Development of a Dietary Index to Assess Overall Diet Quality for Chinese school-aged Children: The Chinese Children Dietary Index (CCDI)

Guo Cheng, Sibylle Kranz, Lars Libuda, Lishi Zhang

Research output: Contribution to journalArticle (Academic Journal)peer-review

44 Citations (Scopus)
633 Downloads (Pure)


Background: A composite measure of diet quality is preferable to an index of nutrients, food groups or health-promoting behaviors in dietary assessment. However, to date such a tool for Chinese children is lacking.

Objective: Based on the current Chinese Dietary Guidelines and Dietary Reference Intakes, a dietary index for Chinese school-aged children, the Chinese Children Dietary Index (CCDI) was developed to assess overall diet quality among children in South China.

Design/Subjects: Dietary data were recorded using 24-hour recalls among 1719 children aged 7-15 years between March and June 2013. Inactivity data and socio-demographic information were also collected. The CCDI included 16 components, which incorporated nutrients, foods/food-groups and health-promoting behaviors. The range of possible CCDI scores was 0-160, with a higher score indicating better diet quality.

Statistical analysis performed: Pearson/spearman correlation was used to assess relative validity using correlations between total CCDI score and age, body mass index (BMI), inactivity, whole grain intake, frequency of fried foods intake, nutrient adequacy ratios for energy intake and 12 nutrients not included in the CCDI, and the mean adequacy ratio (MAR). Finally, a stepwise multiple regression analysis was performed to indicate the factors correlated with CCDI.

Results: The mean CCDI score of this sample was 88.1 points (range: 34.2-137.8), the CCDI score of girls was higher than that of boys and decreased with higher age. Children with higher CCDI had lower BMI and spent less time being inactive. Positive associations were observed between CCDI and the majority of nutrient adequacy ratios and the MAR. Age, paternal educational level and family size were correlated with CCDI.

Conclusion: The CCDI successfully differentiated diets, hence, it can be used to rank-order overall diet quality among Chinese children. As the results showed, diet quality among Chinese children needs to be improved, especially in adolescents.
Original languageEnglish
Pages (from-to)608-617
Number of pages10
JournalJournal of the Academy of Nutrition and Dietetics
Issue number4
Early online date26 Jan 2016
Publication statusPublished - Apr 2016


  • Diet quality
  • Dietary Index
  • Child
  • Adolescent
  • China


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