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."/>
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Table 3 Comparisons of daily caloric, fat and cholesterol intake within MEDFICTS Diet Groups

From: Validation of the MEDFICTS dietary questionnaire: A clinical tool to assess adherence to American Heart Association dietary fat intake guidelines

Block Dietary High Fat Step 1 Step 2 ANOVA
Variable Diet Diet Diet F Sig.
Total calories 1980 1540 1302 12.3 .0001
% fat 40.9 38 30.3 10.1 .0001
% saturated fat 15.7 13.1 10.6 22.1 .0001
Cholesterol 351 309 181 5.3 .006