This study aimed to develop and evaluate the Meal and Snack Assessment (MESA) quality scale to measure meal quality in schoolchildren based on food processing degree. Utilizing a methodological approach grounded in the generalized graded unfolding model (GGUM) of item response theory (IRT), the research analyzed data from 6,399 schoolchildren aged 6 to 15 attending public elementary schools in Florianópolis, Brazil, between 2013 and 2015. The study defined meal quality as a latent trait and involved several steps including item generation and validation. Out of 18 items, 11 showed adequate parameters without differential item functioning across sex or age, categorizing meal quality into three levels: healthy, mixed, and unhealthy. The findings revealed that 40.6% of the children had mixed meal patterns, while 41% had unhealthy patterns, highlighting a higher prevalence of ultra-processed foods, particularly during snack times. This indicates that snacks may be a crucial area for nutritional interventions.
Source: Canva