Development and Validation of Metrics of Diet, Menu, and Meal Quality for Children 2 to 14 Years of Age: Overview

Abstract

Objective: To describe the motivation for undertaking research to validate the Global Diet Quality Score (GDQS) for use among children 2–14 years of age, and to summarize results from the GDQS child validation research initiative presented in this Supplemental Issue. Background: To advance an agenda to address diet quality among children globally requires the availability of diet quality metrics that meet the following 5 criteria: (1) cross-country relevance; (2) cross-country validity; (3) compatibility with the use of low-cost data collection methods; (4) straightforward tabulation methods; and (5) provides a whole-of-diet measure. No existing metric meets all 5 criteria. The research in this Supplement aims to fill this gap. Methods: The GDQS was adapted for 3 different age groups (24–59 months, 5–9 years, and 10–14 years) and validated for predicting nutrient adequacy and noncommunicable disease (NCD)-related outcomes by analyzing cross-sectional dietary data from a diverse set of countries. Longitudinal associations between the GDQS and NCD-related outcomes were also evaluated. Results: Validation results show the GDQS is positively associated with energy-adjusted intakes of micronutrients and fiber, and negatively associated with energy-adjusted intakes of added sugar in most data sets. In longitudinal analyses, the GDQS was negatively associated with several adiposity and cardiometabolic outcomes. Conclusion: To routinely measure the quality of diets of children globally requires a new set of tools. The research in this Supplement helps fill this gap by describing work to develop and validate the GDQS for use among children 2–14 years of age, using data sets from diverse contexts across low-, middle-, and high-income countries. The research also fills a gap in the availability of a standardized metric for assessing the quality of meals and menus in institutional feeding settings by applying the GDQS validated for children to the development of a GDQS-Meal and Menu metric.