TABLE 2.
Description of the instruments identified in the literature and detailed methodology for assessment of healthy and/or sustainable dietary patterns in children and adolescents1
| Instrument | Method for food assessment | Quantitative portions of food | Consumption frequency | Components in analysis | Scoring methods | Score penalty | Score range | Adherence level | References |
|---|---|---|---|---|---|---|---|---|---|
| Based on the principles of the MD | |||||||||
| Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) | 16 items of “yes or no” questions | No | Yes | 1) Fruit, 2) vegetables, 3) fish/seafood, 4) fast-food restaurants, 5) pulses, 6) pasta/rice, 7) cereal products, 8) nuts, 9) olive oil, 10) breakfast, 11) dairy products for breakfast, 12) commercially baked goods or pastries for breakfast, 13) yogurts/cheese, 14) sweets/candies. | Positive answers to questions with a negative connotation with MD adherence (n = 4) are scored −1 point, whereas questions with a positive connotation (n = 12) are scored +1 point. | No | Sum of the components, ranging from −4 to 12. | High adherence: ≥8 points; medium adherence: 4–7 points; poor adherence: ≤3 points | (36, 50–52, 56, 57, 70–77, 85–89, 97–101, 115, 116, 127–136) |
| KIDMED adaptation | FFQ | No | Yes | Removal of the breakfast component. | 24-h dietary recall | 24-h dietary recall | −4 to 13 | Use of the 33rd percentile | (55) |
| Krece Plus test | 15 “yes or no” questions | No | Yes | 1) Olive oil, 2) having breakfast, 3) vegetables, 4) pasta/rice, 5) fish, 6) fruits, 7) cereals at breakfast, 8) yogurts/cheese, 9) nuts, 10) commercially baked goods or pastries for breakfast, 11) sweets/candies, 12) takeaway. | Each item has a score of +1 or −1, depending on whether or not one follows the principles of the MD. | No | Sum of the components, ranging from −15 to 15. | Low nutritional level: ≤5 points; moderate nutritional level: 6–8 points; high nutritional level: ≥9 points | (137) |
| MDS | FFQ, dietary records, or 24-h recalls | No | No | 1) Ratio of MUFAs to SFAs (mainly olive oil), 2) vegetables, 3) fruits and nuts, 4) fish, 5) cereals, 6) pulses, 7) meat and meat products, 8) dairy products, 9) alcohol. | Score of 0 or 1 using the sex-specific sample medians as cutoffs.1–6): < median: 0 points; ≥ median: 1 point.7–8): ≥ median: 0 points; < median: 1 point.9) 0 g: 1 point; >0 g: 0 points. | No | Sum of the components, ranging from 0 to 8. | Higher scores indicate greater adherence. Participants can be categorized into 2 groups: low (<4 points) and high (≥4 points) adherence. | (58) |
| MDS adaptation | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | Alcohol intake was removed. | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | (54) |
| 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | Dairy products are scored as a beneficial component. | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | (53, 78) | |
| 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | MDS is calculated as a continuous variable using standardized z scores. | 24-h dietary recall | Use of quartiles. | 24-h dietary recall | (53) | |
| Semiquantitative questionnaire applied by face-to-face interview | Yes | Yes | 1) Olive oil, 2) butter, margarine, or cream, 3) sweet or carbonated beverages, 4) commercial sweets or pastries, 5) preference of lean meat over red meat, 6) sofrito (sauce with tomato and onion, leek, or garlic simmered in olive oil). | According to the MD recommendations 1 or 0 points. | 24-h dietary recall | Sum of the components, 1–13. | Higher scores indicate greater adherence. | (68) | |
| fMDS | FFQ | No | No | 1) Vegetables and legumes, 2) fruit and nuts, 3) cereals, 4) fish, 5) dairy products, 6) meat products. | Score of 0 or 1 using the sex-specific medians as cutoffs.1–4): < median: 0 points; > median: 1 point.5–6): > median: 0 points; < median: 1 point. | No | Sum of the components, 0–6. | High adherence levels to the fMDS when fMDS > 3. | (37) |
| MAI | Three 24-h dietary recalls | No | No | 1) Bread, 2) whole cereals, 3) pulses, 4) potatoes, 5) vegetables, 6) fresh fruit, 7) nuts, 8) fish, 9) olive oil, 10) wine, 11) milk, 12) cheese, 13) meat, 14) eggs, 15) animal fats and seed oils, 16) sweetened beverages, 17) cakes and cookies, 18) sugar, 19) other dairies, 20) ready or prepared meals. | MAI is obtained by dividing the sum of the percentage of total energy from typical Mediterranean food groups (bread + whole cereals + pulses + potatoes + vegetables + fresh fruit + nuts + fish + olive oil + wine) by the sum of the percentage of total energy from nontypical Mediterranean food groups (milk + cheese + meat + eggs + animal fats and seed oils + sweetened beverages + cakes and cookies + sugar + other dairies + ready or prepared meals). | No | Score ≥ 0. | The higher the score, the greater the adherence to the MAI. | (138) |
| Italian Mediterranean Index (IMI) | FFQ | No | No | 1) Pasta, 2) vegetables, 3) fruit, 4) pulses, 5) olive oil, 6) fish, 7) sugar-sweetened beverages, 8) butter, 9) red meat, 10) potatoes. | 1–6) 3rd tertile: 1 point; all other intakes received 0 points.7–10) 1st tertile: 1 point; all other intakes received 0 points. | No | Sum of the components, 0–10. | MD adherence was classified as low (≤3), medium (4–5), and high (≥6). | (139) |
| MSDPS | FFQ | Yes | Yes | 1) Whole-grain cereals, 2) fruits, 3) vegetables, 4) dairy products, 5) fish/seafood, 6) poultry, 7) olives, legumes, and nuts, 8) potatoes and other starchy roots, 9) eggs, 10) sweets, 11) meat, 12) olive oil. | Based on daily/weekly recommendations presented by the food guide pyramid.Except for olive oil, other MSDPS components are scored continuously from 0 to 10.Exclusive olive oil intake has a score of 10, olive oil besides other vegetable oils scores 5, and no olive oil intake scores 0. | For participants with the number of consumed servings above recommendation, a penalty score was assigned. A 0 score was considered for those who had a negative total MSDPS because of the overconsumption penalty. | 0–100.Equation based on the total score of the MSDPS components dividing by 120, multiplying by 100%, and, finally, multiplying by the proportion of total energy intake in the MD pyramid. | MD adherence was classified as low (15) and high (≥15). | (49) |
| DQI-I adaptedto MD | FFQ | Yes | Yes | 1) Variety (overall food group variety; within-group variety for protein sources), 2) adequacy (vegetable group, fruit group, cereal group, fiber, protein, iron, calcium, vitamin C), 3) moderation (total fat, saturated fat, cholesterol, sodium, empty calorie foods), 4) overall balance (macronutrient ratio, fatty acid ratio). | According to the MD recommendations.Variety: 0–15 or 0–5 each itemAdequacy: 0–5 each itemModeration: 0–6 each itemOverall balance: 0–4 or 0–6 each item | No | Sum of the components, 0–100 points.Variety: 0–20 pointsAdequacy: 0–40 pointsModeration: 0–30 pointsOverall balance: 0–10 points | Higher scores indicate greater adherence. | (66, 69) |
| Based on European recommendations and/or applied in European countries | |||||||||
| BSDS | Food records | No | No | 1) Fruits and Nordic berries, 2) vegetables (including legumes and roots; potatoes excluded), 3) cereals, 4) low-fat milk, 5) fish (salmon, Baltic herring, and mackerel), 6) meat and processed meat products, 7) diet total fat, 8) ratio of PUFA:SFA. | Use of quartiles.(1)–(5) and (8): 1st quartile: 0; 4th quartile: 3.(6)–(7): 1st quartile: 3; 4th quartile: 0. | No | Sum of the components, 0–25. | Higher points indicate higher adherence to the BSDS. | (81) |
| Southern European Atlantic Diet (SEAD) score | FFQ | No | No | 1) Fresh fish (excluding cod), 2) cod, 3) red meat/meat products, 4) dairy products, 5) vegetables and legumes, 6) vegetables soup, 7) potatoes, 8) bread. | Each component is measured as grams per 1000 kcal per day. Score of 0 or 1 using the sex-specific medians as cutoffs: < = 0 points; ≥ = 1 point. | No | Sum of the components, 0–8 points. | Higher points indicate higher adherence. Split into 2 groups: low (≤4 points) and high (≥5 points). | (47, 113) |
| Diet Score based on the Norwegian Health Directorate | FFQ | No | Yes | 1) Fruit and vegetables, 2) fish, 3) lean meat and meat products, 4) low-fat dairy products, 5) sugar, 6) water, 7) physical activity, 8) whole products. | When the Norwegian Health Directorate recommendation is fulfilled, 1 point is given; when it is not, 0 points. | No | Sum of the components, 0–8. | Low (0–3 points), moderate (4–5 points), or high (6–8 points) adherence to the dietary recommendations. | (140) |
| HuSKY | FFQ | No | Yes | 1) Beverages, 2) fruit, 3) vegetables, 4) pasta, rice, potatoes, 5) bread/cereals, 6) dairy products, 7) eggs, 8) meat, 9) fish, 10) fats, 11) sweets/fatty snacks/sugar-rich soft drinks. | For most food groups an intake below the Optimized Mixed Diet for German Children and Adolescents recommendation is assessed proportionally (0–10). Only for meat, fats, and sweets/fatty snacks/sugar-rich soft drinks, 10 points are given when the intake is below or equal to the tolerable consumption. | When more than twice the recommended amount was consumed, points were proportionally subtracted from 100. For meat, fats, and sweets/fatty snacks/sugar-rich soft drinks points were proportionally subtracted from 100 if consumption exceeded the recommendations. | Single points were added together and standardized to a scale from 0 to 100 (HuSKY = Σscorex/number of scorex). | A higher score implies a better overall dietary quality. | (46, 62) |
| Diet Quality Index for Children | FFQ | Yes | Yes | Dietary 1) diversity, 2) quality, 3) equilibrium, and 4) moderation are evaluated by the main food groups:
|
The sum of the 4 scores dividing by 4. According to the Belgium Health Council. | No | −25 to 100 | A higher score implies a better overall dietary quality. | (141) |
| DQI-A | 24-h dietary recall | Yes | Yes | 1) Water, 2) bread and cereals, 3) grains and potatoes, 4) vegetables, 5) fruits, 6) milk products, 7) cheese, 8) meat, fish, eggs, and substitutes, 9) fats and oils. | According to the Belgium Health Council and WHO (0–9 for each component). | No | 0–100 | A higher score implies a better overall dietary quality. | (41) |
| DQI-A in Brazil adaptation | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | In relation to the DQI-A, addition of:
|
According to the Brazilian Ministry of Health. | 24-h dietary recall | −33% to 100% | 24-h dietary recall | (65) |
| Dietary Quality Score for Ireland | 20-item FFQ reported by parents | No | Yes | According to the Irish dietary guidelines, each food item was defined as “healthy” or “unhealthy.” Healthy items: 1) fresh fruit, 2) vegetables, 3) meat, 4) eggs, 5) bread, 6) cereals, 7) potatoes, 8) dairy products, and 9) water. Unhealthy items: 1) meat pie, 2) hot chips, 3) crisps, 4) biscuits, and 5) soft drinks. | For each component a score of 1 = one; 2 = more than one; 3 = not at all; 4 = don't know. For consumption of each healthy item, a value of 0 for not eaten at all, 1 for eaten 1 portion, and 2 for eaten more than once were assigned. Unhealthy items were given a value of −2 for eaten more than once, −1 for eaten once, and 0 for not eaten at all. | No | −5 to 25 | A higher score value implies a better overall dietary quality. | (142) |
| Children's Index of Diet Quality (CIDQ) | 7-d food records + original questionnaire | Yes | No | 1) Cereals and fiber, 2) SFA, 3) MUFA, 4) PUFA, 5) sucrose, 6) vegetables and fruits, 7) calcium. | According to the Nordic Nutrition recommendations | No | Standardized for 0–21 | Low adherence: 0–2 components fulfilled. Medium adherence: 3 or 4 components fulfilled. High adherence: ≥5 components fulfilled. | (40) |
| Swedish Healthy Eating Index for Adolescents 2015 (SHEIA2015) | 24-h dietary recall | Yes | No | 1) Vegetables, 2) pulses, 3) fruits, 4) fiber, 5) whole meal, 6) fish and shellfish, 7) PUFA, MUFA, and SFA, 8) red and processed meat, 9) added sugar. | According to the Nordic Nutrition recommendations. 0 or 1 for each component. | No | 0–9 | A higher score implies a better overall dietary quality. Use of tertiles for adherence. | (94) |
| Riskmaten Adolescents Diet Diversity Score (RADDS) | 24-h dietary recall | Yes | No | 1) Vegetables, 2) pulses, 3) fruits, 4) pasta, rice, grains, and bread, 5) red meat, 6) poultry, 7) eggs, 8) white fish, 9) oil fish, 10) shellfish, 11) dairy products. | Each component varies between 1 and 17 points; 1 point is given if consumption is <5 g and proportionally until the recommendation is reached (17 points). According to the Nordic Nutrition recommendations. | No | Standardized for 1–17 | A higher score value implies a better overall dietary quality. Use of tertiles. | (94) |
| Finnish Children Healthy Eating Index (FCHEI) | Food records | Yes | No | 1) Vegetables, 2) fruits and berries, 3) oils and vegetable oils, 4) fish and skimmed milk, 5) foods with high amounts of sugar. | Consumption is divided by energy intake and categorized according to its variation (deciles), according to the Finnish dietary guidelines for children. | No | 5–40 | A higher score implies a better overall dietary quality. | (143) |
| Based on US recommendations | |||||||||
| DASH score | FFQ, food records, or 24-h dietary recall | No | Yes | 1) Grains, 2) vegetables, 3) fruits, 4) dairy products, 5) nuts, seeds, legumes, 6) red and processed meat, 7) fats/oils, 8) sweets. | There is a maximum component score of 10 for each food group when intake meets recommendations, with lower intakes scored proportionately. Reverse scoring is used when lower intakes are favored. | No | Sum of the components, 0–80 | Higher scores indicate greater adherence. | (80, 81) |
| DASH score adaptation | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall |
|
Use of quintiles. (1) to (5): quintile 1 is assigned 1 point and quintile 5, 5 points. Other components: low intake was desired. | 24-h dietary recall | Sum of the components, 8–40 | Higher scores indicate greater adherence OR Use of centiles (tertiles, quartiles, quintiles). | (48, 55, 59, 60, 79) |
| 24-h dietary recall | 24-h dietary recall | 24-h dietary recall |
|
Use of quintiles | 24-h dietary recall | Sum of the components, 7–35 | 24-h dietary recall | (82) | |
| HLD Index | 24-h dietary recalls | No | Yes | 1) Fruits, 2) vegetables, 3) grains, 4) dairy products, 5) meat, 6) fish/seafood, 7) soft drinks, 8) sweets, 9) watch TV/play computer, 10) moderate to vigorous physical activity. | A 0–4 scoring system is used to assign the appropriate score to each index component according to the USDA recommendations. | No | Sum of the components, 0–40 | Tertiles could be considered (a) “unhealthy diet–lifestyle pattern” (first tertile); (b) “moderate healthy diet–lifestyle pattern” (second tertile); (c) a “healthy diet–lifestyle pattern” (third tertile). | (114) |
| HLD Index adaptation | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | Two components were added to the original HDL index: legumes and eggs. | 24-h dietary recall | 24-h dietary recall | Sum of the components, 0–48 | 24-h dietary recall | (90) |
| Preschoolers Diet–Lifestyle Index (PDL-Index) | 24-h dietary recall or food diaries | No | Yes | 1) Fruits, 2) vegetables, 3) total grains, 4) dairy products, 5) red meat, 6) white meat/legumes, 7) fish and seafood, 8) unsaturated fats, 9) sweets, 10) time spent watching TV/vídeo, 11) moderate-to-vigorous physical activity. | A 0–4 scoring system was used to assign the appropriate score to each index component according to USDA recommendations. | 24-h dietary recall | Sum of the components, 0–44 | Use of tertiles. | (38) |
| Electronic Kids Dietary Index (E-KINDEX) | FFQ and supplementary questions | No | Yes | 1) Bread, 2) cereals (excluding bread), 3) fruits and fruit juices, 4) vegetables, 5) legumes, 6) milk, 7) fish, seafood, 8) meats, 9) salted and smoked meat foods, 10) sweets and junk food, 11) soft drinks, 12) grilled foods, 13) fried foods, 14) breakfast, 15) fast food, 16) number of main meals and snacks, 17) frequency of school meals in the afternoon. | A 4-point scoring system (0–3 or the reverse) is used for most components of the index according to the 1990 USDA recommendations. | No | Sum of the components, 1–87 | Higher values indicate higher adherence. | (92) |
| HEI-1995 | FFQ | Yes | Yes | 1) Grains, 2) vegetables, 3) fruits, 4) milk, 5) meat, 6) total fat, 7) SFA, 8) cholesterol, 9) diet variety, 10) sodium. | Each component scores 0–10 points according to the Food Guide Pyramid (USDA) recommendations. | No | 0–100 | Higher values indicate higher adherence.>80: “good”; 51–80: “needs improvement”; ≤50: “poor”. | (84, 111) |
| HEI-2005 | 24-h dietary recall or 4-d food records | Yes | Yes | 1) Total fruit, 2) whole fruit, 3) total vegetables, 4) dark and orange vegetables and legumes, 5) total grain, 6) whole grain, 7) milk, 8) meat and beans, 9) oil, 10) saturated fats, 11) sodium, 12) calories from solid fats, alcoholic beverages, and added sugar. | Depending on the components, a score of 0–5, 0–10, or 0–20 points is given, according to the USDA recommendations.All components are calculated per 4184 kJ (1000 kcal). | No | 0–100 | Higher values indicate higher adherence.>80: “good”; 51–80: “needs improvement”; ≤50: “poor”. | (61, 144–147) |
| HEI-2010 | 24-h dietary recall | Yes | Yes | 1) Total fruits, 2) whole fruit, 3) total vegetables, 4) greens and beans, 5) whole grains, 6) dairy, 7) total protein foods, 8) seafood and plant proteins, 9) fatty acids, 10) refined grains, 11) sodium, 12) empty calories. | Each component can receive a score ranging from 0 to 20 points, depending on the assigned maximum point total according to the 2010 Dietary Guidelines for Americans.Each average intake is standardized to an intake per 1000 kcal. | 0 | 0–100 | Higher values indicate higher adherence.>80: “good”; 51–80: “needs improvement”; ≤50: “poor”. | (63, 83, 104, 148–152) |
| HEI-2010 adapted to Brazil adaptation | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | According to the Brazilian Ministry of Health recommendations. | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | (153) |
| HEI-2010 adapted for Singapore Health Promotion Board adaptation | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 1) Rice, 2) whole grains, 3) fruits, 4) vegetables, 5) meats and alternatives, 6) dairy products, 7) sodium, 8) energy and total fat, 9) saturated fat, 10) added sugar. | Each component is given 0–10 points according to the Singapore dietary recommendations. | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | (105) |
| HEI-2015 | 24-h dietary recall | Yes | Yes | 1) Total fruits, 2) whole fruits, 3) total vegetables, 4) greens and beans, 5) whole grains, 6) dairy, 7) total protein fruits, 8) seafood and plant proteins, 9) fatty acids, 10) refined grains, 11) sodium, 12) added sugar, 13) saturated fats. | Depending on the components, a score of 0–5 or 0–10 points is given, according to the 2015–2020 Dietary Guidelines for Americans recommendation.The amounts are adjusted per 1000 kcal. | No | 0–100 | Higher values indicate higher adherence. | (109, 154, 155) |
| Youth Healthy Eating Index (YHEI) | FFQ + questionnaire | No | Yes | 1) Whole grains, 2) vegetables, 3) fruits, 4) dairy, 5) meat ratio, 6) snack foods, 7) soda and drinks, 8) multivitaminic use, 9) margarine and butter, 10) fried foods outside home, 11) visible animal fat, 12) dinner with family, 13) fish. | Depending on the components, a score of 0–5 or 0–10 points is given, according to USDA recommendations. | No | 0–85 | Higher values indicate higher adherence. | (45, 118) |
| Diet Quality Index Canadian (DQI-C) | FFQ | Yes | Yes | 1) Vegetables and fruits, 2) grain, 3) milk and alternatives, 4) meat and alternatives, 5) candy and snacks, 6) sugar-sweetened beverages. | Each component is given a score of 0 or 1 according to the Canada's Food Guide recommendations. | No | 0–6 | Higher values indicate higher adherence.≤72: unhealthy diet; 73–77: moderate diet quality; ≥78: healthy diet. | (156) |
| Healthy Dietary Variety Index | FFQ | No | Yes | 1) Starchy food (including potatoes), 2) fruits, 3) vegetables, 4) meat, fish, and alternatives, 5) dairy foods. | Foods are allocated into 1 of the 5 groups according to similar composition.Within each group the contribution of a particular food is truncated at 33%. The recommended number of servings is multiplied by 33%.Considering the USDA recommendations. | No | 0–1 | Higher values indicate higher adherence. | (96) |
| Based on Brazilian recommendations | |||||||||
| School Child Diet Index (ALES) | FFQ | No | Yes | 1) Fruits, 2) vegetables, 3) beans, 4) milk, 5) candies, 6) soft drinks, 7) fried foods, 8) instant noodles, 9) hamburgers, 10) mayonnaise. | According to the recommendations of the Brazilian Ministry of Health.Scores of +1 or −1 to each food component. | No | −10 to 10 | Use of tertiles.<3, poor quality; 3–6, average quality; ≥6, good quality. | (157) |
| Brazilian Healthy Eating Index Revised (BHEI-R) | 24-h dietary recall | Yes | Yes | 1) Total grains, 2) whole grains, 3) total vegetables and legumes, 4) dark and yellow vegetables and legumes, 5) fruits, 6) meat, eggs, and legumes, 7) dairy, 8) oils, 9) saturated fat, 10) sodium, 11) calories from solid fat, alcohol, and added sugar. | Depending on the components, a score of 0–5, 0–10, or 0–20 points is given, according to the Brazilian recommendations. | No | 0–100 | Higher values indicate higher adherence. | (110, 158, 159) |
| Recommended Food Score | FFQ | No | Yes | 1) Vegetables, 2) fruits, 3) lean meat, 4) cereals, 5) dairy products. | Selection of 50 foods from 120 of the FFQ to compose the index groups. The score is calculated by adding 1 point for each food that complied with the recommendations of the Brazilian Ministry of Health. When the recommendation was not fulfilled, the component has 0 points. | No | 0–50 | Higher values indicate higher adherence.>80th percentile: high adherence; <80th percentile: low adherence. | (103) |
| Healthy Eating Index (Brazil) | FFQ | Yes | Yes | 1) Cereals, 2) vegetables, 3) fruits and fruit juices, 4) dairy products, 5) meat and eggs, 6) legumes, 7) oils and fats, 8) sugar, candies, chocolates, and snacks, 9) total fat, 10) saturated fat, 11) cholesterol, 12) sodium, 13) diet variety. | Each component is scored from 1 to 10 according to the recommendations of the Brazilian Ministry of Health. Components 1–8) contribute 50% of the total score and 9–13) the other 50%. | No | Standardized, 0–100 | Higher values indicate higher dietary quality.>80: “good”; 51–80: “needs improvement”; ≤50: “poor”. | (39) |
| Based on Oceania (Australia and New Zealand) recommendations | |||||||||
| Australian Childand Adolescent Recommended Food Score (ACARFS) | 70 questions | No | Yes | 1) Vegetables, 2) fruits, 3) protein food (meat and nonmeat protein), 4) cereals, 5) dairy products, 6) water, 7) spreads/sauce. | The maximum possible score for each component was determined by the number of suitable FFQ items.Score according to the Australian Guide to Healthy Eating | No | Sum of the components, 0–73 | Higher values indicate higher adherence. | (102) |
| Dietary Guideline Index for Children and Adolescents (DGI-CA) | 24-h dietary recalls, FFQ | No | Yes | 1) Variety, 2) fruits, 3) vegetables, 4) bread and cereals, 5) whole-grain cereals, 6) meat and alternatives, 7) dairy, 8) water, 9) extra foods (moderation of salt and sugar), 10) healthy fats (ex. olive oil, nuts). | Depending on the components, a score of 0–5, 0–10, or 0–20 points is given, according to the 2003 Australian Dietary Guidelines for Children and Adolescents. | No | 0–100 | Higher values indicate higher adherence. | (64, 123) |
| Prior derived Diet Quality Index adaptation | FFQ | 24-h dietary recall | 24-h dietary recall | Instead of 10) healthy fats, it includes a “Saturated fats” component. | Each component was scored from 1 to 10. | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | (93) |
| Australian Recommended Food Scores for Pre-Schoolers (ARFS-P) | FFQ for parents | No | Yes | 1) Vegetables, 2) fruits, 3) meat, 4) meat alternatives, 5) grains, 6) dairy products, 7) condiments. | According to the Australian Recommended Food Score.The component scores vary from 0 to the number of questions in that component, plus 1 more possible for vegetables, low-fat dairy, and whole grains. | No | 0–73 | Higher values indicate higher adherence. | (160) |
| Revised Children's Diet Quality Index (RC-DQI) | 24-h recall | Yes | Yes | 1) Total fat, 2) linoleic acid, 3) α-linolenic acid, 4) EPA and DHA, 5) iron, 6) total grains, 7) whole grains, 8) dairy, 9) fruits, 10) vegetables, 11) electronic media use and energy intake interaction. | Depending on the components, a score of 0–2.5, 0–5, or 0–10 points is given, according to the Nutrient Reference Values for Australia and New Zealand. | No | 0–85 | Higher values indicate higher adherence. | (161) |
| Dietary Index for a Child's Eating (DICE) | Original questionnaire to parents | No | Yes | 1) Fruits, 2) vegetables, 3) dairy products, 4) meat and alternatives, 5) bread, 6) cereals. | Each component was scored from 1 to 10 according to the New Zealand Ministry of Health Food and Nutrition Guidelines for 2–18 y. | No | 0–100 | Higher values indicate higher adherence. | (42) |
| Based on Asian recommendations | |||||||||
| Modified version of Revised Children's Diet Quality Index (M-RCDQI) | FFQ | Yes | No | 1) Added sugar, 2) total fat, 3) linoleic acid, 4) α-linolenic acid, 5) EPA and DHA, 6) total grains, 7) fiber, 8) fruits, 9) vegetables, 10) dairy, 11) salty snacks, 12) iron, 13) energy. | According to Iranian recommendations (children consuming within the recommended amounts receive full points, varying from 2.5 to 10 points depending on the component). | No | 0–90 | Higher values indicate higher adherence. | (162) |
| Diet Quality Index for Indian Children (DQIIC) | 21 questions | Yes | Yes | 1) Cereals, 2) pulses, 3) meat and meat products, 4) dairy, 5) vegetables, 6) fruits, 7) sugar, 8) roots and tubers, 9) empty calories foods, 10) frequency of breakfast consumption, 11) frequency of meal given in lunch box, 12) number of meals per day, 13) frequency of consumption of favorite meal, 14) eat out of home in the past 2 d, 15) dietary behavior regarding consumption of advertised foods, 16) consumption of home-food, 17) sodium, 18) total energy from fat. | Depending on the components, a score of 0–4, 0–6, 0–2, 0–10, or 0–8 points is given, according to the Dietary Guidelines for Indian Children. | No | Standardized, 0–90 | Higher values indicate higher adherence.≤72: unhealthy diet; 73–77: moderate diet quality; ≥78: healthy diet. | (163) |
| Chinese's Children's Dietary Index (CCDI) | 24-h dietary recall | Yes | Yes | 1) Grains, 2) vegetables, 3) fruits, 4) dairy products, 5) soybeans and soy products, 6) meat, 7) fish and shrimp, 8) eggs, 9) water, 10) sugar-sweetened beverages, 11) vitamin A, 12) fatty acids, 13) fiber, 14) dietary variety, 15) energy balance, 16) regularly eating breakfast or dinner with parents. | Each component was scored from 1 to 10 according to the Chinese healthy recommendations. | 0 | 0–160 | Higher values indicate higher adherence. | (67, 164) |
| Japanese FoodGuide Spinning Top Score (JFGST) | FFQ | Yes | Yes | 1) Grain dishes, 2) vegetable dishes, 3) fish and meat dishes, 4) milk, 5) fruits, 6) total energy, 7) snacks and beverages. | Each component was scored from 1 to 10 according to the 2000 Dietary Guidelines for Japanese. | No | 0–70 | Higher values indicate higher adherence.Use of tertiles. | (112) |
| Malaysian Healthy Eating Index | FFQ or 2-d dietary record | Yes | Yes | 1) Cereals and grains, 2) vegetables, 3) fruits, 4) dairy products, 5) poultry, meat, and eggs, 6) fish, 7) legumes, 8) energy from total fat, 9) sodium. | Each component was scored from 1 to 10 according to the Malaysian Dietary Guidelines for Children and Adolescents. | No | 0–100 (total score of 9 components/9 × 10) × 100% | Higher values indicate higher adherence.≤46: high risk of a poor dietary quality; ≥47: low risk of a poor dietary quality | (106, 165) |
| Based on the principles of international entities or others | |||||||||
| Obesity-Preventive Lifestyle Score (OPLS) | FFQ | No | Yes | 1) Fruits, 2) vegetables, 3) sugar-sweetened beverages, 4) breakfast, 5) restaurants/fast food, 6) screen time, 7) moderate/ intense physical activity, 8) school sport physical activity, 9) active commuting. | Tertiles and assigned ascending values (0, 1, 2) for favorable behaviors and descending values (2, 1, 0) for unfavorable behaviors. | No | Sum of the components, 0–18 | Higher values indicate healthier lifestyles. | (91) |
| HEI based on WHO recommendation | FFQ | No | Yes | 1) Fruits, 2) vegetables, 3) dairy products, 4) fish, 5) eggs, 6) meat and meat products, 7) salty snacks, 8) sweet foods and soft drinks. | Each food group is assigned 1–4 points.(1) to (5) components: 1st quartile: 1 point; 4th quartile: 4 points.(6) to (8) components: 1st quartile: 4 points; 4th quartile: 1 point. | No | 8–32 | Higher values indicate higher adherence.Use of quartiles. | .(166) |
| DQI-I | FFQ | Yes | Yes | 1) Variety (overall food group variety; within-group variety for protein sources), 2) adequacy (vegetables, fruits, grains, fiber, iron, protein, calcium, vitamin C), 3) moderation (total fat, saturated fat, cholesterol, sodium, empty calories food), 4) overall balance (macronutrient ratio, fatty acid ratio). | Depending on the components, a score of 0–10, 0–20, 0–30, or 0–40 points is given, according to the USDA Dietary Guidelines and 1996 WHO recommendations, | No | 0–100 | Higher values indicate higher adherence.<50: poor diet; 50–70: moderate diet quality; >70: high diet quality. | (108) |
| Healthy Dietary Adherence Score (HDAS) | FFQ | Yes | Yes | 1) Refined sugars, 2) fat intake, 3) whole meal, 4) fruits, 5) vegetables, 6) fish. | Each component was scored from 1 to 10 according to the guidelines common to all 8 countries participating in the study. | No | 0–50 | Higher values indicate higher adherence. | (43) |
| DDS | 24-h dietary recall | Yes | No | 1) Cereals, roots, and tubers, 2) vitamin A–rich fruits and vegetables, 3) other fruits and vegetables, 4) legumes, pulses, and nuts, 5) oils and fats, 6) dairy, 7) meat and fish, 8) eggs, 9) foods rich in sugar. | 0 or 1 point for each component according to the guidelines of the FAO. | No | 0–9 | Higher values indicate higher adherence. | (107, 167–169) |
| DDS adaptation | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 0–48 | 24-h dietary recall | (170) |
| DDS adaptation | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 24-h dietary recall | 0–10 | 24-h dietary recall | (44) |
| Healthy Diet Score (HDS) | 24-h recall or record diaries | No | No | 1) Refined grains, 2) seafood, 3) fried foods, 4) sugar-sweetened beverages, 5) meat, 6) rice, 7) fungi and algae, 8) roots and tubers, 9) wheat. | Computed by summing subscores with each of the leading dietary predictors as 1 point according to the association with cardiometabolic risk. Example: for ≥ median intake of fruit a score of 1 is given and 0 for < median, if fruit intake is inversely related to cardiometabolic risk. | No | 0–9 | Higher values indicate healthier lifestyles. | (45) |
1
BSDS, Baltic Sea Diet Score; DASH, Dietary Approaches to Stop Hypertension; DDS, Dietary Diversity Score; DQI-A, Diet Quality Index for Adolescents; DQI-I, Diet Quality Index International; FAO, Food and Agriculture Organization of the United Nations; fMDS, food frequency–based Mediterranean Diet Score; HEI, Healthy Eating Index; HLD Index, Healthy Lifestyle–Diet Index; HuSKY, Healthy Nutrition Score for Kids and Youth; MAI, Mediterranean Adequacy Index; MD, Mediterranean Diet; MDS, Mediterranean Diet Score; MSDPS, Mediterranean-Style Dietary Pattern Score.