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Table 2 Description and purpose of diet quality indices which have been designed for use or used in paediatric populations presented alphabetically by country (n = 128 indices)

From: Diet quality indices and their associations with health-related outcomes in children and adolescents: an updated systematic review

Index & original author

Type of index

Country of origin

Dietary assessment method

Purpose

Scoring

Age group designed for

Validateda

Menzies remote short-item dietary assessment tool (MRSDAT) [derives DGI-CA score]; Tonkin et al. (2018) [28]

Food

Australia (Remote Aboriginal Communities)

1) 24-h recalls

Reflects adherence to Australian Dietary Guidelines [29] and traditional food consumption

8 components, (6 food groups + breast feeding & consumption of traditional foods). Scoring not described

Young children (6-36 m)

Yes

Menzies remote short-item dietary assessment tool (MRSDAT) [derives DGI-CA score]; Rohit et al. (2018) [30]

Young children (2-4y)

Yes

Dietary Risk Score (DRS); Bell et al. (2014) [31]

Food

Australia

1) TDQb

Adherence of Toddlers dietary patterns to the Australian Dietary Guidelines [29]

3 components, scored 0–336 (then converted to 0–100), calculated proportionally on intake/ recommendation

Young children (12-36 m)

Yes

Australian Recommended Food Score for Preschoolers (ARFS-P); Burrows et al. (2014) [19]

Food & nutrient

Australia

1) FFQ - Australian Eating Survey Pre-schooler Version (AES-P)

Reflects dietary variety within recommended food groups from the Australian Dietary Guidelines [29]

8 components, scored 0–73, points awarded & summed

Young children (2-5y)

Yes

Healthy Preference Index (HPI); Russell et al. (2007) [32]

Food

Australia

1) Food preferences & appetite traits questionnaire

Reflects food preferences & adherence to the Australian Guide to Healthy Eating for children & adolescents [29]

10 components, scored 1–100, points awarded & summed.

2–5

No

Australian Child & Adolescent Recommended Food Score (ACARFS); Marshall et al. (2012) [33]

Food

Australia

1) FFQ

Reflects adherence to the 2003 Australian Dietary Guidelines for Children & Adolescents [29]

8 components, scored 0–73, points awarded & summed

6-14y

No

Unnamed healthy dietary score; Gasser et al. (2017) [34]

Food

Australia

1) 24-h recall

Reflect adherence to the 2013 Australian Dietary Guidelines [29]

7 components, scored 0–14, points awarded & summed

Not specified

No

Dietary Guideline Index for Children & Adolescents (DGI-CA); Golley et al. (2011) [35]

Food

Australia

1) 24 h recall

Reflects adherence to the 2003 Australian Dietary Guidelines for Children & Adolescents & 1998 Australian Guide to Healthy Eating [29]

11 components, scored 0–100, calculation by nutrient analysis.

Not specified

Yes

Dietary Guideline Index (DGI); Lioret et al. (2014) [36]

Food & nutrient

Australia

1) FFQ

Reflecting adherence to the 2003 Australian Dietary Guidelines for Children and Adolescents [29]

10 components, scored 0–10, points awarded and summed for a total score of 0–100.

Not specified

No

Healthy and Unhealthy Diet score, Jacka et al. (2010) [37]

Food

Australia

1) 14-item dietary questionnaire

Adherence to Dietary Guidelines for Children and Adolescents in Australia [29]

Healthy diet core: 4 components, scored 0–4, points awarded and summed. Unhealthy diet score: 4 components, scored 5–30, points awarded and summed

Not specified

No

Raine Eating Assessment in Toddlers (EAT) score; Meyerkort et al. (2012) [38]

Food & nutrient

Australia

1) 24-h recalls

2) FFQ

Reflects adherence to the Dietary Guidelines for Children and Adolescents in Australia [29]

7 components (5 healthy, 2 unhealthy), scored 0–70 points awarded & summed

Not specified

No

The Diet Score; Nyaradi et al. (2015) [39]

Food & nutrient

Australia

1) Modified 24-h dietary recall

Reflects adherence to the Dietary Guidelines for Children and Adolescents in Australia [29]

7 components (healthy and unhealthy), scored 0–70, points awarded & summed

Not specified

No

Unnamed Diet Quality Index; Li et al. (2012) [40]

Food & nutrient

Australia

1) FFQ

Reflects adherence to the Australian Guide to Healthy Eating [29] and Nutrient Reference Values for Australia & NZ [41]

15 components, scored 20–150, calculated by nutrient analysis & servings.

Not specified

No

Core Food Variety Score (CFVS); Scott et al. (2012) [42]

Food

Australia

1) 24 h recall

Reflects adherence to the Australian Guide to Healthy Eating [29]

6 food groups, scored 0–34, points awarded & summed

Not specified

No

Fruit and Vegetable Variety Score (FVVS); Scott et al. (2012) [42]

Food

Australia

1) 24 h recall

Reflects adherence to the Australian Guide to Healthy Eating [29]

6 food groups, scored 0–16, points awarded & summed

Not specified

No

Obesity Protective Dietary Index (OPDI); Spence et al. (2013) [43]

Food

Australia

1) 24 h recall

Reflects adherence to a non-obesogenic diet (with non-core food groups) based on dietary guidelines for Americans [44]

3 food groups, scored 0–30, based on quantile ranking & summed

Not specified

Yes

Short Food Frequency Questionnaire Diet Quality Index (sFFQ-DQI); Kunaratnam et al. (2018) [45]

Food & nutrient

Australia

1) short food frequency questionnaire (sFFQ)

2) 3-day food records (3d-FR)

Reflects adherence to the 2013 Australian dietary guidelines for children and adolescents [29]

13 components, scored 0–5, points awarded and summed, for a total score of 0–65.

2-5y

Yes

Diet Quality Index for Preschool Children (DQI-CH); (Huybrechts et al. (2010) [46]

Food & behaviour

Belgium

1) Food diary/record

2) FFQ

Reflects compliance with Flemish Food-Based Dietary Guidelines [47]

4 components, scored −25 - 100 calculated as percentage of food group intakes

2 – 6y

Yes

Daily Diversity Index (DDI); Sabbe et al. (2008) [48]

Food

Belgium

1) FFQ

Reflects adherence to the 2000 American Food Guide Pyramid [49]

5 components, scored 0–5, points awarded & summed

Not specified

No

Healthy Eating Index for Brazilians (HEI); Rauber et al. (2014) [50]

Food & nutrients

Brazil

1) 24-h dietary recall

Reflects adherence to US Department of Agriculture dietary guidelines [44] with some modifications to meet recommendations of the Brazilian dietary guidelines [51]

10 components, scored 0–100, calculated based on adherence to dietary guidelines, points awarded & summed

Children (3-8y)

Yes

Índice de Alimentação do Escolar (ALES – School Child Diet Index); Molina et al. (2010) [52]

Food

Brazil

1) FFQ

Reflects adherence to recommended national dietary guidelines [51]

15 components, scored −1, 0 or 1, points awarded and summed for a total score of −9-14.

Not specified

No

Adapted Healthy Eating Index (adHEI) Conceicao et al. (2018) [53]

Food & nutrient

Brazil

1) 24-h dietary recall

Reflects adherence to dietary guidelines for Brazilian children [51]

10 components, scored 0–10, points awarded and summed.

Not specified

No

Brazilian Healthy Eating Index (BHEI) [Índice de Qualidade da dieta (IQD)], Fisberg et al. (2004) [54]

Food and nutrients

Brazil

1) 24-h dietary recall

Adherence to The Adapted Food Pyramid for Brazilians [55]

10 components, scored 0–10, points awarded & summed for a total score of 0–100

Not specified

Yes

The Revised Brazilian Healthy Eating Index (BHEI-R), Previdelli et al. (2011) [56]

Food and nutrients

Brazil

1) 24-h dietary recall

Reflects adherence to the Brazilian dietary guidelines [51] recommendations and the measurement of dietary risk factors for chronic diseases

12 components, scored 0–5, 0–10 or 0–20 for the % of total energy value, with all components summed

Not specified

No

Brazilian food habits (BHEI-R); Rodrigues et al. (2016) [57]

Food & nutrients

Brazil

1) FFQ

2) 24-h recalls

Reflects adherence to the Brazilian dietary guideline’s recommendations [51]

12 components, scored 0–5, 0–10 or 0–20, point awarded and summed.

Not specified

No

The Diet Quality Index associated with the Digital Food Guide (DQI-DFG) or “Índice de Qualidade da Dieta associado ao Guia Alimentar Developed by Caivano et al. (2013) [58] in adults, Baldasso et al. (2016) [59] used in adolescents. Digital” (IQD-GAD)

Food & nutrients

Brazil

1) 24-h recall

2) Food records

Reflects adherence to US healthy eating guidelines, dietary reference intakes and food pyramid [44]

12 components, 1–4 based on moderation, 5–12 based on adequacy, scored 0–100, points awarded and summed.

Not specified

No, Validated in adults (Caivano et al. 2013)

Revised Diet Quality Index (IQD-R); Wendpap et al. (2014) [60]

Food & nutrients

Brazil

1) FFQ

Reflects adherence to recommendations of the 2006 Food Guide for the Brazilian Population [51]

11 components, scored 0–100, calculated by nutrient analysis & servings

Not specified

No

Canadian Healthy Eating Index (HEI-C-2010); Jessri et al. (2017) [61] developed in adults, Nshimyumukiza et al. (2018) [62] used among children

Food & nutrient

Canada

1) 24-h recalls

Reflects adherence of adequacy and moderation to the 2007 Canada’s Food Guide [63]

11 components, scored 0–100, calculated by nutrient analysis & servings

≥ 2y

No, Validated In adults (Jessri et al. 2017)

Canadian Healthy Eating Index (HEI-C); Glanville et al. (2006) [64]

Food & nutrient

Canada

1) 24 h recall 2) FFQ

Reflects adherence to the 1993 Canada’s Good Guide to Healthy Eating & 1990 Canadian Nutrient Recommendations [65]

9 components, scored 0–100, calculated by nutrient analysis & servings.

≥3y

No

Canadian Health Eating Index-2009 (HEIC-2009); Woodruff et al. (2010) [66]

Food & nutrient

Canada

1) 24-h recall 2) FFQ

Reflects adherence to the 2007 Eating Well with Canada’s Food Guide [63]

9 components, scored 0–100, calculated by nutrient analysis & servings

≥3y

No

Canadian Healthy Eating Index (HEI-C); Wang et al. (2015) [67]

Food & nutrient

Canada

1) 24-h recalls

Reflects adherence to the 2007 Eating Well with Canada’s Food Guide [63]

9 components, scored 0–100, calculated by nutrient analysis & servings

9-13y

No

School Heathy Eating Index (School-HEI), Tugault-Lafleur et al. (2017) [68]

Food & nutrient

Canada

1) computer-assisted 24-h dietary recall

Dietary compliance with Canadian dietary guidance from the 2007 version of Canada’s Food Guide [63]

2 subsections; scored 0–100, Adequacy: 8 components, scored 0–60. Moderation; 3 components scored 0–40, points awarded & summed

Not specified

No

Unnamed diet quality index; Absolon et al. (1988) [69]

Food & nutrient

Canada

1) 24-h dietary recall

Adherence to Canada’s Food Guide and Recommended Nutrient Intakes for Canadians [63]

5 components, scored 0–8, points awarded & summed

Not specified

No

Adapted Youth Healthy Eating Index (aYHEI); Protudjer et al. (2012) [70]

Food & nutrient

Canada

1) FFQ

Assesses dietary adherence to the United States’ Department of Agriculture’s Dietary Guidelines for Americans [44]

10 components, scored 0–85, point awarded & summed

Not specified

No

Chinese Healthy Eating Index (CHEI); Yuan et al. (2017) [71]

Food & nutrient

China

1) 24-h recalls

Reflects adherence to the updated Dietary Guidelines for Chinese (DGC-2016) [72]

17 components, scored 0–100, calculated by nutrient analysis & servings

≥2y

No, Validated among adults, Yuan et al. (2018)

The Chinese Children Dietary Index (CCDI); Cheng et al. (2016) [73]

Food, nutrient & behaviour

China

1) 24-h recalls

Reflects adherence to Chinese Dietary Guidelines and Dietary Reference Intakes [72]

16 components, scored 0–160, calculated based on intake/ recommendations points awarded & summed

Not specified

Yes

Healthy nutrition score based on food intake for pre-schoolers (HNSP), Peng et al. (2015) [74]

Food & nutrient

China

1) 24-h recalls

2) 3-day food records

Adherence to Chinese Dietary Guidelines [72] for preschool children to detect vitamin A deficiencies

10 components, scored 0–100, points awarded and summed

Not specified

Yes

Foods E-KINDEX; Lazarou et al. (2009) [75]

Food & behaviour

Cyprus

1) FFQ

Reflects risk of being overweight or obese based on adherence to the Mediterranean dietary pattern [76]

13 components, scored 0–37, unspecified scoring method

Not specified

No, (previously validated in children)

Adapted diet quality index; Knudsen et al. (2012) [77] developed in adults, Rohde et al. (2016) [78] used in children

Food

Denmark

1) 4-d diet record

Compliance of children’s diet with the Danish national guidelines [79]

6 components, scored 0–6, calculated as a ratio of reported intake to recommended intake.

Not specified

No

Complementary Feeding Utility Index (CFUI); Golley et al. (2012) [80]

Food & behaviour

England

1) FFQ &

2) independent questionnaire

Reflects adherence to complementary feeding guidelines in Australia [81], NZ [82] USA [83] and UK [84]

14 components, scored 0–1, calculated by summing of probability functions

Not specified

No

Unnamed Diet Quality Score (DQI); Okubo et al. (2015) [85]

Food & nutrient

England

1) FFQ

Describe compliance with the Japanese Spinning Top Guide [86]

Calculated using reported intake & recommendations results split into tertiles, scored 0–8.

Not specified

No

NutricheQ Tool, Rice et al. (2015) [87]

Food

European countriese

1) Food diary/record

Based on suggestions from family paediatricians, the user-requirements of European nutrition experts, and evidence from the literature [87]

3 components, each of the 18 questions has a minimum of 0 and maximum of 3 points, points awarded & summed

Young children (≥12 m)

Yes

The Diet Quality Index for Adolescents (DQI-A); Vyncke et al. (2013) [88]

Food

European countriesh

1) 24-h recalls

Reflects adherence to Adolescent Flemish food based dietary guidelines [47]

3 components, dietary diversity, quality and equilibrium calculated.

Adolescents (12.5–17.5y)

Yes

Healthy Diet Indicator (HDI); Huijbregts et al. (1997) [89]

Food & nutrient

European countiesc

1) Diet history

2) food diary/record

Reflects WHO guidelines to prevent chronic disease [90]

9 components, scored 0–9, points awarded & summed

Not specified

No

Healthy Dietary Adherence Score (HDAS); Arvidsson et al. (2017) [91]

Food

European countriesd

1) FFQ

Reflect adherence to healthy dietary guidelines common for all eight countries participating in the IDEFICS study [92]

5 components, scored 0–10, points awarded & summed

Not specified

No

The Healthy Plate Variety Score (HPVS), Oliveira et al. (2015) [93].

Also referred to Healthy Food Variety Index (HFVI) by Jones et al. (2015) [94]

Food

European countriesf

1) FFQ

Reflects adherence to the US Health Eating Guidelines recommendations and variety [44]

5 components, scored 0–1, points calculated and summed.

Not specified

No

The Diet Quality Index for Adolescents (DQI-A), De Vriendt et al. (2012) [95]

Food

European countriesg

1) 2-day dietary recall

Reflecting dietary diversity, quality and equilibrium related to Flemish dietary guidelines [96]

Dietary Diversity:

The extent of food groups consumed, scoring not described.

Dietary Quality:

3 components, each food item scored: 1, 0, −1, points awarded, summed and divided by the number of foods consumed.

Dietary Equilibrium: Indicates adherence to portion sizes, scoring not described.

Scores were summed for overall DQI-A score from −33·3 and 100%.

Not specified.

No

Ideal Diet Score, also referred to as Healthy Diet Score, Lloyd-Jones et al. (2010) [97] developed in adults, Henriksson et al. (2017) [98] used among chidren

Food & nutrient

European countriesi

1) 24-h recalls

Adherence to American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood [99]

5 components, points awarded based on cut-off values and summed for a total score of 0–5.

Not specified

No

Children’s Index of Diet Quality (CIDQ); Röytiö et al. (2015) [100]

Food & nutrient

Finland

1) Food Consumption Questionnaire 2) 7-d food recall

Reflects adherence to Finnish nutrition recommendations, based on the Nordic nutrition recommendations [101]

14 components, calculated intake compared to recommendations, scored 0–21, points awarded & summed.

Children (2-6y)

Yes

Baltic Sea Diet Score (BSDS); Kanerva et al. (2013) [102] developed in adults, Haapala et al. (2017) [103] used in children

Food

Finland

1) 4-day food record

Assess dietary pattern reflecting the Baltic Sea Diet Pyramid [101]

8 components, calculated ratio of reported intake to recommended intake, points awarded.

Not specified

No

Finnish Children Healthy Eating Index (FCHEI); Kyttälä et al. (2014) [104]

Food & nutrient

Finland

1) 3-d food records

Reflects adherence to the Nordic dietary guidelines [101]

5 components, scored according to food groups and ages, points awarded and summed for a total score of 0–34/41/42 depending on age.

Not specified

Yes

Dietary Adequacy Score (DAS); Guthrie et al. (1981) [105]

Food

Unknown

1) 24 h recall; 2) FFQ

Reflects adequacy of (unknown) Recommended Dietary Allowances for an unknown population

4 components, scored 0–16, points awarded & summed

Not specified

No

Dietary Adequacy Score (DAS); Shatenstein et al. (1996) [106]

Gaza

1) FFQ

Reflects adequacy of Recommended American Dietary Guidelines [44]

PANDiet score; Developed by Verger et al. (2012) among ≥18y, Verger et al. (2016) [107]

Food & nutrient

UK

1) 24-h recal

Reflects adequate nutrient intake based on UK dietary guidelines [108]

2 components (adequacy and moderation) are calculated, and the mean of the two sub-scores are then calculated ranging from 0 to 100.

Infants & young children (12-18 m)

Yes

PANDiet score; Schoen et al. (2017) [109]

Food & nutrient

Germany

1) 3-d weighed food record

Reflects adherence to national reference values for nutrient intake in children based on UK dietary reference values [110].

Infants & young children (9-24 m)

No

Unnamed Dietary Quality Index (DQI), Alexy et al. (2003) [111]

Nutrient

Germany

1) Dietary survey including 3d weighed dietary record.

Reflects adherence to the Dietary Guidelines for an OMD for Children & Adolescents and comparison to reference values for nutrient intakes [112]

12 components, scored 0–12, points awarded & summed

≥2y

Yes

Healthy Nutrition Score for Kids & Youth (HuSKY); Kleiser et al. (2009) [113]

Food

Germany

1) FFQ

Reflects adherence to the Dietary Guidelines for an OMD for Children & Adolescents [112]

11 components, scored 0–100, calculated as ratio of food group intakes

3–17y

No

Recommended Food Group Change Score (RFS); Alexy et al. (1999) [114]

Food

Germany

1) Food diary/ record

Reflects average change in amounts of deviation from the OMD food groups based on individualised recommendations [112]

Number of components change depending on individualised recommendations, scored as a negative or positive percentage of change, servings summed

Not specified

No

Total Food Group Change Score (TFS); Alexy et al. (1999) [114]

Food

Germany

1) Food diary/ record

Reflects average change in amounts of deviation from all OMD food groups [112]

11 components, scored as a negative or positive percentage of change, servings summed

Not specified

No

Nutrient Improvement Score (NIS); Alexy et al. (1999) [114]

Nutrient

Germany

1) Food diary/ record

Reflects average change in dietary intake of German reference values for nutrient intakes [112]

16 components, scored as a ‘-‘or ‘+’ percentage of change, scored by nutrient analysis

Not specified

No

Nutrition Quality Index (NQI) Gedrich et al. (2001) [115]

Nutrient

Germany

1) Food diary/ record

Reflects adequacy as compared the 2002 German, Austrian & Swiss Dietary Reference Values [116]

13–17 components, scored 0–100, calculated by nutrient analysis

Not specified

No, Validated in adults

Nutrition Quality Index (NQI), Cheng et al. (2010) [117]

Nutrient

Germany

1) 3-d weighed food diary/record

Reflects the extent to which a child meets the nutritional recommendation for particular nutrients [118], and indicated diet quality compared to dietary reference values from the German and Austrian Nutrition Society [119].

Components scored 0–100, calculated by nutrient analysis.

Not specified

No

Diet Quality Score; Kohlboeck et al. (2012) [120]

Food

Germany

1) FFQ

Reflects adherence to the OMD food groups based [112]

11 components, scored 0–11, points awarded & summed

Not specified

No

The Preschoolers Diet–Lifestyle Index (PDL-index); Manios et al. (2010a) [121]

Food & behaviour

Greece

1) 24-h dietary recalls

2) Weighed food records) Or Food diaries

Reflects adherence to American Food Guide Pyramid [49]& Canadian Food Guide [65]

11 components, scored 0–44, points awarded & summed

2-5y

Yes

Food Index (FI); Magriplis et al. (2015) [122]

Food

Greece

1) FFQ

Reflects adherence to food recommendations-dietary guidelines (USDA data [123] and the Mediterranean Food Pyramid guidelines [76]).

2 sections: 6 obesogenic and 8 non-obesogenic components. 14 components scored 16–64, calculated with a weighting of 1 or 1.5 for non-obesogenic foods

9-13y

Yes

Unhealthy Food Choices Score (UFCS); Yannakoulia et al. (2004) [124]

Food

Greece

1) FFQ

Reflects adherence to a number of Greek [125]& US Dietary Guidelines [126]

9 categories, scored 9–45, negative & positive points awarded & summed

11–15y

No

Mediterranean Diet Score (MDS); Trichopoulou et al. 1995 [127]

Food & nutrient

Greece

1) FFQ,

2) food diary/record

Reflects adherence to the Mediterranean dietary pattern [76]

8 components, scored 0–8, points awarded & summed

Not specified

No

E-KINDEX; Lazarou et al. (2008) [128]

Food & behaviour

Greece

Unclear

Reflects risk of being overweight or obese from the CYKIDS study [129]

Composed of 3 indices with a total of 30 components, scored 1–87

Not specified

No

Healthy Lifestyle–Diet Index (HLD-Index); Manios et al. (2010b) [130]

Food

Greece

1) 24-h dietary recalls

Adherence to guidelines reflecting Mediterranean dietary patterns [131] and US Department of Agriculture (USDA)‘s My Pyramid [49]

10 components, each scored 0–4, points awarded and summed with a total score of 0–40.

Not specified

Yes

Revised Healthy Lifestyle Index (R-HLD-Index); Manios et al. (2015) [132]

Food

Greece

1) 24-h dietary recalls

Adherence to the updated dietary recommendations for children proposed by the USDA’s ‘Choose My Plate’ [133]

12 components, each scored 0–4, points awarded and summed with a total score of 0–40.

Not specified

No

USAID Dietary Diversity Score (DDS); Enneman et al. (2009) [134]

Food

Guatemala

1) 24 h recall

Indicates diet diversity, quality and quantity of complementary foods based on a publication of USAID (US Agency for International Development) [135] and Guatemalan dietary guide [136]

8 components, scored 0–8, servings summed

Not specified

No

Cooking Pot Dietary Diversity Score (DDS); Enneman et al. (2009) [134]

Food

Guatemala

1) 24 h recall

Indicates diet diversity in adherence with the Guatemalan dietary guide translated [136]

6 components, scored 0–6, servings summed

Not specified

No

INCAP Papers Dietary Diversity Score (DDS); Enneman et al. (2009) [134]

Food

Guatemala

1) 24 h recall

Indicates diet diversity in adherence with INCAP protocol [137]

25 components, scored 0–25, servings summed

Not specified

No

Adolescent Micronutrient Quality Index (AMQI); Chiplonkar et al. (2010) [138]

Food

India

1) 24 h recall

Reflects adherence to the 2005 Dietary Guidelines for Indians [139] & the 2005 Dietary Guidelines for Americans [140]

13 components, scored 0–100, points awarded & summed, unspecified scoring method

Not specified

No

Expected Food Pattern (PPH) also called Desirable Dietary Pattern (DDP) score; Prasetyo et al. (2013) [141]

Food & nutrient

Indonesia

1) 24-h recall

Dietary quality indicator Reflects adequacy and diversity of diet compared to Indonesian recommendations [142]

9 components, scored 1–30. Calculated from reported intake compared to recommendations, points awarded & summed

Not specified

No

Dietary Approaches to Stop Hypertension (DASH)-style diet score; Fung et al. (2008) [143] developed in women; Asghari et al. (2016) [144] used in children

Food and nutrients

Iran

1) FFQ

Reflects foods and nutrients emphasized or minimised in DASH dietary pattern [145]

8 components, scored 8–40, points awarded and summed.

Not specified

No

Nutrient Adequacy Ratio (NARs), Rouhani et al. (2012) [146]

Nutrient

Iran

1) FFQ

Reflects adherence to dietary recommended intake [147]

10 components, divide daily reported intake by recommended intake (DRI) for each nutrient.

Not specified

No

Mean Adequacy Ratio (MAR), Azadbakht (2014) [148]

Nutrient

Iran

1) FFQ

Reflects adherence to dietary reference intake [147]

Calculated as the ratio of the sum of NAR to the number of nutrients (n 10)

Not specified

No

Modified Healthy Eating Index ‘mHEI’, Hooshmand et al. (2018) [149]

Food & nutrient

Iran

1) FFQ

Reflects the USDA food guide pyramid and dietary guideline [150]

10 components, scored 0–10, points awarded and summed.

Not specified

No

Modified revised children’s diet quality index (M-RCDQI), Keshani et al. (2018) [151]

Food & nutrient

Iran

1) FFQ

Based on two previous studies [73, 152] Reflects adherence to the 2005 Dietary Guidelines for Americans [140] and recommendations adjusted to better reflect the Iranian dietary patterns.

13 components, scored 0–90, points awarded & summed

Not Specified

No

Dietary Guidelines for Americans Adherence Index (DGAI); Fogli-Cawley et al. (2006) [153] developed in adults, Mohseni-Takalloo et al. (2016) [154] used in adolescents.

Food

Iran

1) FFQ

Reflects adherence to the Dietary Guidelines for Americans [140]

20 components, scored 0–20, calculated reported intake/ recommended intake, points awarded and summed.

Not specified.

No

Un-weighted Diet Quality Score (DQS), Perry et al. (2015) [155]

Food & nutrient

Ireland

1) FFQ

2) 24-h recall

Reflects adherence to Irish guidelines and guided by Food Safety Authority of Ireland recommendations [156]

20 components, ‘healthy’ [157] & ‘unhealthy’ [6] components scored −5-25, points awarded & summed

Not Specified

No

Mediterranean diet quality index (M-DQI); Gerber (2006) [158] developed in adults; Tarabusi et al., (2010) [159] Used in children

Food and nutrient

Italy

1) 24-h dietary recall 2) FFQ

Reflects adherence to Dietary recommendations from the 1989 National Academy of Sciences publication [160], adherence to the 1989 Recommended Dietary Allowances [161] with Mediterranean diet adaptions of adolescent’s diets to the Mediterranean diet [162].

7 components, scored 0–14, calculated as a percentage of adherence to the Mediterranean diet, points awarded and summed.

Not specified

No, (validated among adults Gerber, 2016)

Food-based diet quality score; Nishimura et al. (2015) [163] developed in adults; Kuriyama et al. (2016) [164], developed modified score in adolescent/adult;

Food

Japan

1) diet history questionnaire (DHQ)

Assessed the adherence to the food-based Japanese dietary guidelines [86]

6 components, scored 0–10, the score was calculated proportionately between 0 and 10 and summed

18y & adults

No

Korean Dietary Action Guides for Children Adherence Index (KDAGCAI); Choi et al. (2013) [165]

Food & behaviour

Korea

1) FFQ

Reflects adherence to the Korean Dietary Action Guides for Children [166]

19 components, scored 1–5, scores averaged for a total score of 1–5.

Children (3-12y)

No

Dietary Diversity Score (DDS8) & Dietary Diversity Score (DDS8-R); Moursi et al. (2008) [167]

Food

Madagascar

1) 24 h recall

Relation of diet diversity [168] to micronutrient density based on recommended nutrient intakes from FAO/WHO recommendations [169]except for calcium [170]and zinc [171]

8 components, scored 0–8, points awarded & summed

Infants (6-23 m)

No

Dietary Diversity Score (DDS7) & Dietary Diversity Score (DDS7-R); Moursi et al. (2008) [167]

7 components, scored 0–7, points awarded & summed (fats and oils excluded)

Unnamed Diet quality index for muti-ethnic Asian toddlers, Chen et al. (2018) [172]

Food

Malaysia

1) FFQ

Reflects adherence to the Singapore Dietary Guidelines for toddlers [173]

7 components, scored 0–65, calculated as a ratio of reported intake/ recommended intake, points awarded & summed

Toddlers (1-2y)

Yes

Healthy Eating Index for Malaysians; Lee et al., (2011) [174] developed in adults, Rezali et al. (2015) [175] used in adolescents

Food and nutrient

Malaysia

1) 2-day Dietary Recall

Assessed degree of compliance with recommended Malaysian Dietary Guidelines for Children and Adolescents [176]

9 components, scored 0–10, points awarded and summed and a composite score in percentage was calculated.

Not specified

Yes

Diet quality score for preschool children; Voortman et al. (2016) [177] developed for preschool children, van der Velde et al. (2018) [178] used in school-aged children

Food & nutrient

Netherlands

1) FFQ

Adherence to the dietary recommendations for children from the Dutch Guidelines for a Healthy Diet of 2015 [179]

10 components, scored 0–10, calculated the ratio of reported & recommended intake, ratios summed.

8y

Yes

Diet Quality Score for Preschool Children; Voortman et al. (2015) [177]

Food & nutrient

Netherlands

1) FFQ

Reflects adherence to national and internationalj guidelines: The Netherlands [180], Germany [181], Switzerland [182] Belgium [183], Northern Ireland [184] and US [185]. Scientific literature on foods that were not consistently reported int these guidelines were also considered (e.g. sugar sweetened beverages, fish and whole milk) [186,187,188]

10 components, scored 0–10, points awarded and summed

Not specified

Yes

Dietary Index for a Child’s Eating (DICE), Delshad et al. (2018) [189]

Nutrient

New Zealand

1) 4-d estimated food record

Reflects adherence to the recommended NZ Food and Nutrition guidelines [190] and meeting nutrient reference values for Australia and New Zealand [191]

13 components, scored 0–100, points awarded & summed

Children (2-18y)

Yes

Diet Quality Index for NZ adolescents (NZDQI-A); Wong et al. (2013) [192]

Food & Nutrient

New Zealand

1) Food questionnaire 2) 4-day food record

Reflecting adherence of adequacy and variety to the New Zealand Food and Nutrition Guidelines for Healthy Adolescents [193].

5 components, scored 0–100, calculated from adequacy x variety, points awarded & summed

Adolescents (14-18y)

Yes

Healthy Dietary Habits Score for Adolescents (HDHS-A); Wong et al. (2014) [194]

Food & Nutrient

New Zealand

1) 24-h recalls

2) DHQ

Reflecting adherence for NZ Food and Nutrition Guidelines for Healthy Children and Young People [190].

5 components, scored 0–68, points awarded & summed

Adolescents (15-18y)

Yes

Norwegian Adolescent Diet Score; Handeland et al. (2016) [195]

Food & behaviour

Norway

1) FFQ

Reflects adherence to Norwegian dietary recommendations [196]

8 components, scored 0–8, (7 food, 1 physical activity) scored 0 or 1 calculated from cut off values, points summed

Adolescents (14-15y)

Yes

Dietary Diversity Score (DDS); Kennedy et al. (2007) [197]

Food

Philippines

1) 24 h recall, 2) FFQ

Indicates diet diversity in adherence with development & analysis guidelines for developing countries (Arimond et al., 2005; Kennedy & Nantel 2006)

10 components, scored 1–9, servings summed

Not specified

No

Healthy Eating index (HEI); Vilela et al. (2014) [198]

Food & nutrient

Portugal

1) FFQ

Reflects adherence to the WHO food and nutrition policy [199]

7 components, scored 7–28, quartiles calculated for each and scored/reverse scored.

Young children (2y & 4-5y)

No

Diet Quality Index Score (DQIS); Rios et al. (2016) [200]

Food

Puerto Rico

1) FFQ

Reflects adherence to age-specific dietary guidelines by WIC [201], WHO [202] and the American Academy of Paediatrics [203]. (0-24 m not included in national dietary guidelines)

9 components, score 0–55, calculated from adequacy of intake, point awarded & summed.

Infants and toddlers. (0-24 m)

Yes

Diet Quality Score; Crombie et al. (2009) [204]

Food

Scotland

Unclear

Reflects adherence to the Caroline Walker Trust recommendations for under 5y [205]

5 components, dichotomous scoring for each component summed

2-5y

No

Mediterranean dietary pattern (MDP); Trichopoulou et al. (2003) [206] developed in adults, Mariscal-Arcas et al. (2010) [207] used in children

- Also referred to as Mediterranean-diet scale

Food & nutrient

Spain

1) FFQ

2) 24-h recall

Reflects the degree of adherence to the traditional Mediterranean diet [76]

9 components, calculated from intakes and recommended intakes

Not specified

No

Mediterranean Diet Quality Index International (Med DQI-I); Mariscal-Arcas et al. (2007) [208]

Food & nutrient

Spain

1) 24 h recall & FFQ

Reflects worldwide (WHO [209], USA [150, 210] & China [211, 212] adherence to dietary food & nutrient recommendations and included use of Spanish recommended daily intakes [213] with specific Mediterranean adaptations

4 major components each with sub-components, scored 0–100, calculated by nutrient analysis

Not specified

No

Mediterranean Diet Quality Index for children & adolescents (KIDMED); Serra-Majem et al. (2004) [214]

Food & behaviour

Spain

1) 24 h recall & FFQ, 2) independent questionnaire, 3) FFQ & independent questionnaire, 4) 24 h recall

Reflects adherence to the Mediterranean Diet Model [76, 215]

16 components, scored 0–12, points awarded & summed

Not specified

No

Breakfast Quality Index (BQI); Monteagudo et al. (2012) [216]

Food & nutrient

Spain

1) FFQ

Adherence to guidelines of the US [217,218,219], China [211, 212] Mediterranean dietary patterns [76]

10 components, scored 0–10, points awarded & summed

Not specified

No

Youth Healthy Eating Index-Taiwan (YHEI-TW); Chiang et al. (2011) [220] used, not described; Lee et al. (2012) [221] used in youth.

Food & nutrient

Taiwan

1) 24-h dietary recall 2) FFQ

Reflects adherence to the Dietary Guidelines for Americans [222]

11 components, points awarded and summed for a total score of 0–90.

Not specified

No

Youth Healthy Eating Index-Taiwan Revised (YHEI-TwR-90) Chen et al. (2018) [223]

Food & nutrient

Taiwan

1) 24-h dietary recall 2) FFQ

Reflects adherence to the Dietary Guidelines for Americans [150]

10 components, scores calculated from nutrient analysis and summed, for a total score of 0–90.

Not specified

No

Youth Healthy Eating Index-Taiwan Revised (YHEI-TwR-70); Chen et al. (2018) [223]

8 components, scores calculated from nutrient analysis and summed, for a total score of 0–70.

Infant & Child Feeding Index (ICFI); Ruel et al. (2002) [224]

Food & behaviour

Designed in the USA for use in Latin America

1) 24 h recall & FFQ, 2) 24 h recall, 3) 7d recall

Reflects adequacy of the 1998 WHO [225]& the 1999 Academy of Educational Development complementary feeding recommendations [226]

5 components, scored 0–12, points awarded & summed

6–36 m

No

Healthy Eating Index (HEI); Kennedy et al. (1995) [227]

Food & nutrient

USA

1) 24 h recall & food diary/ record, 2) FFQ, 3) 24 h recall, 4) Food diary/ record

Reflects adherence to the Dietary Guidelines for Americans & the USDA Food Guide Pyramid (1992) [150]

10 components, scored 0–100, calculated by nutrient analysis

≥2y

Yes

Healthy Eating Index-2010 (HEI-2010); Guenther et al. (2013) [228]

Food & nutrient

USA

1) 24-h recalls

Reflects adherence to the 2010 Dietary Guidelines for Americans [185] and the accompanying USDA Food Patterns [229]

12 components, scored 0–100, calculated by nutrient analysis & servings & summed

≥2y

No, (Later validated by Guenther et al. 2014)

Healthy Eating Index-2005 (HEI-2005); Britten et al. (2006) [230] developed in abstract, not described, Guenther et al. (2008) [231]

Food & nutrient

USA

1) 24 h recall, 2) food diary/record

Reflects adherence to the 2005 dietary guidelines [140] MyPyramid Food Guidance System [232]

12 components, scored 0–100, calculated by nutrient analysis

2–18y

No

Children’s Diet Quality Index (C-DQI); Kranz et al. (2004) [233]

Food & nutrient

USA

1) 24 h recall

Reflects adherence to the 1998 Food Guide Pyramid for 2–6y for components relevant to public health [234]

8 components, scored 0–70, calculated by nutrient analysis & servings

2–5y

No

Revised Children’s Diet Quality Index (RC-DQI); Kranz et al. (2006) [235]

Food, nutrient & behaviour

USA

1) 24 h recall, 2) Food diary/record

Reflects adequacy of nutrients & food group intakes which are of a public health concern [140, 236, 237]

13 components, scored 0–95, calculated by nutrient analysis & servings

2–18y

No

Food Variety Index for Toddlers (VIT), Cox et al., 1997 [238]

Food & nutrient

USA

1) 24-h recalls

2) food diary/ records

Reflect dietary adequacy and adherence to food groups in the Food Pyramid [150] dietary guidelines recommendations and food groups.

5 components, ratio calculated from 0.00–1.00 for each, then a total VIT score was averaged.

24-36 m

No

Food Variety Index for children (VIC), Skinner et al., 1999 [239]

24-60 m

The Healthy Eating Preference Index (HEPI); Sharafi et al. (2015) [240]

Food & nutrient

USA

1) Preschool-Adapted Liking Survey (PALS), and healthy variety score

Reflects adherence to Dietary Guidelines for Americans 2010 [185]

Scored − 250-250, foods categorised into liking groups and healthy variety score calculated, then conceptual weights were assigned to foods and adherence to dietary guidelines assessed.

Pre-school (3-5y)

Yes

Nutrient Rich Foods index (NRF) Drewnowski et al. (2009) [241]

Food & Nutrient

USA

1) 24 h recall

Reflects adherence to Dietary Guidelines for Americans and consumption of nutrient rich foods [242]

NRFj 9.3

12 components, constructed from 9 encouraged nutrients minus 3 discouraged nutrients, calculated from percentage of reference intake

≥4y

No

Alternative Healthy Eating Index (AHEI); Chiuve et al. (2012) [243] developed in adults, Harris et al. (2016) [244] used in adolescents

Food & nutrient

USA

1) FFQ (HS-FFQ)

Reflects dietary patterns to lower risk of chronic disease [218] and US dietary Guidelines [222] based on validation of the index in previous studies [245,246,247]

9 components, scored 2.5–87.5, calculated by nutrient analysis & servings

13-18y

No

Youth Healthy Eating Index (YHEI); Feskanich et al. (2004) [248]

Food & behaviour

USA

1) FFQ

Reflects adherence to American Dietary Guidelines [249]

13 components, scored 0–100, points awarded & summed

Not specified

No

Alternative Healthy Eating Index (AHEI); McCullough et al. (2002) [245]

Food & nutrient

USA

1) FFQ

Reflects dietary patterns to lower risk of chronic disease [218] and US dietary Guidelines [219]

Indicates diet diversity in adherence with development & analysis guidelines for developing countries [216, 217]

9 components, scored 2.5–87.5, calculated by nutrient analysis & servings

Not specified

No

Diet Quality Index (DQI); Patterson et al. (1994) [250]

Food & nutrient

USA

1) 24 h recall, 2) 24 h recall & food diary/ record

Reflects adherence to the 1989 Recommended Dietary Allowances [161]

8 components, scored 0–16, points awarded & summed

Not specified

No

Diet Quality Index-International (DQI-I); Kim et al. (2003) [251] developed in adults, Setayeshgar et al. (2017) [252] used in Canadian children

Food & nutrient

Designed in USA to be of international use

1) FFQ,

2) 24 h recall & FFQ

Reflects worldwide (WHO [209], USA [150, 210] & China [211, 212] adherence to dietary food & nutrient recommendations

4 major components with sub-components, scored 0–100, calculated by nutrient analysis & servings

Not specified

No

Grain, Fruit, Vegetables, Dairy & Mild (GFVDM) Variety Score; Falciglia et al. (2009) [253]

Food

USA

1) 24 h recall

Reflects adherence to the 1992 Food Guide Pyramid food groups [150]

5 food categories, servings summed

Not specified

No

Grain, Fruit & Vegetable (GFV) Variety Score; Falciglia et al. (2009) [253]

Food

USA

1) 24 h recall

Reflects the 2000 Dietary Guidelines for variety [249]

3 food categories, servings summed

Not specified

No

Modified KIDMED (M-KM); Wang et al. (2015) [67] abstract not described, Martin-Calvo et al. (2016) [254]

Food

USA

1) FFQ (YAQ)

Adherence to Mediterranean dietary pattern (MDP) [255]

16 components, scored 1, 0 or − 1, points awarded and summed for a total score of −4 to 12.

Not specified

No

Healthy Diet Score, Anderson et al. (2015) [256]

Food

USA

1) FFQ

Assesses healthy/unhealthy components of the diet independently. Binary variables based on US dietary recommendations for pre-schoolers [257].

Healthy diet score:3 components, scored 0–6, points awarded and summed. Unhealthy diet score: Scored 0–24 points awarded & summed.

Not specified

No

Adapted Complementary Feeding Utility Index (aCFUI); Au et al. (2018) [258]

Food & behaviour

USA

1) 24-h dietary recall

Reflects adherence to complementary feeding guidelines and the USDAinfant nutrition and feeding guidelines [201]

13 components, scored 0–13, by calculating the probability functions, then summed.

Not specified

No

A Priori Diet Quality Score (APDQS);

Mursu et al. (2013) [259] developed in women, Hu et al. (2016) [260] used in adolescents

Food & nutrient

USA

1) FFQ (YAQ)

Reflects adherence to the Mediterranean dietary pattern (without alcoholic items) [255]

34 components, 13 beneficial, 12 adverse and 9 neutral, calculated as the sum of quintile scores 0–4 for beneficial foods plus scores in the reverse order (4–0) for adverse foods.

Not specified

No

Dietary Approaches to Stop Hypertension (DASH) diet score; Günther et al. (2009) [261]

Food & nutrient

USA

1) FFQ

Reflects adherence to DASH dietary pattern [145] and the dietary guidelines for Americans [140]

8 components, scored 0–80, calculated by reported intake/ recommendations, points awarded and summed

Not specified

No

  1. d day, DHQ Dietary Habits Questionnaire, FFQ Food frequency questionnaire, g gram, HS-FFQ High school food frequency questionnaire, h hour, INCAP Institute of Nutrition of Central America & Panama, m month, OMD Optimised mixed diet, NZ New Zealand, UK United Kingdom, USA United States of America, USAID United States Agency for International Development, USDA United States Department of Agriculture, WHO World Health Organisation, WIC Women, Infants, and Children Nutritional Supplementation Program, y year, YAQ Youth and Adolescent Food Frequency Questionnaire
  2. aDescribed as validated by the authors of the paper
  3. bToddler dietary questionnaire
  4. cFinland, Italy, and Netherlands
  5. dBelgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden
  6. eIreland and Italy
  7. fPortugal, UK, France, and Greece
  8. gGhent, Belgium; Stockholm, Sweden; Vienna, Austria; Pecs, Hungary; Athens, Greece; Zaragoza, and Spain
  9. hVienna in Austria, Ghent in Belgium, Lille in France, Dortmund in Germany, Athens and Heraklion in Greece, Pe’cs in Hungary, Rome in Italy, Zaragoza in Spain and Stockholm in Sweden
  10. iSpain, France, Germany Hungary, Greece, Italy, Belgium, Austria, Sweden, and United Kingdom
  11. jNutrient Rich Foods Index (NRF) can range from 5 to 15 nutrients