Designing a nutritional scoring system for assessing diet quality for children aged 10 years and under in the UK

In the UK there is no Diet Quality Index (DQI) that enables estimates of diet quality to be made for children of different age groups. This paper discusses the methodological complexities of designing an appropriate DQI for children aged 10 years and under, using dietary data in the National Diet and Nutrition Survey (NDNS) in relation to UK dietary guidelines. Two stages of the process of developing this score are described. The final score was employed as an outcome measure in secondary analysis of the NDNS and as a means of sampling 48 case study children from the NDNS. This DQI, like all composite measures, produces a summary of overall dietary quality. This may mask individual components important for understanding the health impacts of children's diets. However, DQIs are methodologically advantageous over 'data driven' dietary pattern approaches because they are based on existing knowledge of optimal dietary patterns and provide clear nutritional benchmarks for comparing dietary quality for population sub-groups. Our innovative scoring system enables children's diets to be compared for different age groups relative to UK dietary guidelines and is appropriate for use in quantitative analysis and for assessing diet quality more qualitatively for small groups of children.