BACKGROUND Evaluating diet quality is a way to monitor a population's adherence to dietary guidelines. OBJECTIVE To adapt the Healthy Eating Index-2015 (HEI-2015) to the Brazilian population, to evaluate the validity and reliability of the adapted HEI-2015, and to assess diet quality of Brazilian adults as well as socioeconomic and demographic factors associated with diet quality. DESIGN In this cross-sectional study, two dietary records from nonconsecutive days were used to obtain food intake information. The collected socioeconomic and demographic data included sex, age, education, per capita income, and residence area. PARTICIPANTS/SETTING A representative sample (n=27,760) of the Brazilian adult population participated in the Nutrition Dietary Survey 2008-2009. MAIN OUTCOME MEASURES Total and component scores for the adapted HEI-2015. The validity and reliability of the index were tested. STATISTICAL ANALYSIS PERFORMED Mean total and component scores were estimated for the adapted HEI-2015. Also, the proportion of subjects that achieved the maximum score for each component was calculated. Regarding validity and reliability analysis, principal components analysis examined the number of dimensions; Pearson correlations were estimated between total score, components, and energy, and Cronbach's coefficient α was estimated. Diet quality was compared among socioeconomic and demographic categories. RESULTS The mean total score for the adapted HEI-2015 was 45.7 (95% CI: 45.4 to 46.0). Women had higher diet quality scores (46.4; 95% CI: 46.1 to 46.7) than men (44.9; 95% CI: 44.6 to 45.3). Age, education, and per capita income were directly associated with the adapted HEI-2015 total score. Greater than or equal to 50% of subjects received the maximum adapted HEI-2015 component scores for "total protein foods," "seafood and plant proteins," "fatty acids," and "sodium." In contrast, less than 30% of subjects received the maximum component scores for "total vegetables," "dairy," and "saturated fats." Higher percentages of women received the maximum component scores for "total fruits," "whole fruits," "total vegetables," "greens," "dairy," and "sodium," whereas higher percentages of men received the maximum component scores for "total protein foods," "seafood and plant proteins," "fatty acids," "added sugars," and "saturated fats" components. Finally, validity analysis revealed weak correlations between component scores and energy and weak to moderate correlations with total scores; six dimensions were responsible for the total variance in diet quality and the standardized Cronbach's coefficient α was .65 (unstandardized=.64). CONCLUSIONS Brazilian adults have suboptimal diet quality as assessed by the adapted HEI-2015. Diet quality varied by socioeconomic and demographic factors. Results support the validity and the reliability of the index.

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巴西人口的饮食质量及相关的社会经济和人口因素：2008-2009 年全国饮食调查分析

背景评价饮食质量是监测人群对饮食指南的遵守情况的一种方式。目标 使健康饮食指数 2015 (HEI-2015) 适应巴西人口，评估改编后的 HEI-2015 的有效性和可靠性，并评估巴西成年人的饮食质量以及与饮食相关的社会经济和人口因素质量。设计 在这项横断面研究中，使用非连续天数的两个饮食记录来获取食物摄入信息。收集的社会经济和人口数据包括性别、年龄、教育、人均收入和居住面积。参与者/环境 巴西成年人口的代表性样本 (n=27,760) 参加了 2008-2009 年的营养膳食调查。主要结果测量 改编后的 HEI-2015 的总分和组成部分。对该指标的效度和信度进行了检验。执行的统计分析 对改编后的 HEI-2015 的平均总分和组成部分得分进行了估计。此外，还计算了每个组件获得最高分的受试者比例。在效度和信度分析方面，主成分分析考察了维数；估计总分、成分和能量之间的 Pearson 相关性，并估计 Cronbach 系数 α。在社会经济和人口统计类别之间比较饮食质量。结果 改编后的 HEI-2015 的平均总分为 45.7（95% CI：45.4 至 46.0）。女性的饮食质量得分（46.4；95% CI：46.1 至 46.7）高于男性（44.9；95% CI：44.6 至 45.3）。年龄、学历、人均收入与调整后的 HEI-2015 总分直接相关。大于或等于 50% 的受试者在“总蛋白食物”、“海鲜和植物蛋白”、“脂肪酸”和“钠”方面获得了最高调整后的 HEI-2015 组件分数。相比之下，只有不到 30% 的受试者在“总蔬菜”、“乳制品”和“饱和脂肪”方面获得了最高分。较高比例的女性在“总水果”、“整个水果”、“总蔬菜”、“蔬菜”、“乳制品”和“钠”方面获得最高分，而较高比例的男性在“总蛋白食物”、“海鲜和植物蛋白”、“脂肪酸”、“添加糖”和“饱和脂肪”成分。最后，效度分析揭示了组件分数与能量之间的弱相关性，以及与总分的弱到中等相关性；六个维度负责饮食质量的总方差，标准化的克朗巴赫系数 α 为 0.65（未标准化=0.64）。结论 根据改编后的 HEI-2015 评估，巴西成年人的饮食质量欠佳。饮食质量因社会经济和人口因素而异。结果支持该指数的有效性和可靠性。六个维度负责饮食质量的总方差，标准化的 Cronbach 系数 α 为 0.65（未标准化 = 0.64）。结论 根据改编后的 HEI-2015 评估，巴西成年人的饮食质量欠佳。饮食质量因社会经济和人口因素而异。结果支持该指数的有效性和可靠性。六个维度负责饮食质量的总方差，标准化的克朗巴赫系数 α 为 0.65（未标准化=0.64）。结论 根据改编后的 HEI-2015 评估，巴西成年人的饮食质量欠佳。饮食质量因社会经济和人口因素而异。结果支持该指数的有效性和可靠性。