Table 1. Description of the scoring system of the 10 dietary (and lifestyle) scores.
| Index | Type | Scoring | Cut-offsa | Ease of calculation |
|---|---|---|---|---|
| Healthy Eating Index HEI-2010 Based on Dietary Guidelines for Americans 2010 [28] | Diet (Food and nutrients) | 12 components. Score range: 0–100 pointsb Adequacy: total fruit, whole fruit, total vegetables, greens and beans, whole grains, dairy, total protein foods, seafood and plant proteins, fatty acids balance Moderation: Refined grains, sodium, empty calories | Predefined | Moderate Available SAS macroc Need to convert food group intake from grams to cup or ounce equivalents |
| Diet Quality Index–International DQI-I[27] | Diet (Food and nutrients) | 17 components. Score range: 0–100 pointsb Variety: overall food group variety (0–15 pts); within-group variety for protein source (0–5 pts) Adequacy: vegetables, fruits, cereals, fiber, protein, Fe, Ca, vitamin C (0–5 pts each). Moderation: total fat, saturated fat, cholesterol, sodium, empty-energy foods (0–6 pts) Overall balance: macronutrient ratio (carbohydrate:protein:fat, 0–6 pts); fatty acid ratio (PUFA:MUFA:SFA, 0–4 pts) | Predefined | Complex Definition of empty-energy foods requires complex calculation. Requires extensive nutrient information. |
| WHO Healthy Diet Indicator WHO HDI [5] | Diet (Food and nutrients) | 7 components. Score range: 0–7 points SFA, PUFA, cholesterol, protein, dietary fiber; fruit and vegetables, free sugars | Predefined | Simple |
| Healthy Lifestyle Index HLI [29] | Diet (Food and nutrients) and lifestyle | Healthy diet: 7 components. Score range: 0–63 points Cereal fiber, folate, ratio PUFA:SFA, fatty fish (as a marker for omega-3 fatty acids), margarine (as a marker for trans-fats), glycaemic load, fruits and vegetables. Center-specific deciles, scored from 0 to 9 (inverse for trans-fat and glycaemic load), 0 = least healthy consumption Health index: 5 components. Score range: 0–20 (4 points each) never smoking, no alcohol, intense physical activity, low BMI, healthy diet score (quintiles, the highest scores 4, the lowest 0) | Population dependent | Moderate Requires folate and glycaemic load and lifestyle indicators: smoking, BMI, physical activity and alcohol. |
| Cancer WCRF guideline score [13] | Diet (Food) and lifestyle | 7 components (women) or 6 components (men). Score range: 0–7 points (women), 0–6 (men) Selected recommendations: weight management, physical activity, foods and drinks that promote weight gain (energy density and sugary drink intake), plant foods, animal foods, alcoholic drinks, breastfeeding (women only) | Predefined | Moderate Requires data on breastfeeding, BMI and physical activity. |
| Hypertension Dietary Approaches to Stop Hypertension DASH diet score[30] | Diet (Food) | 8 components. Score range 8–40 points (5 points each)b Negative components: sweet beverages, meat, sodium Beneficial components: Fruit, vegetables, legumes and nuts, wholegrain, low fat dairy. Sex-specific quintiles, scoring from 1 to 5 in each category. | Population dependent | Simple Rank intake into quintiles Requires detail on wholegrain and low fat dairy. |
| Mediterranean Diet Score MDS[4] | Diet (Food and nutrients) | 9 components. Score range: 0–9 points 5 beneficial components 1 point if above sex-specific median, 0 if below: fruit, vegetable, legumes, grains, fish 2 detrimental components 1 point if below median, 0 if above: meat, dairy products 1 component on fat: Mono-unsaturated Fatty Acids / Saturated Fatty Acids ratio 1 component on ethanol: 1 point if within a range of intake (10-50g/day for men, 5-25g/d for women) | Population dependent | Simple Rank intake according to the median |
| Relative Mediterranean score rMED[31] | Diet (Food and nutrients) | 9 components. Score range: 0–18 points Same 5 beneficial components as MDS but points 0, 1, 2 attributed to tertiles 1, 2 and 3, inverse quotation for the 2 detrimental components Component on fat: olive oil intake 0 point for non-consumption, 1 point below median, 2 points above | Population dependent | Simple Rank intake into tertiles Requires data on olive oil. |
| Mediterranean Style Dietary Pattern Score MSDPS[32] | Diet (Food) | 13 components. Score range: up to 100 points (10 points each) Whole-grain, cereals, fruits, vegetables, dairy, wine, fish, poultry, olives-legumes-nuts, potatoes, eggs, sweets, meats, olive oil. Scoring depends on number of servings recommended per day or week (e.g. consume 60% of recommended serving, score = 6). If consumption is above recommended number of servings, points are deducted accordingly. Negative points are possible. | Predefined | Complex Requires to classify “Mediterranean” and “non-mediterranean” food and their contribution to the overall diet. |
| Healthy Nordic Food Index HNFI [33] | Diet (Food) | 6 components. Score range: 0–6 points 1 point if above sex-specific median, 0 if below: fish and shellfish, cabbage, whole grain bread, apples and pears, root vegetables | Population dependent | Simple Rank intake according to the median Requires data on sub groups of vegetables (cabbage and root) and wholegrain. |
a Refers to the thresholds used to allocate points for each component.
b Sodium data was not available. HEI-2010 score ranged between 0 and 95; DQI-I score ranged between 0 and 94 points; DASH score ranged between 7–35 points