The Healthy Eating Index: Design and Applications

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Abstract

Objective To develop an index of overall diet quality.

Design The Healthy Eating Index (HEI) was developed based on a 10-component system of five food groups, four nutrients, and a measure of variety in food intake. Each of the 10 components has a score ranging from 0 to 10, so the total possible index score is 100.

Methods/subjects Data from the 1989 and 1990 Continuing Survey of Food Intake by Individuals were used to analyze the HEI for a representative sample of the US population.

Statistical analyses performed Frequencies, correlation coefficients, means.

Results The mean HEI was 63.9; most people scored neither very high nor very low. No one component of the index dominated the HEI score. People were most likely to do poorly in the fruit, saturated fat, grains, vegetable, and total fat categories. The HEI correlated positively and significantly with most nutrients; as the total HEI increased, intake for a range of nutrients also increased.

Discussion/conclusions The HEI is a useful index of overall diet quality of the consumer. The US Department of Agriculture will use the HEI to monitor changes in dietary intake over time and as the basis of nutrition promotion activities for the population. J Am Diet Assoc. 1995; 95:1103-1108.

Section snippets

Overall Structure of Healthy Eating Index

The HEI has 10 components, which are based on different aspects of a healthful diet. For each component, respondents receive a score ranging from 0 to 10. Thus, the overall index has a range from 0 to 100. The components are defined as follows and described more fully in Table 1. Components 1 through 5 measure the degree to which a person's diet conforms to the serving recommendations of the USDA Food Guide Pyramid (12) for five major food groups: grains, vegetables, fruits, milk, and meat.

Results

The mean HEI score for 1989 and 1990 combined was 63.9 (Table 4). Few people scored very high or very low on the HEI. Only 2% to 3% of the sample had a mean score below 40. Similarly, 11% to 12% of the sample had an HEI score higher than 80.

No one category contributed disproportionately to the mean score (Table 5). Mean component scores were lowest for fruits (4.0) and saturated fat (5.1). Mean component scores for grains, vegetables, and total fat were similar, ranging from 6.1 to 6.3. The

Discussion and Applications

The HEI was developed using the most current scientific information available including the Dietary Guidelines. The HEI is a mechanism that allows individuals to assess the overall quality of their diets, not simply isolated components. Development of the HEI involved a number of key design decisions, which are discussed next.

Obesity is an ever-increasing public health problem in the United States, and during the early development work for the HEI, the possibility of including a component that

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