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Review
. 2021 Dec 1;12(6):2435-2494.
doi: 10.1093/advances/nmab053.

Methodological Aspects of Diet Quality Indicators in Childhood: A Mapping Review

Ángela Hernández-Ruiz  1 , Liza Alejandra Díaz-Jereda  2 , Casandra Madrigal  1   3 , María José Soto-Méndez  1 , Anneleen Kuijsten  2 , Ángel Gil  1   4   5   6   7
Affiliations
Review

Methodological Aspects of Diet Quality Indicators in Childhood: A Mapping Review

Ángela Hernández-Ruiz et al. Adv Nutr. .

Abstract

Diet quality indicators (DQIns) are tools that aim to assess an individual's overall diet quality. Previous reviews focused mainly on health-related outcomes but did not provide detailed information about components, assessment variables, or important methodological issues for the development and application of DQIns in the pediatric age. The current mapping review aims to provide comprehensive guidance regarding DQIns developed through a priori methodology in children aged ≤14 y that have been applied worldwide. A mapping review was conducted, whereby 1665 original articles describing the development, modifications, and updates of DQIns, published up to June 26, 2020, in English and Spanish, were retrieved. A total of 139 articles were identified and classified into 13 subgroups. There were 10 overall DQIns: Healthy Eating Indexes (n = 25), Dietary Diversity Scores (n = 20), Diet Quality Indexes (n = 16), Food Variety Scores (n = 11), Healthy and Unhealthy Scores (n = 11), Feeding and Eating Indexes (n = 10), Diet Quality Scores (n = 5), Nutritional Adequacy and Micronutrients Indexes (n = 5), Dietary Guidelines Indexes (n = 5), and Other Healthy Diet Indexes (n = 13). Three additional subgroups of dietary and lifestyle indicators found were Mediterranean Diet Indexes (n = 10), Diet-Lifestyle Indexes (n = 5), and Breakfast Quality Indexes (n = 3). This compilation of DQIns will help researchers select the most appropriate tool for future epidemiological studies by considering a careful selection of information about the assessment components, scoring methods, and key methodological issues. The main limitations of this review are that, due to its nature, a risk-of-bias assessment was not performed and the article screening was completed in 2 databases (PubMed/MEDLINE and Scopus). More research is needed to identify health-related outcomes associated with DQIns in the pediatric population, using clearer and more standardized methodological criteria.

Keywords: adolescent; child; diet index; diet quality; dietary assessment; dietary indicators; index specification; mapping review; methodological criteria; pediatrics.

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Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram for the selection of studies. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
FIGURE 2
FIGURE 2
Proposed classification of the indicator approaches for assessing diet quality indicators in children and adolescents.
FIGURE 3
FIGURE 3
Synthesis of the main issues analyzed in terms of components and scoring methods.
FIGURE 4
FIGURE 4
Overall distribution of diet quality indicators and other dietary and lifestyle indicators according to covered ages. Dark and light gray bars show the ages covered in each publication. PL, population level.
FIGURE 4
FIGURE 4
Overall distribution of diet quality indicators and other dietary and lifestyle indicators according to covered ages. Dark and light gray bars show the ages covered in each publication. PL, population level.
FIGURE 4
FIGURE 4
Overall distribution of diet quality indicators and other dietary and lifestyle indicators according to covered ages. Dark and light gray bars show the ages covered in each publication. PL, population level.
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