Understanding the Healthy Eating Index
The Healthy Eating Index (HEI) is a comprehensive dietary tool developed by the U.S. Department of Agriculture (USDA) to measure the alignment of a diet with the Dietary Guidelines for Americans. On a scale of 0 to 100, the HEI assesses diet quality by evaluating two main categories: adequacy and moderation. A higher score indicates better diet quality and a stronger correlation with positive health outcomes, such as reduced risk for chronic diseases. For example, research has shown that individuals with higher HEI scores tend to have lower risks of mortality from all causes, heart disease, and cancer.
The Components of the HEI
The HEI-2020, based on the 2020-2025 Dietary Guidelines, includes 13 components, with nine focused on adequacy and four on moderation. Adequacy components encourage higher intake of food groups like total fruits, whole fruits, total vegetables, greens and beans, whole grains, dairy, total protein foods, seafood and plant proteins, and fatty acids. Moderation components aim to limit refined grains, sodium, added sugars, and saturated fats.
The National Average HEI Score
Based on data from the National Health and Nutrition Examination Survey (NHANES) from 2017-2018, the average HEI-2020 score for the U.S. population aged two and older was 58 out of a possible 100. This score falls into the "needs improvement" category. A "good" diet has an HEI score of 81 or higher, while a score of 50 or lower is considered "poor". These findings reveal that, on average, the American population's diet quality needs improvement and highlight the need for continued public health efforts.
Factors Affecting HEI Scores
HEI scores vary significantly across different segments of the population, influenced by several socioeconomic and demographic factors.
- Age: Average HEI scores tend to decline from early childhood to adulthood and then rise again in older age groups. Toddlers often have the highest scores, with dips for adolescents and young adults before increasing after age 60.
- Socioeconomic Status (SES): Higher education and income levels are generally correlated with higher HEI scores. Lower scores are often seen in individuals from lower-income households and those with less education, potentially due to factors like access to affordable nutritious food.
- Gender: Research often indicates that females tend to have slightly higher HEI scores than males.
- Race/Ethnicity: Studies show variations in average HEI scores across different racial and ethnic groups, possibly linked to cultural dietary patterns and other factors.
Strategies for Improving Your HEI Score
Improving your personal HEI score involves focusing on both adequacy and moderation components. This often means shifting towards more whole, nutrient-dense foods and away from processed items. Key steps include increasing the intake of fruits, vegetables, whole grains, and legumes, while limiting refined grains, added sugars, and excess sodium. Choosing healthier protein sources like fish and plant-based options, diversifying your diet, and cooking more at home can also contribute to a better score.
HEI for Diet Comparison: Standard vs. Adaptive Scoring
The standard HEI is useful for the general population but has limitations when comparing diverse dietary patterns that exclude certain food groups. Adaptive Component Scoring (ACS) addresses this by adjusting the total possible score when discretionary food groups are intentionally omitted, providing a more equitable assessment for various healthy eating patterns.
| Feature | Standard HEI Scoring | Adaptive Component Scoring (ACS) |
|---|---|---|
| Primary Purpose | Measures adherence to the Dietary Guidelines for Americans for a broad US population. | Compares diet quality across culturally diverse or alternative eating patterns that naturally omit certain food groups. |
| Score Calculation | All components contribute to the total score of 100 points. | Adjusts the total possible score by excluding discretionary food groups when intentionally omitted. |
| Application Scope | Best for assessing general US population health trends based on national guidelines. | More suitable for fair comparison of diets like vegan or specific cultural diets. |
| Inclusivity | Less inclusive of non-standard, yet healthy, dietary patterns. | More inclusive and culturally sensitive, providing a more equitable assessment for a wider range of healthy eating patterns. |
| Result Interpretation | A high score indicates strong alignment with traditional Dietary Guidelines. | A high score indicates strong adherence within the parameters of a specific dietary pattern. |
Conclusion
The average Healthy Eating Index (HEI) score for Americans, around 58, indicates a need for dietary improvement across the population. The HEI is a vital tool for assessing diet quality based on federal guidelines and is linked to chronic disease risk. Factors like age and socioeconomic status influence scores. Improving dietary quality involves increasing nutrient-dense foods and limiting less healthy components. For non-traditional diets, adaptive scoring offers a more tailored assessment. The HEI serves as a key metric for public health efforts to enhance national wellness.
