Quality and Validity of Diet Quality Indices for Use in Australian Contexts: A Systematic Review
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Cheung, HC
McAuley, E
Ross, LJ
Maclaughlin, HL
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Abstract
Diet quality indices (DQIs) are tools used to evaluate the overall diet quality against dietary guidelines or known healthy dietary patterns. This review aimed to evaluate DQIs and their validation processes to facilitate decision-making in the selection of appropriate DQIs for use in Australian contexts. A search of CINAHL, PubMed and Scopus electronic databases was conducted for studies published between January 2010 - May 2020, which validated a DQI, measuring >1 dimension of diet quality (adequacy, balance, moderation, variety) and was applicable to the Australian context. Data on constructs, scoring, weighting and validation methods (construct validity, criterion validity, reliability and reproducibility) were extracted and summarised. The quality of the validation process was evaluated using COSMIN Risk of Bias and Joanna Briggs Appraisal checklists. The review identified 27 indices measuring adherence to: national dietary guidelines (n=13), Mediterranean diet (n=8), and specific population recommendations and chronic disease risk (n=6). Extensiveness of the validation process varied widely across and within categories. Construct validity was the most strongly assessed measurement property, while evaluation of measurement error was frequently inadequate. DQIs should capture multiple dimensions of diet quality, possess a reliable scoring system, and demonstrate adequate evidence in their validation framework to support use in the intended context. Researchers need to understand the limitations of newly developed DQIs and interpret results in view of the validation evidence. Future research on DQIs is indicated to improve evaluation of measurement error, reproducibility and reliability.
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British Journal of Nutrition
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This accepted manuscript is distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Tan, MS; Cheung, HC; McAuley, E; Ross, LJ; Maclaughlin, HL, Quality and Validity of Diet Quality Indices for Use in Australian Contexts: A Systematic Review, British Journal of Nutrition, 2021