{"doi":"10.3389/fnut.2024.1398450","title":"Simulation model to assess the validity of the clinical portfolio diet score used in the PortfolioDiet.app for dietary self-tracking: a secondary analysis of a randomized controlled trial in hyperlipidemic adults","abstract":"Introduction The Portfolio Diet combines cholesterol-lowering plant foods for the management of cardiovascular disease risk. However, the translation of this dietary approach into clinical practice necessitates a user-friendly method for patients to autonomously monitor their adherence. Objective This study aimed to develop and validate the clinical-Portfolio Diet Score (c-PDS) as a food-based metric to facilitate self-tracking of the Portfolio Diet. Methods Using a simulation model to estimate the c-PDS, the validity was assessed in a secondary analysis of a completed trial of the Portfolio Diet in 98 participants with hyperlipidemia over 6 months. Concurrent and predictive validity of the estimated c-PDS were assessed against the reference measure (weighed 7-day diet records) and concomitant changes in LDL-C from baseline to 6 months. Bland–Altman analysis was used to assess the limits of agreement between the two methods. Results The c-PDS was positively correlated with dietary adherence as measured using the 7-day diet records ( r = 0.94, p < 0.001). The c-PDS was negatively correlated with change in LDL-C ( r = −0.43, p < 0.001) with a 1-point increase in the c-PDS being associated with a − 0.04 mmol/L (CI:−0.06,−0.03; p < 0.001) or a 1.09% reduction in LDL-C. Visual evaluation of the Bland–Altman plots showed reasonable agreement. Conclusion These findings indicate good validity of the c-PDS for primary prevention in adults with hyperlipidemia. The predictive validity findings have informed the goals and messaging within the PortfolioDiet.app, a digital health application for delivering the Portfolio Diet. Future research will assess the effectiveness of the intended combination of the c-PDS and the PortfolioDiet.app in supporting behavior change.","journal":"Frontiers in Nutrition","year":2024,"id":456304,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9428,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":856232,"name":"Andrea J. Glenn","orcid":"0000-0002-9302-2676","position":1,"is_corresponding":false},{"id":846545,"name":"Laura Chiavaroli","orcid":"0000-0002-8900-6366","position":2,"is_corresponding":false},{"id":1281186,"name":"Gloria A. Morgan","orcid":null,"position":3,"is_corresponding":false},{"id":1280720,"name":"Robert G. Josse","orcid":"0000-0001-5447-6264","position":4,"is_corresponding":false},{"id":509838,"name":"Vasanti Malik","orcid":"0000-0002-9453-4796","position":5,"is_corresponding":false},{"id":1280721,"name":"Christopher P. F. Marinangeli","orcid":"0000-0002-0881-9921","position":6,"is_corresponding":false},{"id":857155,"name":"Cyril W.C. Kendall","orcid":null,"position":7,"is_corresponding":false},{"id":860759,"name":"David J.A. Jenkins","orcid":"0000-0003-1192-9571","position":8,"is_corresponding":false},{"id":846548,"name":"John L. Sievenpiper","orcid":"0000-0002-3270-5772","position":9,"is_corresponding":false},{"id":1280719,"name":"Meaghan E Kavanagh","orcid":"0000-0002-8708-4467","position":0,"is_corresponding":true}],"reference_count":54,"raw_metadata":null,"created_at":"2026-07-19T02:03:27.785212Z","pmid":"39171108","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}