Índices de qualidade da dieta direcionados à população em geral que abarcam a diversidade ou variedade alimentar: uma revisão de escopo

Abstract

Introduction: To date, no state-of-the-art systematizations have been identified on the design and validation of diet quality indices that include dietary diversity as one of their components and indices/indicators of diet variety and diversity. Objective: Systematize the existing literature on the design and validation of diet quality indices that encompass dietary diversity or variety and indices/indicators of variety and diversity. Method: A scoping review was carried out on this topic. The searches were carried out using the following databases: Medline (via Ovid), Embase, Web of Science, Scopus and Lilacs. Studies that designed or validated diet quality indices and variety and diversity indices/indicators were eligible. Results: 50 design studies were identified, of which 33 also carried out the performance assessment of diet quality indices and diversity and variety indices/indicators and ten correspond to studies that only carried out the performance assessment of these indices or indicators. In these studies, 55 diet quality indices and indices/indicators of dietary variety and diversity were identified. It was observed that the diet quality indices and the variety and diversity indices/indicators showed significant heterogeneity in relation to their components (foods, food groups and/or nutrients) and constructs (when present), scoring methods, cut-off points and reference periods and methods for assessing food consumption. On the other hand, there was convergence in relation to the presence of food groups referring to grains, vegetables, fruits, milk and meat and the use of local dietary recommendations (such as Food Guides) in establishing the parameters of indices and indicators, in addition to presenting one or more components and/or constructs composed of foods or nutrients whose consumption in large quantities is not recommended or is limited based on dietary guidelines. For most of the diet quality indices included in the present study, a conceptual definition was not identified of food variety or diversity, just a definition of its operationalization. In this review, it was observed that 40 (73,0%) of the 55 indexes and indicators identified had at least one validation study, and for 34 of them (85,0% of the 40), only one study was carried out. Of the 43 studies that carried out validation, 37 (86,0%) carried out one of the types of validation (or construct, or content, or relative/criterion) and six (14,0%) carried out two of the types of validation. Of this total of studies, 38 (88.4%) carried out some type of construct validation, nine (20.9%), relative/criterion validation and two (4.7%), content validation. Conclusion: This scoping review encompasses exclusively measures that encompass the component of variety or diversity. It presents a summary of its constituent elements in order to disseminate the heterogeneity present in the measures and facilitate consultation by researchers interested in the subject.