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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Food Policy and Economics
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1519829
This article is part of the Research Topic Food-Based Dietary Guidelines View all 6 articles

Comparing three summary indices to assess diet quality of Canadian children: a call for consensus

Provisionally accepted
Seyedehatefeh Panahimoghadam Seyedehatefeh Panahimoghadam 1Paul J Veugelers Paul J Veugelers 1Julia Dabravolskaj Julia Dabravolskaj 2Truc Tran Truc Tran 3Katerina Maximova Katerina Maximova 2,3*
  • 1 School of Public Health, University of Alberta, Edmonton, Alberta, Canada
  • 2 Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
  • 3 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

The final, formatted version of the article will be published soon.

    The Healthy Eating Index-Canada 2015 (HEI-C 2015), Diet Quality Index-International (DQI-I), and Healthy Eating Food Index 2019 (HEFI-2019) are commonly used to summarize the quality of Canadian diets. This paper sought to compare these three diet quality indices with respect to their ability to assess which index best captures diets of different quality in Canadian children and to discriminates between population subgroups. Methods: Data were collected in school-based surveys from grade 4-6 students (9-12 years old) in western Canada through 24-hour dietary recall in 2016 (n=336), 2018 (n=454), and 2020/2021 (n=909). Diet quality was assessed using HEI-C 2015, DQI-I and HEFI-2019. Agreement between the three indices was assessed using weighted Cohen's kappa. Univariate and multivariable linear regression models assessed diet quality according to student's sex, grade level, school material/social deprivation, and geographic region.Results: HEFI-2019 scores had the widest range, while DQI-I had the smallest. Agreement was 0.55 between HEI-C 2015 and DQI-I, 0.38 between HEI-C 2015 and HEFI-2019, and 0.29 between DQI-I and HEFI-2019. Boys and students from materially deprived areas reported diets of lower quality, irrespective of the index. There were no differences in diet quality across grade levels and geographic region. Energy consumption was associated positively with DQI-I and negatively HEFI-2019 scores.The three indices demonstrated fair to moderate agreement and varying ability to discriminate diet quality between different population subgroups of Canadian children. This study shows that the choice of a diet quality index affects the interpretation of results and practical considerations, yielding different conclusions with respect to the determinants of children's diet quality. Seeking consensus on which diet quality index to use for research, policy and/or practice would help support dietary research and policy development, and promote dietary guidelines implementation.

    Keywords: dietary assessment, Diet quality index, Children, healthy eating, Epidemiology, Public Health

    Received: 30 Oct 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Panahimoghadam, Veugelers, Dabravolskaj, Tran and Maximova. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Katerina Maximova, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, M5B 1W8, Ontario, Canada

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