A Population's Mean Healthy Eating Index2005 Scores Are Best Estimated by the Score of the Population Ratio when One 24Hour Recall

Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer, 52161 Israel.
Journal of Nutrition (Impact Factor: 3.88). 10/2008; 138(9):1725-9.
Source: PubMed


The USDA Healthy Eating Index-2005 (HEI-2005) is a tool to quantify and evaluate the quality of diet consumed by the U.S. population. It comprises 12 components, expressed as ratios of a food group or nutrient to energy intake. The components are scored on a scale from 0 to M, where M is 5, 10, or 20. Ideally, the HEI-2005 is calculated on the basis of the usual dietary intake of an individual. Intake data, collected via a 24-h recall, are often available for only 1 d for each individual. In this article, we examine how best to estimate a population's mean usual HEI-2005 component and total scores when 1 d of dietary information is available for a sample of individuals from the population. Three methods are considered: the mean of individual scores, the score of the mean of individual ratios, and the score of the ratio of total food group or nutrient intake to total energy intake, which we call the population ratio. We investigate via computer simulation which method is the least biased. The simulations are based on statistical modeling of the distributions of intakes reported by 738 women participating in the Eating at America's Table Study. The results show that overall, the score of the population ratio is the preferred method. We therefore recommend that the quality of the U.S. population's diet be assessed and monitored using this method.

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Available from: Phillip Kott, May 12, 2014
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    • "In addition, similar results have been observed when the self-rated overall diet quality question responses were correlated with dietary biomarkers (sodium, potassium)Loftfield et al., 2014). Another limitation is that the HEI is typically used to quantify and evaluate population adherence to dietary guidelines; however, we used individual-level data to calculate mean HEI scores, which is not universally accepted as the preferred method for describing such scores (Freedman et al., 2008). Self-rated diet quality as measured by a single indicator helped to identify those with the poorest diet quality according to the HEI. "
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    ABSTRACT: Objective: Chronic conditions such as cardiovascular disease and cancer can result from a number of diet-related environmental and behavioral factors. Screening for poor diet is helpful in developing interventions to prevent chronic disease, but measuring dietary behavior can be costly and time-consuming. The purpose of this study was to test the ability of a self-rated, single-item measure for evaluating diet quality among individuals and populations. Methods: A 24-h dietary recall and single-item self-rated diet quality measure were collected for 485 adults. From dietary recalls, Healthy Eating Index-2010 (HEI) scores were computed and compared with self-rated diet quality. Data were collected in 2013 among adult (18 years and older) New York City residents. Results: The study sample was 57% female, 47% white, 56% college educated, and 45% in the highest income tertile. The mean HEI score was 56.5 out of a possible 100. Women averaged higher HEI scores compared to men (58.1 vs 54.3, p=.01). There was a modest yet significant correlation between HEI scores and self-rated diet quality (ρ= 0.29, p<.01). Overall, mean HEI score increased as self-rated diet quality improved (from 48.2 for "poor" to 63.0 for "excellent"). Conclusions: The single-item measure of self-rated diet quality may provide a simple method of identifying those with the worst diet quality. Further investigation of this measure's validity is needed with alternative measures of dietary intake and with health outcomes.
    Full-text · Article · Jan 2016
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    • "For example, is the increase in diet quality due to general improvements across the population at a steady rate or due to larger improvements amongst those with the lowest (or highest) diet quality? To address 6 There are various ways to calculate the HEI score for a population of interest (see Freedman et al. (2008, 2010) for in depth discussions). Because we are interested in the number and depth of individuals below a particular HEI score, we use the mean score of individuals instead of the more frequently used score of the population ratio. "
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    ABSTRACT: This paper uses stochastic dominance to measure changes in the distribution of overall dietary quality in the U.S. over the period 1989{2008. Diet quality is often used as as a proxy for wellbeing and an outcome variable for a wide variety of interventions. For the population as a whole, we nd signi cant improvements in diets across all levels of dietary quality. Further, we nd improvements for both low-income and higher-income individuals alike. We show that the improvements vary between these groups with regards to the timing and distributional location. Further, we nd that over half of the improvement for all individuals can be explained by changes in food formulation and changes in demographics.
    Full-text · Article · Jan 2012
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    • "We call this the score of the population ratio. The HEI-2005 total score is calculated as the sum of these scores over the 12 components [16]. "
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    ABSTRACT: The aim of this study was to use the Healthy Eating Index-2005 (HEI-2005) to assess diet quality and determine the relationship between the HEI-2005 and the energy and nutrient intakes of adolescents. A cross-sectional study was conducted on 1,104 healthy adolescents, mean age of 15.8 ± 1.24 years. Dietary intake was measured with the 24-hour dietary recall method, and dietary quality was assessed by means of the HEI-2005. Diet quality scores ranged from 23.7 to 77.5. The mean score was found to be 51.5 ± 9.07 according to the HEI-2005. There were no differences according to gender; 42.8% had a poor diet and 57.2% had a diet that needs improvement. No subjects had a "good diet". Lower mean subgroup scores were found for whole grains, total vegetables, total fruits, dairy products, and meat and beans. Fruits and vegetables scores were significantly high in girls, whereas sodium, oil, and meat and beans scores were significantly high in boys. Total HEI-2005 scores were increasingly associated with parental education level when age and gender were adjusted. There was a negative correlation between HEI-2005 scores and age, total energy intake, and fat intake. Positive correlation was only observed in the HEI-2005 scores for protein and dietary fibre intakes. Consequently, the overall diet quality and nutritional habits of Turkish adolescents need modification and improvement. In the family, measures should be initiated by the government, including advertisements and campaigns.
    Full-text · Article · Aug 2011 · Nutrition research and practice
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