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

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.