70 [high fat diet]) was negligible (kappa statistic = 0.036). The MF was accurate at the extremes of fat intake, but could not reliably identify the 3 AHA dietary classifications. Alternative MF cutpoints of <30 (Step 2), 30–50 (Step 1), and >50 (high fat diet) were highly sensitive (96%), but had low specificity (46%) for a high fat diet. ROC curve analysis identified that a MF score cutoff of 38 provided optimal sensitivity 75% and specificity 72%, and had modest agreement (kappa = 0.39, P < 0.001) with the FFQ for the identification of subjects with a high fat diet. Conclusions The MEDFICTS questionnaire is most suitable as a tool to identify high fat diets, rather than discriminate AHA Step 1 and Step 2 diets. Currently recommended MEDFICTS cutpoints are too high, leading to overestimation of dietary quality. A cutpoint of 38 appears to be providing optimal identification of patients who do not meet AHA dietary guidelines for fat intake."/>
Dietary Data | Male (N = 131) | Female (N = 33) | Total (N = 164) |
---|---|---|---|
MEDFICTS Data: | |||
Diet Group Distribution (%)* | |||
High fat diet | 19.8 | 9.1 | 17.7 |
Step 1 diet | 44.3 | 39.4 | 43.3 |
Step 2 diet | 35.9 | 51.5 | 39.0 |
Total MEDFICTS Score | 49 ± 27** | 41 ± 27 | 48 ± 27 |
Block Dietary Data: | |||
Total Calories | 1576 ± 674 | 1321 ± 530 | 1525 ± 654 |
% fat | 35.8 ± 14.0 | 34.4 ± 1.0 | 35.5 ± 13.0 |
% saturated fat | 12.7 ± 0.4 | 12.2 ± 0.4 | 12.6 ± 0.4 |
Cholesterol (mg/dl) | 283 ± 311 | 201 ± 98 | 267 ± 283 |