Article

Modifications to the Healthy Eating Index and its ability to predict obesity: the Multi-Ethnic Study of Atherosclerosis.

Department of Epidemiology, University of Washington, Seattle, WA, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.92). 07/2008; 88(1):64-9.
Source: PubMed

ABSTRACT The Healthy Eating Index (HEI) is a measure of diet quality developed based on the Dietary Guidelines for Americans (DGA).
The objective was to assess the diet quality of a multi-ethnic population using and comparing the 2 HEIs, the updated HEI (HEI-05) based on the 2005 DGA and the original 1990 HEI (HEI-90), with the objective of predicting obesity outcomes.
A longitudinal analysis of survey and clinical data from 6236 middle-aged and elderly white, African American, Hispanic, and Chinese participants of the Multi-Ethnic Study of Atherosclerosis (MESA) was conducted. Baseline diet quality was assessed with the use of HEI-90 and HEI-05. Baseline and 18-mo follow-up body mass index (BMI) and waist circumference (WC) data were predicted by using z score multiple regression models, and categorical obesity status was predicted by using multinomial logistic regression.
Overall, the HEI-05 had larger z score beta coefficients than did the HEI-90 (eg, in whites, -0.53 compared with -0.48 in baseline BMI, -0.54 compared with -0.47 in follow-up BMI, -1.67 compared with -1.56 in baseline WC, and -1.57 compared with -1.44 in follow-up WC). Among whites only, both HEIs were significant predictors of BMI and WC (all P < 0.001). The odds of being obese rather than normal weight were inversely related to HEI z scores primarily in whites (P < 0.05).
The changes to the 2005 DGA, as reflected by HEI-05, appear to better predict obesity outcomes in this multi-ethnic population, primarily in whites. Additional research on ethnic-specific DGA adherence and its relation to health outcomes is needed.

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    • "In the present study, the previously described HEI-2005 (Guenther et al. 2007, 2008), adapted to Brazilian dietary guidelines (B-HEI), was applied in an attempt to establish this relationship. The finding that the subset of individuals with the highest B-HEI values had better measures of body adiposity (lower BMI and waist circumference) is in agreement with the results of 2 other studies (Guo et al. 2004; Gao et al. 2008). It is noteworthy that in our analysis of single components, saturated fatty acids intake, which has been recognized as a major nutrient responsible for weight gain in modern societies, may have contributed to the finding of an inverse association with waist circumference (WHO 2003; Hooper et al. 2012). "
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    • "Examination of the total diet and nutrient intake patterns of individuals may provide better measures of diet exposure, helping identify individuals who may benefit from targeted nutritional risk interventions [9] [10]. Few studies have evaluated overall dietary quality using composite dietary indices/scores in relation to abdominal adiposity, [10] [11] [12] [13] [14] [15] [16] and the majority are cross-sectional investigations [11] [12] [13] [14] [15]. Further, none of the existing composite dietary quality indices/scores are based on a specific evidence basis for the most consistent dietary determinants of abdominal or peripheral obesity. "
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