ABSTRACT
BACKGROUND: There is a disproportionate burden of low diet quality among young adults compared with other adult subpopulations that is not understood. Perceived and objective diet qualities are studied to understand possible barriers to change. OBJECTIVE: To explore the association between perceived diet quality and objective diet quality in young adults in the United States. DESIGN: This cross-sectional study used data from the 2013-2014 National Health and Nutrition Examination Survey to calculate total Healthy Eating Index-2010 (HEI-2010) score and component scores and study their relationships with perceived diet quality scores. PARTICIPANTS/SETTING: The sample consisted of 1,261 young adults, aged 18 to 30, with 24-hour recall data. MAIN OUTCOME MEASURES: Perceived and objective diet quality were evaluated. STATISTICAL ANALYSES PERFORMED: Multiple regression analysis was used to test the ability to predict total HEI-2010 scores from perceived diet quality scores. Ordered logit was used to test whether HEI-2010 component scores predicted the odds of having higher perceived diet quality. RESULTS: Excellent (b=8.442, P<0.001), very good (b=9.733, P<0.001), and good (b=5.527, P<0.001) perceived diet quality were significant predictors of total HEI-2010 score, compared with the referent category of poor perceived diet quality. The full regression model predicted 17.0% of the variance in total HEI-2010 score. Whole fruit (odds ratio [OR]=1.098, P=.017), whole grains (OR=1.046, P=.023), and empty calories (OR=1.054, P<0.001) were each significantly associated with the odds of having a higher rating of perceived diet quality (fair, good, very good, excellent) instead of a poor rating of diet quality; the difference in odds was low across categories. CONCLUSIONS: There are significant relationships between perceived and objective diet quality, but other variables play a substantial role in explaining these two types of diet quality.
