Development of the VEGANScreener, a tool for a quick diet quality assessment among vegans in Europe
Authors: Kronsteiner-Gicevic Selma , Bogl Leonie H. , Wakolbinger Maria , Müller Sandra , Dietrich Joelina , Keyzer Willem , Bullón-Vela Vanessa , Selinger Eliska , Keller Vanessa , Tabar Ainara Martínez , Asif Tooba , Craig Leone , Kyle Janet , Schlesinger Sabrina , Köder Christian , Ouradova Anna , Henikova Marina , Lippevelde Wendy , Cahova Monika , González Miguel Angel Martínez , Willett Walter , Bes-Rastrollo Maira , Gojda Jan , Henauw Stefaan , Keller Markus , Kuzma Marek , Schernhammer Eva 
Published: January 2024

Background
The adoption of plant-based and vegan diets is on the rise, paralleling heightened awareness of animal welfare, environmental issues related to climate change, and potential health concerns associated with consumption of animal-source foods. However, plant-based diets are not inherently healthy. Similar to omnivorous diets, they may contain excessive amounts of sugar, sodium, and saturated fats, or lack diversity. Moreover, vegans might be at risk of inadequate intake of certain vitamins and minerals commonly found in foods they avoid, such as riboflavin, niacin, cobalamin, vitamin D, iodine, iron, zinc, calcium, selenium, and long-chain n-3 fatty acids. To address this, we developed the VEGANScreener, a tool designed to assess the diet quality of vegans in Europe.
Methods
Our approach combined best practices in developing diet quality metrics with scale development approaches and involved: a) narrative literature synthesis, b) evidence evaluation by an international panel of experts, and c) translation of evidence into a diet screener. We employed a modified Delphi technique to gather opinions from an international expert panel, which involved identifying an item pool across various diet quality domains, two online feedback and voting rounds, and a concluding online consensus meeting transforming items into measurable dietary quality indicators.
Results
Twenty five experts in the fields of nutrition, epidemiology, preventive medicine and diet assessment participated in the first round, and 19 in the subsequent round. Initially, these experts provided feedback on a pool of 38 proposed items from the literature review. Consequently, 35 revised items, with 17 having multiple versions, were suggested for further consideration. In the second round, 29 items were retained, and any residual issues were addressed in the final consensus meeting. The ultimate screener draft encompassed 29 questions and one sub-question; 17 of these questions focus on foods and nutrients to promote, and 12 (plus one sub-question) address foods and nutrients to limit. In total, the screener contains 24 food- and five nutrient-based questions.
Conclusion
We have elucidated the development process of the VEGANScreener, a novel diet quality screener for vegans. Future endeavors involve contrasting the VEGANScreener against benchmark diet assessment methodologies and nutritional biomarkers and testing its acceptance. Once validated, this instrument holds potential for deployment as a self-assessment application for vegans and as a preliminary dietary screening and counseling tool in healthcare settings.