title: The development and evaluation of the Australian child and adolescent recommended food score: a cross-sectional study.
abstract: BACKGROUND
  Diet quality tools have been developed to assess the adequacy of dietary patterns for predicting future morbidity and mortality. This study describes the development and evaluation of a brief food-based diet quality index for use with children at the individual or population level. The Australian Child and Adolescent Recommended Food Score (ACARFS) was developed to reflect adherence to the Dietary Guidelines for Children and Adolescents in Australia and modelled on the approach of the US Recommended Food Score.
  
  
  METHODS
  The ACARFS has eight sub-scales and is scored from zero to 73. The diet quality score was evaluated by assessing correlation (Spearman's correlations) and agreement (weighted κ statistics) between ACARFS scores and nutrient intakes, derived from a food frequency questionnaire in 691 children (mean age 11.0, SD 1.1) in New South Wales, Australia. Nutrient intakes for ACARFS quartiles were compared with the relevant Australian nutrient reference values.
  
  
  RESULTS
  ACARFS showed slight to substantial agreement (κ 0.13-0.64) with nutrient intakes, with statistically significant moderate to strong positive correlations with all vitamins, minerals and energy intake (r = 0.42-0.70). ACARFS was not related to BMI.Participants who scored less than the median ACARFS were more likely to have sub-optimal intakes of fibre, folic acid and calcium.
  
  
  CONCLUSIONS
  ACARFS demonstrated sufficient accuracy for use in future studies evaluating diet quality. Future research on its utility in targeting improvements in the nutritional quality of usual eating habits of children and adolescents is warranted.
authors.affiliation: Lighthouse Nutrition Pty Ltd, 1/23 Namitjira Place, Ballina 2478NSW, Australia..
authors.forename: Skye
authors.initials: S
authors.lastname: Marshall
authors.forename: Jane
authors.initials: J
authors.lastname: Watson
authors.forename: Tracy
authors.initials: T
authors.lastname: Burrows
authors.forename: Maya
authors.initials: M
authors.lastname: Guest
authors.forename: Clare E
authors.initials: CE
authors.lastname: Collins
mesh_terms: D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002136:Calcium, Dietary / Q000008:administration & dosage; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D004032:Diet / Q000592:standards* / Q000706:statistics & numerical data; D004043:Dietary Fiber / Q000008:administration & dosage; D005247:Feeding Behavior; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D009517:New South Wales; D015596:Nutrition Assessment; D009753:Nutritive Value; D012016:Reference Values; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D054928:Validation Studies as Topic
chemical_list: D002136:Calcium, Dietary; D004043:Dietary Fiber; D018977:Micronutrients; D005492:Folic Acid