# Implementing a Diet Risk Score (DRS) for Spanish-Speaking Adults in a Clinical Setting: A Feasibility Study

## TL;DR

A Spanish version of a diet risk score was tested for feasibility in assessing diet-related cardiometabolic disease risk among Spanish-speaking adults in a clinical setting.

## Contribution

The study developed and validated a Spanish-translated Diet Risk Score (DRS-S) for use in clinical settings with Spanish-speaking populations.

## Key findings

- The DRS-S showed significant agreement with the HEI-2015 dietary assessment tool.
- The DRS-S is feasible for use in resource-limited clinical settings to identify individuals at risk for cardiometabolic disease.
- Further testing is needed to evaluate the impact of dietary interventions based on DRS-S results.

## Abstract

Tools to briefly assess diet among US Spanish-speaking adults are needed to identify individuals at risk for cardiometabolic disease (CMD) related to diet. Two registered dietitian nutritionists (RDNs) recruited bilingual medical students to translate the validated Diet Risk Score (DRS) into Spanish (DRS-S). Participants were recruited from a federally qualified health center. Students administered the DRS-S and one 24-h recall (Automated Self-Administered 24-Hour (ASA24®) Dietary Assessment Tool) on one day; a second recall was administered within 1 week. Recalls were scored using the Healthy Eating Index (HEI)-2015, a measure of adherence to the Dietary Guidelines for Americans. Spearman correlations, weighted kappa, and ANOVA were conducted using SAS 9.4 to assess the relative validity of the DRS-S. Thirty-one Spanish-speaking adults (female: n = 17, 53%; mean age: 58 (42–69)) completed assessments. The mean DRS-S was 9 (SD = 4.2) (max: 27; higher score = higher risk) and the mean HEI-2015 score was 65.7 (SD = 9.7) (max: 100; higher score = lower risk), with significant agreement between measures (r: −0.45 (p = 0.01)), weighted kappa: −0.3 (p = 0.03). The DRS-S can be used in resource-constrained settings to assess diet for intervention and referral to RDNs. The DRS-S should be tested in clinical care to assess the impact of dietary changes to reduce CMD risk.