Translation, Cross-Cultural Adaptation, and Psychometric Validation of Dietary Behavior Instruments into Arabic for the MENA Region: A Systematic Review from BRIDGE Project

$\textbf{Background/Objectives:}$ Accurate assessment of dietary behaviors is essential for understanding their impact on health and guiding nutritional policies. Given the escalating prevalence of noncommunicable diseases in the MENA region, the availability of culturally adapted and psychometrically validated Arabic-language instruments is essential for accurate health assessment. This systematic review aims to identify and evaluate studies that have translated, adapted, or validated dietary behavior measurement instruments into Arabic.

$\textbf{Methods:}$ Following the PRISMA guidelines and registered in PROSPERO (CRD420251157552), a search was conducted in PubMed, Scopus, and Web of Science. Studies including the validation, translation, or adaptation of instruments into Arabic among Arabic-speaking populations were included. Methodological quality was assessed using the COSMIN checklist.

$\textbf{Results:}$ Thirty-two studies were included, published between 2006 and 2025, primarily in Lebanon (n = 14) and Saudi Arabia (n = 6). The instruments measured various concepts: dietary intake, diet quality, eating disorders, etc. ... mehrWhile internal consistency and structural validity were frequently assessed with adequate methodological quality, content validity, measurement error, and responsiveness were either under-reported or failed to meet COSMIN standards.

$\textbf{Conclusions:}$ Despite an increasing volume of publications, the methodological quality of Arabic instrument validation remains heterogeneous, with significant gaps in the assessment of longitudinal properties. Efforts are needed to improve the rigor of adaptation processes and to evaluate key properties such as responsiveness in order to ensure reliable tools for research and clinical practice in the MENA region