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Background  Adolescence is an important life stage for the development of dietary preferences and health behaviour. Longitudinal studies indicated that cardiovascular status in adolescence predicts cardiovascular risk marker values in adulthood. Several diet quality indices for adolescents have been developed in the past, but literature concerning associations between indices and biomarkers of dietary exposure and cardiovascular status is rather sparse. Hence, the aim of this study was to analyse associations of dietary indices with biomarkers of dietary exposure and cardiovascular status.    Methods  For the present analysis, data from the German Health Interview and Examination Survey for Children and Adolescents ( KiGGS  2003–2006) were used. The analysis included 5,198 adolescents, aged 12 to 17 years. The Healthy Food Diversity Index ( HFD ), the Healthy Nutrition Score for Kids and Youth ( HuSKY ), the Indicator Food Index ( IFI ) and a simple fruit/vegetable intake index were derived from food frequency questionnaire information to indicate a healthy diet. Adjusted mean values for homocysteine, uric acid,  CRP , total cholesterol,  HDL-C , ferritin,  HbA1c , folate, vitamin B 12  and  BMI  were calculated using complex-samples general linear models for quintiles of the different indices. Furthermore, the agreement in ranking between the different indices was calculated by weighted kappa. All statistical analyses were conducted for boys and girls separately, and were adjusted for potential confounders.    Results  Folate was positively associated with the  HFD , the  HuSKY , and fruit/vegetable intake for both boys and girls and with  IFI  for boys. Among girls, positive associations were seen between vitamin B 12  and the  IFI  and between diastolic blood pressure and the  IFI  as well as fruit/vegetable intake. A negative association was found between homocysteine and the  HFD , the  HuSKY , and the  IFI  for both boys and girls and with fruit/vegetable intake for boys. Among boys, uric acid and  HbA1c  were negatively and prevalence of obesity positively associated with the  IFI .    Conclusions  Overall, the indices, even the simpler ones, seem to have a similar general capability in predicting biomarkers of dietary exposure. To predict risk of cardiovascular disease dietary indices may have to be more specific.

Associations of dietary indices with biomarkers of dietary exposure and cardiovascular status among adolescents in Germany