Nutrition plays a vital role in the prevention of chronic diseases such as coronary heart disease, hypertension, and diabetes. The Healthy Eating Index (HEI) is a measure of the overall quality of an individual's diet. It was developed by the U.S. Department of Agriculture (USDA) to assess how well American diets comply with the 2000 Dietary Guidelines for Americans and the Food Guide Pyramid.
The HEI measures the intake of ten dietary components to provide a single score out of a possible 100 points. A diet with a score greater than 80 is considered "good," one with a score of 51-80 is considered "fair," and one with a score of less than 51 is considered "poor." Each component contributes equally to the overall score.
Components 1–5 assess how well an individual's diet complies with the Food Guide Pyramid serving recommendations for the Grain, Vegetable, Fruit, Milk, and Meat Groups. Recommended servings for each food group are calculated based on diets containing 1,600, 2,200, and 2,800 calories per day. Components 1–5 have a maximum of 50 points, with 10 coming from each food group. A score of zero is assigned to a group if no items from that category are consumed. Intermediate scores are calculated proportionately to the number of servings consumed.
Component 6 assesses total fat consumption as a percentage of total caloric intake. Ten points are given if fat intakes are less than or equal to 30 percent of total calories. Zero points are given if the proportion of fat
By applying the Healthy Eating Index (HEI) to data gathered by various consumer surveys, the USDA is able to assess the quality of Americans' diets. Recent HEI results suggest that Americans need to eat more fruit.
to total calories is 45 percent or higher. Intakes between 30 percent and 45 percent are scored proportionately.
Component 7 assesses saturated fat consumption as a percentage of total caloric intake. Ten points are given to saturated fat intakes of 10 percent or less of total calories. Zero points are given if the saturated fat intake is 15 percent or more of total calories. Scores between the two cutoff values are calculated proportionately.
Component 8 assesses total cholesterol intake. It is recommended that individuals consume no more than 300 milligrams of cholesterol daily. Ten points are given if cholesterol intake is less than or equal to 300 milligrams. Zero points are given when intake reaches 450 milligrams or more. Values between the two cutoff points are scored proportionately.
Component 9 assesses total sodium intake. Individuals should ideally consume no more than 2,400 milligrams of sodium daily. Ten points are given at an intake level of 2,400 milligrams or less. Zero points are given at a level of 4,800 milligrams or more. Scores between the two levels of intake are scored proportionately.
Component 10 assesses variety in the diet. While there is agreement that individuals should eat a variety of foods daily, there is no consensus of how to measure variety. The HEI measures variety by adding together the number of "different" foods eaten in amounts sufficient to contribute at least one-half of a serving in a food group. Ten points are given if at least half a serving of eight or more different types of food items are eaten daily. Zero points are given if at least half a serving of three or fewer different foods were eaten in a day. Intermediate intakes are calculated proportionately.
The USDA periodically applies the HEI to data from the national food consumption surveys. The most recent HEI uses data from the National Health and Nutrition Examination Survey (NHANES). Previous data were based on the Continuing Survey of Food Intakes by Individuals (CSFII). Current data are based on 24-hour dietary recalls of representative samples. The HEI is computed for Americans two years of age and older. The findings indicated that:
- HEI scores have improved slightly since 1989, but did not change significantly from 1996 to 2000.
- The mean HEI score for 1999-2000 was 63.8.
- Most Americans need to improve their diet, especially in the Fruit Group and Milk Group.
- HEI scores improved with education.
- HEI is only modestly affected by income.
- Non-Hispanic blacks, low-income groups, and those with a high school diploma (or less education) had lower-quality diets.
- Women tend to have higher scores than men.
The HEI is a practical tool for assessing dietary quality, and results from the index can provide insights on how to improve eating patterns. Different strategies need to be developed to reach different segments of the population. The USDA Center for Nutrition and Public Policy has developed an interactive, self-assessment version of the Healthy Eating Index, which can be found on its Web site.
Delores C. S. James
Basiotis, P.; Carlson, A.; Gerrior, S.; Juan, W.; and Lino, M. (2002). The Healthy Eating Index 1999–2000. Washington, DC: U.S. Department of Agriculture.
U.S. Department of Health and Human Services (2000). Healthy People 2010, Conference Edition, in Two Volumes. Washington, DC: U.S. Public Health Service.
Center for Nutrition and Public Policy. "The Interactive Healthy Eating Index." Available from <http://220.127.116.11/default.asp>
U.S. Department of Agriculture. "The Healthy Eating Index." Available from <http://www.nalusda.gov/fnic>