) a method developed by the institute for nutrition sciences in europe (inse) as one of the most efficient ways to assess diet quality ( sofaer, 1999 ).
defining a diet according to conventional food consumption patterns has been a long-standing priority in nutritional science. for a long time the common belief was that a healthy diet would be high in fruits, vegetables, whole grains, low fat dairy and fish and low in saturated fats, refined grains and red meat (wilson et al. 2008). dietary guidelines set by health organisations have generally recommended such consumption patterns to the public (who 2013, nop). since then, however, knowledge about the health benefits of eating certain foods (among other concerns) has dramatically increased and so has the understanding about how to optimise a diet that maximises health and minimises disease risk. thus, food consumption patterns have changed over time and today dietary recommendations are usually based on the concept of achieving an adequate consumption of different nutrients (who healthy diet factsheet, guenther et al. 2013). in addition, dietary recommendations are typically based on certain diet characteristics, such as eating dietary targets to reduce the risk of developing chronic diseases and in some cases, special dietary practices to help individual groups, such as pregnant women or those who are lactating.