Compatibility of the food compass with dietary indices and sustainable eating behaviors: toward a multidimensional assessment tool

Abstract Background Non-communicable diseases remain the leading cause of global mortality, with diet being a major modifiable risk factor. The Food Compass (FC), a novel nutrient profiling system, offers a broader perspective. This study aimed to assess the correlation between a Dietary Index (DI) derived from Food Compass and two established indices Healthy Eating Index (HEI) and the Mediterranean Adequacy Index (MAI), and to examine its association with sustainable and healthy eating behaviors (SHEB). Methods In this cross-sectional study, 294 participants completed a questionnaire to collect sociodemographic information, underwent anthropometric measurements, and provided 24-hour dietary recalls. From these dietary recalls, HEI, MAI, and DI scores were calculated. SHEB was assessed using a validated scale. Results The DI showed significant correlations with HEI ( r = 0.20, p < 0.01) and MAI ( r = 0.46, p < 0.01). Only the DI demonstrated a significant association with SHEB ( r = 0.17, p < 0.01). Bland–Altman analyses revealed overall agreement between the indices, with HEI showing relatively homogeneous differences from the DI. Regression analysis confirmed DI as an independent predictor of SHEBS (β = 0.12, p = 0.034). Conclusions FC may serve as a novel, multidimensional dietary assessment tool that better captures sustainable eating behaviors compared to traditional indices.