title: Systematic review of diet quality indices and their associations with health-related outcomes in children and adolescents.
abstract: BACKGROUND
  Diet quality indices add an important dimension to dietary assessment. The aim of this systematic review was to: (i) identify and describe the attributes and applications of diet quality indices developed for use or used in paediatric populations; (ii) describe associations between these diet quality indices and health-related variables in paediatric populations; and (iii) identify factors that are associated with diet quality in paediatric populations worldwide.
  
  
  METHODS
  Studies were identified by searching electronic databases for relevant papers from 1980 to October 2013 using keywords. Inclusion criteria were original studies that utilised a quantitative measure of diet quality in children and adolescents aged 0-18 years.
  
  
  RESULTS
  One hundred and nineteen studies met the inclusion criteria, from which 80 different diet quality indices were identified. The majority of studies had >1000 participants and were of acceptable quality. Of the 56 studies that investigated health-related outcomes, weight status was the most researched. Europe produced the most number of diet quality indices (n = 27 indices). Of the 119 studies, seven intervention studies were identified. Paediatric diet quality indices were found to be associated with environmental, behavioural and maternal factors.
  
  
  CONCLUSIONS
  The use of diet quality indices in paediatric populations is a rapidly expanding area of research in diverse populations internationally. In economically disadvantaged countries, diet quality indices may be predictive of child growth. However, prospective cohort, intervention and validation studies are required to draw stronger conclusions concerning risk of future disease in paediatric populations in general.
authors: Nutrition and Dietetics, Faculty of Health, School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia.
authors: S
authors: S
authors: Marshall
authors: T
authors: T
authors: Burrows
authors: C E
authors: CE
authors: Collins
mesh_terms: D000293:Adolescent; D002648:Child; D004032:Diet / Q000592:standards*; D004034:Diet Surveys; D005247:Feeding Behavior; D006262:Health; D006801:Humans; D009752:Nutritional Status; D011446:Prospective Studies
keywords: diet index; diet quality; diet variety; nutrition assessment; pediatric; systematic review