REFRESH的验证：用于环境可持续和健康饮食快速评估的膳食筛选器。

IF 3.8 3区医学 Q2 NUTRITION & DIETETICS

Journal of Nutrition Pub Date : 2025-07-01 DOI:10.1016/j.tjnut.2025.05.029

Ujué Fresán , Anna Boronat , Itziar Zazpe , Maira Bes-Rastrollo , Joren Buekers , Rafael de la Torre , Guillaume Chevance

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引用次数: 0

摘要

背景：促进可持续饮食的紧迫性，加上卫生专业人员对饮食可持续性的知识有限，突出表明需要简单的工具来协助在临床环境中倡导这种饮食。目的：设计一种膳食筛选器来评估膳食健康和环境可持续性，并对其进行验证。方法：REFRESH （environmental Sustainable and Healthy diets，环境可持续健康饮食快速评价）是一种针对10种低环境影响健康饮食的关键食物组的二分法工具。每个食物组的得分为0或1分，总分从0到10，其中0表示对环境可持续和健康饮食的坚持最低，10表示最高。采用库德-理查森-20 （KR-20）系数评价内部一致性。REFRESH的相对效度与食物日记比较，评估项目一致性，并使用Bland-Altman分析REFRESH总分。交叉分类测试低、中、高坚持可持续健康饮食，以及加权kappa指数。通过从食物日记中获得的fresh衍生评分与促进健康和有害的食物组和营养素以及环境影响指标之间的Pearson相关性来评估结构效度。结果：REFRESH的KR-20系数为0.70，内部一致性较好。它与食物日记的一致性很高（60-88%），Bland-Altman分析表明REFRESH得分比食物日记平均高1.1分。交叉分类显示59%的方法之间的一致性，只有1%的参与者在相反的类别中被错误分类。新鲜感得分与促进健康的食物种类和营养素呈正相关，与有害的食物种类和营养素呈负相关。得分越高，对环境的影响越小。结论：REFRESH在评估饮食健康和环境可持续性方面证明了良好的有效性，有助于识别次优饮食的个体。REFRESH可以从https://osf.io/avby9/下载。

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Validation of REFRESH: A Dietary Screener for Rapid Evaluation FoR Environmentally Sustainable and Healthy Diets

Background

The urgency of promoting sustainable diets, coupled with limited knowledge of dietary sustainability among health professionals, highlights the need for simple tools to assist in advocating for such diets in clinical settings.

Objectives

We aimed to design a dietary screener to assess dietary healthiness and environmental sustainability, and validate it.

Methods

Rapid Evaluation FoR Environmentally Sustainable and Healthy diets (REFRESH) is a dichotomous tool targeting 10 key food groups for healthy diets with low environmental impacts. Each food group is scored as either 0 or 1 point, resulting in a total score ranging from 0 to 10—where 0 indicates the lowest and 10 the highest adherence to an environmentally sustainable and healthy diet. Internal consistency was assessed using the Kuder Richardson-20 (KR-20) coefficient. REFRESH’s relative validity was compared against food diaries, evaluating item agreement, and using Bland–Altman analysis for the total REFRESH score. Cross-classification was tested in low, medium, and high adherence to sustainable healthy diets, along with weighted kappa index. Construct validity was evaluated through Pearson correlation between REFRESH-derived scores and health-promoting and detrimental food groups and nutrients, and environmental impact indicators, as derived from food diaries.

Results

REFRESH had a KR-20 coefficient of 0.70, indicating good internal consistency. It showed high agreement with food diaries (60%–88% item agreement), and Bland-Altman analysis indicated that mean REFRESH scores were 1.1 points higher than food diaries. Cross-classification showed 59% agreement between methods, with only 1% of participants misclassified in the opposite category. REFRESH-derived scores positively correlated with health-promoting food groups and nutrients, and negatively with detrimental ones. Higher scores were linked to reduced environmental impacts.

Conclusions

REFRESH has demonstrated good validity for assessing dietary healthiness and environmental sustainability, helping identify individuals with suboptimal diets. REFRESH can be downloaded from https://osf.io/avby9/.

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来源期刊

Journal of Nutrition 医学-营养学

CiteScore

7.60

自引率

4.80%

发文量

260

审稿时长

39 days

期刊介绍： The Journal of Nutrition (JN/J Nutr) publishes peer-reviewed original research papers covering all aspects of experimental nutrition in humans and other animal species; special articles such as reviews and biographies of prominent nutrition scientists; and issues, opinions, and commentaries on controversial issues in nutrition. Supplements are frequently published to provide extended discussion of topics of special interest.