Development and validation of a Meal Index of dietary Quality (Meal IQ) to assess the dietary quality of school lunches

Abstract

Objective: School lunch programmes are one strategy to promote healthier dietary habits in children, but better evaluation tools for assessing the dietary quality of such programmes are needed. The aim of the present study was to develop and validate a simple index to assess the dietary quality of school lunches for children aged 7-13 years. Design: A Meal Index of dietary Quality (Meal IQ) was developed to consist of seven components (nutrients and food groups) based on dietary issues for children aged 7-13 years, which were identified in a national dietary survey. The Meal IQ was validated against calculated nutrient contents of school lunches both provided by the school and brought from home. Setting: At eight public schools from all over Denmark, data were collected on 191 individual lunches brought from home (which is most common in Denmark) and thirty-one lunches provided as part of a school food programme. In addition thirty-two lunches provided at eighteen other public schools were included. Subjects: A total of 254 school lunches. Results: A higher Meal IQ score was associated with a higher overall dietary quality, including lower contents of fat, saturated fat and added sugars, higher contents of fibre, various vitamins and minerals, and more fruits, vegetables and fish. Conclusions: The Meal IQ is a valid and useful evaluation tool for assessing the dietary quality of lunches provided by schools or brought to school from home.

Validation of a digital photographic method for assessment of dietary quality of school lunch sandwiches brought from home

“…Fruits and vegetables are separate components in the Meal IQ, and each component in the Meal IQ scores from 0 to 4 points. If fruits or vegetables are not represented in the meal, the score is 0; and if the meal contains 75 g or more, 4 points are given (15). Further analyses show that the problem of underestimating fruits and vegetables does not exist when estimating weights under 85 g of vegetables and 115 g of fruits.…”

“…A Meal IQ that was developed as a scoring system and published earlier (15) was applied as the tool to assess the dietary quality from the digital images and from the weighed school lunch sandwiches (Fig. 2).…”

“…The total Meal IQ score for a single meal can range from 0 to 28 [for more details on the Meal IQ, see Ref. (15)].…”

Indices for the assessment of nutritional quality of meals: a systematic review

“…The dietary assessment method used in each study is presented in Table 2. The studies that were analysed in the systematic review were based on the collection of dietary information through the application of 24-h recalls (25) , food diaries (29) , FFQ (26) , menus (23) , weighted foods (27,28) and meal screeners (30) . The methods observed for data collection regarding dietary intake are the ones traditionally used for research in nutrition, with exception of the meal screener, which was proposed and validated especially for the development of the meal quality index in the study conducted by Fulkerson et al (30) .…”

“…The number of components among the indices ranged between three and fifteen items. Most of the indices included three items as components for meal quality assessment: (I) total fat or some specific type of fat (23,(26)(27)(28)(29) , (II) fruits and vegetables (23,(26)(27)(28)(29) and (III) cereals or whole grains (25)(26)(27)(28) . Other items usually prevalent in meal quality indices were dairy products and Ca (25,26) , diversity of food items and food groups (23,30) and added sugar (28,29) .…”