Development and validation of the Brazilian Dietary Guidelines Adherence Score (BraScore): a novel index to assess the adherence to the Dietary Guidelines for the Brazilian Population

Abstract Objective: We aimed to describe the development and evaluation of the Brazilian Dietary Guidelines Adherence Score (BraScore). Design: The process comprised multiple steps: defining guiding principles, identifying food components, setting scoring cut-off points and assessing validity and reliability. Setting: Nationally representative sample of the Brazilian population. Participants: 46 164 Brazilians aged ≥ 10 years. Results: The BraScore has ten components: to be consumed (legumes; fruits; vegetables and diversity), to be limited (red meat; other animal-based foods; processed foods; table sugar and cooking salt) and to be avoided (ultra-processed foods). Scores range from 0 to 100, with higher values indicating greater adherence to the Dietary Guidelines. Analyses showed a weak correlation with energy intake (coefficient: –0·12) and substantial variability among individuals (1st percentile: 20·5; 99th: 77·7). Scree plot analysis revealed multidimensionality, indicating four distinct patterns. The scores differentiated population groups (older adults and rural residents had higher scores) and were high for diets developed by nutritionists (84·6–97·6 points). The reliability analysis yielded a coefficient of 0·6, suggesting acceptable internal consistency. Conclusions: The BraScore is a valid and reliable tool to assess adherence to the Dietary Guidelines for the Brazilian Population.