Fig. 1

Study design flowchart. The Meal and Snack Assessment (MESA) Quality Scale development was guided by recommendations for psychometric studies, a science that studies the measurement of non-directly observable phenomena (latent traits): Latent trait definition (1); Item generation (2); Dimensionality analysis (3); Estimation of item parameters (4); Linear transformation of parameters (5); Scale levels definition (6); Assessment of scale's validity (7), and reliability (8); Estimation of the latent trait of the individuals in the sample (9)