Five-Factor Screener: Scoring Procedures

How Analytical Scoring Procedures Were Developed

Scoring procedures were developed to convert a respondent's screener responses to estimates of individual dietary intake for fruits and vegetables (servings), fiber (gm), added sugar (tsp), calcium (mg), and dairy (servings) using USDA's 1994-96 Continuing Survey of Food Intakes of Individuals (CSFII 94-96) dietary recall data. The following equations were estimated in the CSFII 94-96:

For fiber and calcium:

E (Dietary Factor) = b₀ + b₁N_FG1P₁ + b₂N_FG2P₂ + ... + b₂₀N_FG20P₂₀

E (Dietary Factor) indicates the expected values for fiber and calcium, and assumes a normal distribution. In the CSFII 94-96 dataset fiber was positively skewed and required a cube-root transformation to approximate normality. Calcium required a quarter-root transformation. N_FGk is the usual number of times per day an individual consumed food group k; P_k is the median portion size of group k; and k indexes the 20 food groups. These 20 food groups were formed to reflect the same food groups on the screener. We calculated weighted least-squares estimates of the regression coefficients b_k, k = 0, ..., 20 on CSFII 94-96 adults aged 18 and above, stratifying by gender and excluding extreme exposure values. We first included all 20 food groups in the regression model. After examining the results, we dropped food groups that failed to attain statistical significance at the α = 0.25 level to form more parsimonious final models. In the fiber model, salad and soda were dropped for women. In the calcium model, all foods attained statistical significance. Because of the complex survey design, the analysis was performed using SUDAAN (RTI Inc., Research Triangle Park, NC).

For servings of fruits and vegetables:

E (Fruits and Veg^1/2) = b₀ + b₁ (N_FG1P₁ + N_FG2P₂ + ... + N_FG9P₉)^1/2

Servings of fruits and vegetables was square-root-transformed to approximate normality; N_FGk is the usual number of times per day an individual consumed food group k; P_k is the median portion size of group k; and k indexes the 9 fruit and vegetable food groups. We calculated weighted least-squares estimates of the regression coefficients b₀ and b₁ on the adults in the CSFII 94-96 sample, stratifying by gender and excluding extreme exposure values.

For teaspoons of added sugar:

E (Added Sugar^.33) = b₀ + b₁ (N_FG1P₁ + N_FG2P₂ + ... + N_FG4P₄)^.33

Teaspoons of added sugar was cube-root-transformed to approximate normality; N_FGk is the usual number of times per day an individual consumed food group k; P_k is the median portion size of group k; and k indexes the 4 added sugar food groups. We calculated weighted least-squares estimates of the regression coefficients b₀ and b₁ on the adults in the CSFII 94-96 sample, stratifying by gender and excluding extreme exposure values.

For servings of dairy:

E (Dairy^1/2) = b₀ + b₁ (N_FG1P₁ + N_FG2P₂)^1/2

Servings of dairy was square-root-transformed to approximate normality; N_FGk is the usual number of times per day an individual consumed food group k; P_k is the median portion size of group k; and k indexes the 2 dairy food groups. We calculated weighted least-squares estimates of the regression coefficients b₀ and b₁ on the adults in the CSFII 94-96 sample, stratifying by gender and excluding extreme exposure values.

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Scoring Procedures

We performed the following steps with the NHIS 2005 Cancer Control Supplement dietary data to estimate the individual's intake of servings of fruits and vegetables, fiber, added sugar, calcium, and servings of dairy.

1. Estimation of N_FGk: All reported frequencies were standardized to a common unit of time by converting them to daily frequencies.

   Frequency Response	NFGk: Daily Frequency
   Never	0
   1-3 times per month	0.067
   1-2 times per week	0.214
   3-4 times per week	0.5
   5-6 times per week	0.786
   1 time per day	1
   2 times per day	2
   3 times per day	3
   4 times per day	4
   5 or more times per day	5

2. Estimation of P_k: The median age- and gender-specific portion sizes for each food were estimated from CSFII 94-96. For fiber and calcium variables, the units were in grams (Tables 1-2); for fruit and vegetable servings variables, the units were in Pyramid servings of fruits and vegetables (Tables 3a & 3b); for dairy servings, the unit was Pyramid servings of dairy (Table 4); and for teaspoons of added sugar, the unit was Pyramid teaspoons of added sugar (Table 5).

   For fruit and vegetables, a Pyramid serving was defined by the U.S. Department of Agriculture in the 1992 Dietary Guidelines Food Guide Pyramid as:

   • vegetables: 1 cup raw leafy, 1/2 cup of other vegetables, or 3/4 cup vegetable juice; and
   • fruit: 1 whole fruit, 1/2 cup of cut-up fruit, or 3/4 cup fruit juice.

   More recently, the 2005 Dietary Guidelines measure fruits and vegetables in cup equivalents. See MyPyramid for definitions of cup equivalents.

   Both metrics are provided for these 2005 data.

   For the milk group, a Pyramid serving is defined as:

   • 1 cup of milk or yogurt;
   • 1½ ounces of natural cheese; and
   • 2 ounces of processed cheese.

   For added sugar, a Pyramid serving is 1 teaspoon.

   Table 1. Median Portion Size (P_k) in Grams per Mention by Age for Fiber and Calcium Analyses: Men

   Food Group	Age Group
   	18-27	28-37	38-47	48-57	58-67	68-77	78-99
   Cooked Cereals (P1)	354.000000	219.630000	247.000000	247.000000	234.000000	239.000000	234.000000
   High-fiber Cereal (P2)	33.000000	33.000000	33.000000	33.000000	22.000000	22.000000	22.000000
   Moderate-fiber cereal (P3)	84.000000	66.000000	58.000000	64.125000	50.000000	47.000000	39.000000
   Low-fiber cereal (P4)	64.000000	54.000000	54.000000	40.625000	40.000000	30.375000	29.000000
   Milk (P5)	325.333333	268.400000	274.500000	244.000000	233.833333	206.000000	183.000000
   Regular Soda (P6)	453.866667	372.000000	372.000000	372.000000	370.200000	368.400000	368.000000
   Fruit Drinks (P7)	480.000000	376.500000	378.265000	372.000000	306.000000	248.000000	248.000000
   Fruit Juice (P8)	372.000000	311.250000	249.000000	249.000000	248.000000	186.750000	186.750000
   Fruit (P9)	131.750000	128.000000	123.200000	127.500000	122.000000	118.000000	114.250000
   Salad (P10)	30.000000	47.833333	42.500000	41.250000	42.500000	41.250000	44.666667
   French fries (P11)	112.500000	114.000000	100.000000	100.000000	85.500000	85.500000	97.000000
   Other potatoes (P12)	210.000000	193.000000	193.000000	161.000000	150.000000	127.000000	113.250000
   Dried beans (P13)	222.500000	188.095000	178.000000	189.750000	226.800000	199.333333	214.000000
   Other vegetables (P14)	61.250000	74.166667	75.625000	81.666667	76.000000	73.332500	70.000000
   Tomato sauce (P15)	63.000000	125.000000	125.000000	156.250000	122.500000	125.000000	125.000000
   Salsa (P16)	62.250000	62.250000	49.275000	43.875000	16.000000	31.130000	31.130000
   Whole Grain Bread (P17)	56.000000	54.000000	52.000000	52.000000	51.000000	48.250000	48.000000
   Doughnuts, sweet rolls, muffins (P18)	71.000000	77.500000	72.800000	65.000000	63.000000	57.000000	57.000000
   Cookies, pie, cake, brownies (P19)	64.000000	66.000000	66.000000	73.733333	67.500000	64.000000	61.000000
   Cheese (P20)	35.440000	28.350000	30.470000	29.390000	28.350000	28.350000	28.350000

   
   

   Table 2. Median Portion Size (P_k) in Grams per Mention by Age for Fiber and Calcium Analyses: Women

   Food Group	Age Group
   	18-27	28-37	38-47	48-57	58-67	68-77	78-99
   Cooked Cereals (P1)	234.000000	234.000000	234.000000	234.000000	226.800000	234.000000	227.475000
   High-fiber Cereal (P2)	42.750000	42.750000	42.750000	42.750000	27.970000	27.970000	27.970000
   Moderate-fiber cereal (P3)	60.000000	57.000000	53.000000	49.500000	42.000000	39.083333	40.000000
   Low-fiber cereal (P4)	46.500000	37.500000	36.250000	33.000000	27.000000	26.000000	25.000000
   Milk (P5)	244.000000	244.000000	244.000000	214.250000	183.750000	183.000000	183.000000
   Regular Soda (P6)	372.000000	372.000000	370.200000	368.400000	330.666667	366.000000	368.200000
   Fruit Drinks (P7)	360.000000	341.000000	250.000000	250.000000	248.000000	240.000000	221.200000
   Fruit Juice (P8)	280.125000	249.000000	248.800000	233.250000	189.755000	186.600000	186.700000
   Fruit (P9)	118.000000	118.000000	118.000000	118.000000	118.000000	112.427143	109.000000
   Salad (P10)	33.750000	32.083333	47.000000	55.000000	43.750000	34.333333	41.250000
   French fries (P11)	79.500000	70.000000	70.000000	70.000000	66.000000	70.000000	64.000000
   Other potatoes (P12)	122.000000	127.000000	119.000000	113.000000	105.000000	105.000000	105.000000
   Dried beans (P13)	132.750000	126.500000	126.500000	141.750000	130.550000	172.000000	178.000000
   Other vegetables (P14)	56.000000	62.043333	64.415000	64.920000	65.000000	67.375000	71.333333
   Tomato sauce (P15)	125.000000	113.400000	62.500000	125.000000	62.500000	62.500000	62.500000
   Salsa (P16)	32.000000	31.130000	36.565000	27.847500	31.130000	16.000000	16.000000
   Whole Grain Bread (P17)	50.000000	48.000000	47.500000	45.000000	45.000000	42.400000	34.000000
   Doughnuts, sweet rolls, muffins (P18)	67.333333	58.000000	57.000000	58.500000	57.000000	59.000000	47.000000
   Cookies, pie, cake, brownies (P19)	56.700000	50.000000	48.800000	55.200000	57.000000	48.675000	52.666667
   Cheese (P20)	28.250000	24.000000	24.000000	26.250000	28.350000	26.250000	28.350000

   
   

   Table 3a. Median Portion Size (P_k) in Pyramid Servings* per Mention by Gender and Age for Fruits and Vegetables Analyses

   Food Group	Age Group
   	18-27	28-37	38-47	48-57	58-67	68-77	78-99
   Men
   100% fruit juice (P1)	2.000000	1.667500	1.335000	1.335000	1.334000	1.001000	1.001000
   Fruit (P2)	1.301000	1.301000	1.229571	1.227333	1.168000	1.168000	1.052333
   Salad (P3)	0.545000	0.708000	0.754500	0.750000	0.833500	0.750000	0.822500
   Fried potatoes (P4)	2.000000	2.000000	1.773000	1.710000	1.400000	1.250000	1.250000
   Other potatoes (P5)	2.000000	2.000000	1.999000	1.999000	1.914000	1.544000	1.508000
   Dried beans (P6)	1.374000	1.047000	1.065000	1.227000	1.000000	1.000000	1.114000
   Other Vegetables (P7)	0.750000	0.906000	0.974500	1.000000	1.000000	0.880000	0.833333
   Tomato sauce (P8)	0.500000	0.541000	0.541000	0.812000	0.541000	0.541000	0.541000
   Salsa (P9)	0.533000	0.533000	0.421500	0.386500	0.137000	0.266000	0.266000
   Women
   100% fruit juice (P1)	1.500500	1.334000	1.334000	1.251250	1.019500	1.000500	1.000500
   Fruit (P2)	1.168000	1.168000	1.168000	1.168000	1.150500	1.083833	1.000000
   Salad (P3)	0.613500	0.572500	0.833333	1.000000	0.795500	0.625000	0.750000
   Fried potatoes (P4)	1.481000	1.365500	1.272000	1.400000	1.000000	1.026000	1.000000
   Other white potatoes (P5)	1.544000	1.544000	1.528000	1.544000	1.499000	1.516000	1.272000
   Dried beans (P6)	0.964000	0.684000	0.800000	0.687000	0.822000	0.807000	1.000000
   Other Vegetables (P7)	0.702200	0.779333	0.792500	0.788500	0.774000	0.833000	0.856750
   Tomato sauce (P8)	0.541000	0.541000	0.273000	0.541000	0.500000	0.500000	0.500000
   Salsa (P9)	0.274000	0.266000	0.322500	0.238250	0.266000	0.137000	0.137000

   
   

   Table 3b. Median Portion Size (P_k) in Cup Servings** per Mention by Gender and Age for Fruits and Vegetables Analyses

   Food Group	Age Group
   	18-27	28-37	38-47	48-57	58-67	68-77	78-99
   Men
   100% fruit juice (P1)	1.499160	1.250580	1.000980	1.000980	1.000176	0.750735	0.750735
   Fruit (P2)	0.999580	0.933450	0.867300	0.867300	0.867300	0.774916	0.657060
   Salad (P3)	0.272700	0.353970	0.377235	0.374963	0.416640	0.375000	0.411323
   Fried potatoes (P4)	0.721125	0.727700	0.641000	0.641000	0.548055	0.480750	0.499980
   Other potatoes (P5)	1.000400	1.140030	0.999600	0.999600	0.999490	0.833175	0.754400
   Dried beans (P6)	0.717550	0.551540	0.566720	0.612360	0.500250	0.502285	0.575360
   Other Vegetables (P7)	0.387675	0.473920	0.499840	0.500240	0.499905	0.460585	0.416899
   Tomato sauce (P8)	0.249900	0.271250	0.271250	0.406875	0.271250	0.271250	0.271250
   Salsa (P9)	0.266430	0.266430	0.210897	0.195683	0.068480	0.133236	0.133236
   Women
   100% fruit juice (P1)	1.124370	1.000960	1.000176	0.938130	0.764776	0.750728	0.750434
   Fruit (P2)	0.749235	0.867300	0.844838	0.789970	0.742350	0.712640	0.620475
   Salad (P3)	0.306788	0.286335	0.416625	0.499950	0.397688	0.312469	0.374963
   Fried potatoes (P4)	0.509595	0.455110	0.448700	0.448700	0.394856	0.444260	0.444260
   Other white potatoes (P5)	0.782020	0.876945	0.771260	0.771260	0.749700	0.771260	0.644235
   Dried beans (P6)	0.492150	0.341550	0.430530	0.345763	0.430685	0.430530	0.500400
   Other Vegetables (P7)	0.364468	0.395882	0.404303	0.408330	0.416913	0.436560	0.452214
   Tomato sauce (P8)	0.271250	0.271250	0.136710	0.271250	0.249900	0.249900	0.249900
   Salsa (P9)	0.136960	0.133236	0.163080	0.119187	0.133236	0.068480	0.068480

   
   

   Table 4. Median Portion Size (P_k) in Pyramid Servings* per Mention by Gender and Age for Dairy Analyses

   Food Group	Age Group
   	18-27	28-37	38-47	48-57	58-67	68-77	78-99
   Men
   Milk (P1)	1.250500	1.083000	1.100400	1.000000	0.916667	0.833333	0.750000
   Cheese (P2)	0.741000	0.641333	0.667000	0.600000	0.575000	0.499000	0.370000
   Women
   Milk (P1)	1.000000	1.000000	0.999000	0.874000	0.750000	0.718750	0.750000
   Cheese (P2)	0.517000	0.470000	0.494000	0.494000	0.470000	0.379000	0.494000

   
   

   Table 5. Median Portion Size (P_k) in Pyramid Servings* per Mention by Gender and Age for Added Sugar Analyses

   Food Group	Age Group
   	18-27	28-37	38-47	48-57	58-67	68-77	78-99
   Men
   Soda (P1)	11.835000	9.990000	9.947000	9.683000	9.683000	9.631000	9.605000
   Fruit drinks (P2)	9.627000	8.561000	8.985000	8.194000	6.815000	5.463000	5.307000
   Doughnuts, sweet rolls, muffins (P3)	4.3080000	4.196000	3.707000	3.095000	2.897000	2.837000	2.781500
   Cookies, pie, cake, brownies (P4)	5.189000	5.027000	4.845000	4.716000	4.730000	4.428000	3.968000
   Women
   Soda (P1)	9.815000	9.683000	9.683000	9.644000	8.443500	8.370000	9.683000
   Fruit drinks (P2)	7.997000	7.876000	6.418000	6.002000	6.418000	5.116000	5.116000
   Doughnuts, sweet rolls, muffins (P3)	2.966000	2.966000	2.797000	2.966000	2.498000	2.627000	2.627000
   Cookies, pie, cake, brownies (P4)	4.133000	3.650000	3.842000	3.719000	4.027500	3.571000	3.166500

3. For fiber (grams) and calcium (mg), estimation of b_k, k = 0, ..., 20: the values for each parameter, for each gender, are in the following table:

   Table 6. Estimated Regression Coefficients for Foods as Predictors of Fiber (gm) and Calcium (mg), by Gender

   Parameter	Men		Women
   	Fiber (cube root)	Calcium (quarter root)	Fiber (cube root)	Calcium (quarter root)
   Intercept (b0)	2.015301	4.482732	1.838259	4.155762
   Cooked Cereals (b1)	0.000558	0.000318	0.000671	0.000484
   High-fiber Cereal (b2)	0.011463	0.006716	0.019873	0.006744
   Moderate-fiber cereal (b3)	0.003515	-0.000355	0.004688	0.000074
   Low-fiber cereal (b4)	-0.000425	-0.002023	0.001493	-0.001305
   Milk (b5)	0.000180	0.002204	0.000169	0.002580
   Regular Soda (b6)	0.000043	0.000089	---	0.000095
   Fruit Drinks (b7)	0.000141	0.000105	0.000115	0.000326
   Fruit juice (b8)	0.000166	0.000123	0.000229	0.000195
   Fruit (b9)	0.000985	0.000170	0.001009	0.000264
   Salad (b10)	-0.000447	-0.000938	---	-0.000723
   French fries (b11)	0.001517	0.001159	0.001381	0.000414
   Other potatoes (b12)	0.000720	0.000349	0.000693	0.000489
   Dried beans (b13)	0.002156	0.000511	0.003217	0.001035
   Other vegetables (b14)	0.000899	0.000400	0.000925	0.000396
   Tomato sauce (b15)	0.001315	0.000948	0.001204	0.000287
   Salsa (b16)	0.003632	0.002179	0.003239	0.002679
   Whole grain bread (b17)	0.002927	0.000406	0.003401	0.000680
   Doughnuts, sweet rolls, muffins (b18)	0.000979	0.001198	0.001683	0.001873
   Cookies, pie, cake, brownies (b19)	0.001006	0.001771	0.001377	0.002451
   Cheese (b20)	0.001206	0.014186	0.000513	0.015442

4. For Pyramid servings of fruits and vegetables, estimation of b₀ and b₁, the model is:

   E (Dietary Factor^1/2) = b₀ + b₁ (N_FG1P₁ + N_FG2P₂ + ... + N_FG9P₉)^1/2

   For Pyramid servings of fruits and vegetables, including and excluding French fries, for each gender, the estimates of the parameters are:

   Table 7a. Estimated Regression Coefficients for Sum of Foods Predicting Servings of Total Fruits and Vegetables and Fruits and Vegetables Excluding French Fries, by Gender

   Parameter	Men	Women
   Summary Variable with French fries
   Intercept (b0)	0.704319	0.658819
   b1	0.835532	0.796243
   Summary Variable excluding French fries
   Intercept (b0)	0.729653	0.639540
   b1	0.822694	0.804796

5. For cups of fruits and vegetables (2005 MyPyramid definition), including and excluding French fries, for each gender, the estimates of the parameters are:

   Table 7b. Estimated Regression Coefficients for Sum of Foods Predicting Cups of Total Fruits and Vegetables and Fruits and Vegetables Excluding French Fries, by Gender

   Parameter	Men	Women
   Summary Variable with French fries
   Intercept (b0)	0.529258	0.502480
   b1	0.839721	0.792683
   Summary Variable excluding French fries
   Intercept (b0)	0.559458	0.495205
   b1	0.819797	0.794978

6. For Pyramid servings of dairy, estimation of b₀ and b₁, the model is:

   E (Dietary Factor^1/2) = b₀ + b₁ (N_FG1P₁ + N_FG2P₂)^1/2

   For Pyramid servings of dairy, for each gender, the estimates of the parameters are:

   Table 8. Estimated Regression Coefficients for Sum of Foods Predicting Servings of Dairy, by Gender

   Parameter	Men	Women
   Intercept (b0)	0.417414	0.385301
   b1	0.831739	0.782852

7. For Pyramid teaspoons of added sugar, estimation of b₀ and b₁, the model is:

   E (Dietary Factor^1/3) = b₀ + b₁ (N_FG1P₁ + N_FG2P₂ + ... + N_FG4P₄)^1/3

   For Pyramid teaspoons of added sugar, for each gender, the estimates of the parameters are:

   Table 9. Estimated Regression Coefficients for Sum of Foods Predicting Teaspoons of Added Sugar, by Gender

   Parameter	Men	Women
   Intercept (b0)	1.672746	1.591494
   b1	0.534485	0.491231

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   * Using 1992 Food Guide Pyramid definitions of servings.

   ** Using 2005 MyPyramid definitions of cups of fruits and vegetables.