The present review provides an overview of the different dietary quality indices in use. In the first decades, most indices were developed for the general adult population and were based on the American dietary guidelines and the Mediterranean diet. This review focuses on new, other dietary quality indices with special attention to the make-up of the score and methodological issues.
Most of the new diet quality indices are based on the national dietary recommendations in Europe and Australia. In addition, one index is based on international recommendations and two indices use recommendations for the prevention of specific diseases. In addition, there are dietary scores that focus on specific groups (children, pregnant women), and on dietary variety or diversity.
The use of diet quality indices becomes more widespread and tailored to the specific purpose and population. However, different approaches are also due to arbitrary choices because of lacking knowledge on healthy diets and unsolved methodological issues. The ways of dealing with differences in energy intake, scoring each component, and combining the different components into one measure are aspects that still need further research.
National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Correspondence to Marga C. Ocké, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands Tel: +31 30 274 3814; fax: +31 30 274 4466; e-mail: MC.Ocke@rivm.nl