Development and Validation of a Dietary Adherence Index for Mexican Women Based on the Mexican Dietary Guidelines...

Women of childbearing age have the highest prevalence of malnutrition in Mexico. The 2023 Mexican Healthy and Sustainable Dietary Guidelines (GASS) aim to address this issue through health and sustainability recommendations. However, the absence of tools that assess adherence limits monitoring and policy application.

To develop and validate the GASSMx-2023 tool (GASSMx-2023 index) and its associated score to measure adherence to the GASS among Mexican women aged 20-49 years.

A methodological study was conducted to develop a tool based on GASS food groups, subgroups, and recommended intake levels. Validation was conducted using a national subsample of women from the 2020 National Health and Nutrition Survey (ENSANUT) and involved three phases: i) content validity by expert judgment, ii) internal consistency, and iii) construct validity.

The developed tool includes nine components and 15 subcomponents; the maximum score was 95 points, based on adequacy, moderation, and optimal intake metrics. Content validity was acceptable (coefficient = 0.8). Vegetables, fruits, whole grains, eggs, and beef accounted for 71% of the score variability. The index showed independence from energy intake and good discriminatory power, distinguishing women in extreme quartiles. It also detected differences between groups based on diet-related individual characteristics, in accordance with the GASS framework.

The GASSMx-2023 index is a novel tool for assessing adherence to the GASS and distinguishing dietary quality among Mexican women aged 20-49. Its ability to identify key consumption patterns and support nutrition policy makes it a valuable instrument for improving dietary health in Mexico.