Perceived and calculated diet quality improvements in a randomized mHealth weight loss trial.
Jessica Cheng, Tina Costacou, Bonny Rockette-Wagner, Susan M Sereika, Molly B Conroy, Andrea M Kriska, Jacob K Kariuki, Mary Lou Klem, Bambang Parmanto, Lora E Burke
Author Information
Jessica Cheng: Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
Tina Costacou: Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
Bonny Rockette-Wagner: Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
Susan M Sereika: Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
Molly B Conroy: Division of General Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA. ORCID
Andrea M Kriska: Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
Jacob K Kariuki: Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
Mary Lou Klem: Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
Bambang Parmanto: Department of Health Information Management, School of Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
Lora E Burke: Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. ORCID
The diet quality of US adults is poor and cross-sectional analyses suggest self-perception of healthful dietary intake may be overestimated. This analysis assessed the concordance between calculated and perceived diet quality and changes in diet quality among adults seeking weight loss and enrolled in a 12-month randomized behavioral trial. Healthy Eating Index-2015 diet quality (HEI) was calculated from self-administered 24-hour recalls. Perceived diet quality (PDQ) was measured on a 100-point scale. Higher scores indicate better diet quality. Concordance was assessed using the concordance correlation coefficient and Bland-Altman plots. The one hundred and five participants with complete dietary data were mostly female and white. There was good agreement between HEI and PDQ scores at 12 months for less than a third of participants. Most of the disagreement arose from PDQ scores being higher than HEI scores. Even fewer participants had good agreement between HEI changes and PDQ changes. Participants perceived greater improvement in diet quality than indicated by HEI score changes. Concordance was low at 12 months and for change in diet quality. Despite the diet quality of adults seeking weight loss being suboptimal and not improving, many perceived their diet quality and diet quality improvements as better than calculated. Future studies might explore the effect of misperceptions on weight loss outcomes.
