Abstract

Background and Objectives: Malaysian Healthy Diet Online Survey (MHDOS) is an online survey designed to measure diet quality of Malaysian adults. This study aimed to assess the relative validity and test-retest reliability of the MHDOS. Methods and Study Design: This nationwide cross-sectional study was conducted from May to November 2022 among 218 Malaysian adults. Participants completed the MHDOS, underwent an interview-administered 24-hour diet recall (24DR), and repeated the MHDOS within two weeks. Relative validity was assessed by correlating food group servings from the MHDOS and 24DR using Spearman's correlation coefficients. Construct validity was evaluated by comparing Diet Score tertiles with food group servings, energy, and nutrient intakes from the 24DR. Linear trend analysis was used to compare food group and nutrient intakes across the Diet Score tertiles. Reliability was measured using the Intra-class correlation coefficient (ICC) between the initial and repeated MHDOS administrations. Results: The MHDOS demonstrated moderate-to-good reliability, with ICC ranging from 0.70-0.86 for different components and 0.90 for the total Diet Score. Spearman correlation coefficients for mean food group intakes estimated from the MHDOS and 24DR ranged from 0.21-0.44 (p <0.001). Higher Diet Scores were associated with greater intake of total fibre, vitamin C, thiamine, niacin, potassium, calcium, phosphorus, and iron, as well as increased consumption of vegetables, fruits, and water (p-trend <0.01). Conclusions: MHDOS has good test-retest reliability and its derived Diet Score is associated with better nutrient and food group intake as estimated from 24DR. The MHDOS is a valid and reliable tool for assessing diet quality among Malaysian adults.

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