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

Abstract

This systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs, SciELO, Scopus, Cochrane, Embase and Google Scholar. The literature search resulted in seven different meal quality indices. Each article was analysed in order to identify the following items: authors, country, year, study design, population characteristics, type of meal evaluated, dietary assessment method, characteristics evaluated (nutrients or food items), score range, index components, nutritional references, correlations performed, validation and relationship with an outcome (if existing). Two studies developed instruments to assess the quality of breakfast, three analysed lunch, one evaluated dinner and one was applied to all types of meals and snacks. All meal quality indices reviewed were based on the evaluation of presence or absence of food groups and relative contributions of nutrients, according to food-based guidelines or nutrient references, adapting the daily dietary recommendations to one specific meal. Most of the indices included three items as components for meal quality assessment: (I) total fat or some specific type of fat, (II) fruits and vegetables and (III) cereals or whole grains. This systematic review indicates aspects that need further research, particularly the numerous approaches to assessing meals considering different foods and nutrients, and the need for validation studies of meal indices.

Nutritional quality of meals and snacks assessed by the Food Standards Agency nutrient profiling system in relation to overall diet quality, body mass index, and waist circumference in British adults

“…Thus, understanding how nutritional quality of meals and snacks is associated with overall diet quality and health status (such as measures of body fatness) is important for the development of science-based recommendations of meals and snacks for consumers [ 5 ]. While Dietary Reference Intakes and other dietary recommendations are given on a per day basis, nutritional advice considering meals and snacks separately might also be easier and more practical for people to understand and follow dietary guidelines [ 5 , 6 ].…”

“…Another important issue is a lack of established tools for assessing nutritional quality of meals and snacks [ 6 ]. In this context, the British Food Standards Agency (FSA) nutrient profiling system [ 35 – 37 ] may be a suitable or attractive choice.…”

Childhood Obesity and Quality of Meals: The Saudi School Meal and Home Meal Study SSMHMS – A Cross Sectional Study

“…In addition, we were using super tracker due to its convenience and easy use and also it is considered a method that is applicable to the community to enhance healthy eating by measuring nutrients intake in the diet, but unlikely for the Saudi populations [42]. However for the future we aim to use other meal analysis softwares, combined with food composition tables to define Saudi meals, and also not only focusing on carbohydrates, fats and proteins but also on essential nutrients including vitamins and minerals [43]. These results has been added to this paper in order to find a solution and discuss possible ways to reach mothers in our next studies.…”

Agreement between two Meal Quality Indexes adapted to evaluate food consumption of institutionalized elderly

“…The quality of food and of meals can be assessed by means of consumption patterns, by a priori dietary indexes, such as the Meal Quality Index (MQI) [16] and the Main Meal Quality Index (MMQI) [17]. However, there is a lack of dietary indexes to evaluate the meal quality of the elderly, especially of those institutionalized, since no index applied to this target audience has been found in the literature to date [18,19].…”