Is adherence to the Chinese Dietary Guidelines associated with better self-reported health? The Chinese Dietary Guidelines Adherence Score.

BACKGROUND AND OBJECTIVES: Poor adherence to dietary guidelines is related to physical and mental disorders, as reflected in self-reported health statuses. This study evaluates the association between diet quality and selfreported health within the Shanghai Diet and Health Study.

METHODS AND STUDY DESIGN: We used Chinese Dietary Guidelines Adherence scores to assess diet quality in a cross-sectional study of 4487 subjects above 15 years of age, who completed three-day 24h diet recalls and responded to self-reported health questionnaires. A composite health score was calculated based on Item Response Theory, using the Rasch model. Multiple linearregression models were evaluated to assess the relationship between self-reported health status and diet quality.

RESULTS: Based on the various adherence scores, we divided our sample into fifths. Based on these divisions and with the exception of a single instance, our results show a significant trend: self-reported health declines with declining adherence to official dietary guidelines. This trend was even significant when controlling for a large number of potential confounders.

CONCLUSIONS: This study shows that consumption of a healthy and balanced diet, as reflected in adherence to the Chinese Dietary Guidelines, is related to increased levels of overall health among Shanghai residents.