Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece.
Adv Nutr. 2011 Jul;2(4):295-303. doi: 10.3945/an.110.000166. Epub 2011 Jun 28.
In this article, we review studies that have used dietary indexes to assess different aspects of diet in relation to health outcomes and sociodemographic factors in childhood populations of developed countries. Eighty-four papers published from 1980 to mid-2010 including 90 unique dietary indexes were reviewed. Seventy-two indexes were developed (or have been adapted) specifically for childhood populations; 38 of these were used to assess diet-disease associations, mostly of diet and obesity. In the majority of these studies, small inverse associations between dietary indexes and obesity indexes were shown. Children who were younger, female, and from high-income families had better dietary quality scores. Forty-nine indexes (of 90) were compared with other aspects of dietary intakes or behaviors, with correlations ranging from very low to modest (∼r = 0.05-0.50). Only 2 validation studies compared an index with nutritional biomarkers, and correlations were quite weak for most plasma nutrients (P < 0.10). Overall, a large number of indexes have been created and used, but the majority of studies are descriptive. Fewer analytic studies on index-health associations have been performed, and most analyses insufficiently adjusted for confounders. Thus, prospective and intervention research in diverse populations is needed to further test these tools. In conclusion, indexes are potentially useful methods for dietary assessment, because they offer valuable information on overall dietary patterns in children. However, understanding the advantages and limitations when applying them in research and public health settings is important, and more research is needed to further develop their utility.
本文综述了 1980 年至 2010 年年中期间，在发达国家儿童人群中，使用饮食指数评估不同方面的饮食与健康结果和社会人口因素关系的研究。共综述了 84 篇文献，其中包括 90 个独特的饮食指数。其中 72 个指数是专门为儿童人群开发（或改编）的；其中 38 个用于评估饮食与疾病的相关性，主要是饮食与肥胖的相关性。在这些研究中，大多数研究表明饮食指数与肥胖指数之间呈负相关，但关联程度较小。年龄较小、女性和来自高收入家庭的儿童具有更好的饮食质量评分。49 个指数（共 90 个）与其他饮食摄入或行为方面进行了比较，相关性从非常低到适度（约 r = 0.05-0.50）。只有 2 项验证研究将指数与营养生物标志物进行了比较，且大多数血浆营养素的相关性都很弱（P < 0.10）。总体而言，已经创建和使用了大量的指数，但大多数研究都是描述性的。关于指数与健康关联的分析性研究较少，且大多数分析对混杂因素的调整不足。因此，需要在不同人群中开展前瞻性和干预性研究，以进一步检验这些工具。总之，指数是评估饮食的潜在有用方法，因为它们提供了有关儿童整体饮食模式的有价值的信息。然而，了解在研究和公共卫生环境中应用它们的优势和局限性非常重要，并且需要进一步研究以进一步提高它们的效用。
