Evidence map›Paper›PMID 41317033›Full record

ArticleNutrition reviews2026

Scoping Review of Dietary Quality Indices: Heterogeneity of Definitions and Health Associations among Adults.

Christine El-Khoury, Franziska Jannasch, Matthias B Schulze

Abstract readScoping Review
In one paragraph

Article in Nutrition reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Christine El-KhouryDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.ORCID 0009-0002-3665-130X
Franziska JannaschDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.ORCID 0000-0003-3478-4758
Matthias B SchulzeDepartment of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 14558 Nuthetal, Germany.ORCID 0000-0002-0830-5277

Funding

European Union's Horizon 2020 research and innovation program 727565Federal Ministry of Agriculture, Food and Regional IdentityFederal Ministry of Agriculture, Food and Regional Identity based on a decision of the Parliament of the Federal Republic of Germany via the Federal Office for Agriculture and Food 2822ERA12FParliament of the Federal Republic of Germany via the Federal Office for Agriculture and Food 2822ERA12F
6 · The paper itself

Abstract

The application of dietary quality indices (DQIs) is limited by inconsistent methods and suboptimal reporting, but the effect of index composition heterogeneity on the strength of disease associations is not clear. A scoping review was carried out to identify evidence on the most common disease-related DQIs and assess the heterogeneity of their application and its possible implications. We systematically identified umbrella reviews, systematic reviews, and primary studies that investigated the association of DQIs with all-cause mortality, risk of or mortality from cardiovascular diseases, type 2 diabetes, and cancer among adults. Compositions of the prioritized DQIs were explored in primary studies and the degree of deviance from the original DQI versions was quantified. A meta-regression was conducted to investigate the association between the degree of score modification and disease risk estimates. From 175 eligible primary studies, 51 DQIs were identified and retrieved from 20 systematic reviews included in 2 umbrella reviews. The most common indices were the Mediterranean diet (MedDiet scores), Alternative Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI), and Dietary Inflammatory Index (DII). Higher diet quality reflected by these indices was associated with beneficial health outcomes in 17 meta-analyses. Heterogeneity of MedDiet scores was not considered, because it has been addressed in previous reviews. Substantial heterogeneity was identified in the remaining DQI applications. Among studies that reported composition details, AHEI-2010 and DII were modified in almost all studies, and DASH and HEI-2015 in half of the studies. The underlying reasons were mainly related to population- and study-specific characteristics. DQI modifications did not appear to substantially influence the direction or strength of associations with mortality and disease risk. However, heterogeneity of index composition and its suboptimal reporting limit the reproducibility and comparability of results from studies on DQIs and health outcomes, and standard applications are preferred.

Indexed as

DietDiet, HealthyAdultCardiovascular DiseasesDiabetes Mellitus, Type 2Dietary Approaches To Stop HypertensionDiet, MediterraneanHumansNeoplasmsall-cause mortalitycancercardiovascular diseasesdietary quality indicestype 2 diabetes

Identifiers

PMID41317033
PMCPMC13659007

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.