(P07-004-25) Global Diet Quality Score (GDQS)-Meal and Menu Benchmarks: Assessing the Nutritional Quality of Meals and Menus in Institutional Settings

Objectives: School feeding programs operate in almost every country but are rarely evaluated for nutritional quality in a comparable way globally. The Global Diet Quality Score (GDQS)-Meal and Menu metrics were developed to provide an easy and cost-effective way to measure the nutritional quality of meals/menus in institutional settings. The suite of metrics consists of an overall metric (Total GDQS-Meal/Menu), an intermediate metric (Base GDQS-Meal/Menu), and four sub-metrics (Healthy GDQS+ Meal/Menu, Unhealthy GDQS- Meal/Menu, Fortification and Biofortification Meal/Menu, and Food Group Diversity Meal/Menu). The purpose of this study was to validate benchmarks for these metrics and sub-metrics.

Methods: The validation of the GDQS-Meal and Menu benchmarks included identifying school meal/menu data from five countries; tabulating the GDQS-Meal and Menu metrics for each of the meals/menus for three age groups (24-59 months, 5-9 years, 10-14 years); matching food items in the school meal/menu data with energy and 11 critical nutrients of public health concern; comparing the nutrient levels of the meals/menus with the recommended meal/menu amount for each nutrient; calculating nutrient ratios to compare the nutrient level provided in each meal/menu to the recommended amount for each nutrient (1/3 of age- and sex-specific Recommended Dietary Allowances); and comparing the set of nutrient ratios to the GDQS-Meal and Menu scores and benchmarks.

Results: The results from the validation analyses show that across the meals and menus analyzed the proposed benchmarks meaningfully discriminate between meals and menus that are of lower and higher nutritional quality. Results were consistent across the 5-9- and 10-14-year age groups for all metrics and sub-metrics. Limited data for the 24-59-month age group precluded robust analyses but indicated validity for the Fortification and Biofortification Meal/Menu sub-metric.

Conclusions: The results from the validation study suggest that the GDQS-Meal and Menu benchmarks provide an objective measure by which to evaluate the nutritional quality of school meals and menus comparably over time, across schools, contexts, and countries. The benchmarks provide interpretable cut-points on which to make decisions for improving the quality of the meals and menus in institutional settings.

Funding Sources: The Rockefeller Foundation