Evaluation of epidemiologic data can provide insight into areas of focus for promoting dietary changes as a part of a community-based weight loss intervention. The Dietary Approaches to Stop Hypertension (DASH) dietary pattern has been shown to promote weight maintenance and reduce cardio-metabolic risk. Researchers have created different diet quality scores to reflect DASH adherence, but little is known about the relationship between perceived diet quality (PDQ) and diet quality measured by DASH score in US adults. We compared PDQ and a nutrient-based DASH score using 2005-06 NHANES data for adults greater than or equal to19 years (n=4419). Participants rated diet quality on a 5-point scale and PDQ scores were generated (low, medium, high). Day 1 of 24-h recall data was used to estimate DASH scores by assigning 0, 0.5 (DASH goals), or 1 point (optimal) for each of 9 nutrients (per 1000 kcal): total fat, saturated fat, protein, cholesterol, fiber, calcium, magnesium, potassium, sodium (scores ranged from 0-9 points). Scores and nutrient intake were compared across PDQ levels using linear regression, adjusted for age, sex, income, education, and race. Thirty-three percent of adults had high PDQ. Those with high PDQ had higher DASH scores than those with low PDQ (3.0+/-0.1 vs. 2.5+/-0.1,p<0.001), but their average score did not reflect DASH accordance. In particular, adults with high PDQ reported higher saturated fat (10.5+/-0.2% energy) and sodium intake (1596+/-36 mg/1000 kcal) compared to optimal DASH goals (saturated fat: 6% energy;sodium: 1143 mg/1000 kcal). Results for those with high vs. low PDQ were similar for Whites (3.0+/-0.1 vs. 2.5+/-0.1,p=0.001) and Blacks (2.7+/-0.1 vs. 2.2+/-0.1, p=0.001), but there was no difference between PDQ groups for Mexican Americans (3.1+/-0.2 vs. 2.9+/-0.1, p=0.4). Among Mexican Americans, there is scant evidence for a relationship between perceived diet quality and DASH score. Among other racial/ethnic groups, high perceived diet quality may be associated with a better diet, but not a diet sufficiently aligned with DASH goals. Therefore, a future community-based intervention that incorporates the DASH dietary goals must counter inaccurate perceptions about diet quality as a barrier to dietary behavior change.
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