What Is the Healthy Eating Index (HEI)?
The "healthy eating scale" most commonly refers to the Healthy Eating Index (HEI), a tool developed by the U.S. Department of Agriculture (USDA) and the National Cancer Institute (NCI). The HEI is a single, summary measure of overall diet quality, assessing how closely a person's diet adheres to the Dietary Guidelines for Americans (DGA). It provides a score ranging from 0 to 100, where a higher score indicates a diet that is better aligned with the DGA recommendations.
The HEI is more than just a simple checklist; it's a sophisticated metric that accounts for both the adequacy of certain food groups and the moderation of others. This makes it a valuable tool for public health researchers, dietitians, and policymakers to monitor the dietary status of populations and to guide nutrition education and health promotion programs. While the HEI provides a quantitative measure of diet quality, it's important to remember that it is a scientific and research-oriented scale, and less of a personal tool for everyday use like a simple food diary or a calorie counter.
How the Healthy Eating Scale is Calculated
The HEI assigns scores based on 13 components, reflecting the key recommendations from the latest Dietary Guidelines for Americans. These components are divided into two categories: adequacy components and moderation components. Each component is given a maximum score, and the total HEI score is the sum of the scores for all 13 components, with a maximum of 100 points. Scores for intakes between the minimum and maximum standards are calculated proportionately.
Adequacy Components (Foods to Encourage)
These components represent food groups and nutrients that are encouraged for good health. For these, higher intake results in a higher score.
- Total Fruits: Includes whole fruits and 100% fruit juice.
- Whole Fruits: Includes all forms of fruit except juice.
- Total Vegetables: Includes all vegetables and legumes.
- Greens and Beans: Specifically measures intake of dark green vegetables and legumes.
- Whole Grains: Measured as a percentage of total grain intake.
- Dairy: Includes milk, yogurt, cheese, and fortified soy beverages.
- Total Protein Foods: Includes meat, poultry, seafood, eggs, nuts, seeds, and legumes.
- Seafood and Plant Proteins: Focuses on intake of seafood, nuts, seeds, and soy products.
- Fatty Acids: A ratio of unsaturated to saturated fatty acids, where a higher ratio is desirable.
Moderation Components (Foods to Limit)
These components represent dietary elements that should be consumed in moderation. For these, lower intake results in a higher score.
- Refined Grains: Intake of grains that are not whole grains.
- Sodium: Total sodium consumption.
- Added Sugars: Sugars added during the processing of foods.
- Saturated Fats: Percentage of total energy from saturated fats.
Comparing Healthy Eating Scales: HEI-2015 vs. HEI-2020
The Healthy Eating Index has been updated over the years to align with the latest scientific understanding presented in the Dietary Guidelines for Americans. While the HEI-2015 and HEI-2020 are very similar for adults, the HEI-2020 is designed to align with the 2020-2025 Dietary Guidelines, which included specific recommendations for toddlers for the first time.
| Component | HEI-2015 Scoring Standard (Adults) | HEI-2020 Scoring Standard (Adults) | Notes |
|---|---|---|---|
| Total Fruits | ≥0.8 cup equiv. per 1,000 kcal | ≥0.8 cup equiv. per 1,000 kcal | No change for adults. |
| Added Sugars | ≤6.5% of energy | ≤6.5% of energy | No change for adults. HEI-Toddlers-2020 targets 0%. |
| Saturated Fats | ≤8% of energy | ≤8% of energy | No change for adults. Special considerations for toddlers. |
| Seafood and Plant Proteins | ≥0.8 oz equiv. per 1,000 kcal | ≥0.8 oz equiv. per 1,000 kcal | No change for adults. HEI-Toddlers-2020 standard differs. |
| Legumes Allocation | Allocated to four categories | Allocated to four categories | Method was adjusted slightly in HEI-2015, carried over to HEI-2020. |
| Overall Score | Maximum of 100 points | Maximum of 100 points | Overall scoring principle is consistent. |
How to Improve Your Score on the Healthy Eating Scale
Improving your diet involves focusing on the core principles measured by the HEI. Here are some actionable steps based on the adequacy and moderation components:
- Prioritize Whole Foods: Increase your intake of whole fruits, a variety of vegetables, and whole grains. Aim to make at least half your plate fruits and vegetables.
- Choose Lean Proteins: Opt for lean meats, poultry, fish, eggs, and plant-based protein sources like beans, lentils, and nuts. This helps reduce saturated fat intake.
- Embrace Healthy Fats: Replace solid fats like butter and lard with unsaturated vegetable oils. The HEI specifically rewards a higher ratio of unsaturated to saturated fats.
- Limit Added Sugars: Reduce your consumption of sugary drinks, snacks, and sweets. The HEI gives a better score for less than 6.5% of calories from added sugars, while the WHO suggests aiming for less than 5% for additional benefits.
- Cut Back on Sodium: Be mindful of your salt intake, especially from processed and packaged foods. Cooking at home from fresh ingredients is a great way to control sodium levels.
- Increase Variety: The original HEI included a component for dietary variety, a principle that remains important for ensuring a broad range of nutrients. Try new foods and incorporate different colors on your plate.
Conclusion: Using the Healthy Eating Scale for Wellness
While the Healthy Eating Index is a complex scientific tool, its underlying message is clear: a balanced, varied diet rich in whole foods and low in added sugars, saturated fats, and sodium is the key to good health. For individuals, understanding the HEI can provide a framework for making healthier food choices that align with established dietary guidelines. By focusing on increasing fruits, vegetables, whole grains, lean protein, and healthy fats, while limiting less desirable components, you can significantly improve your overall diet quality. Ultimately, the Healthy Eating Scale serves as a powerful reminder that focusing on the quality of our diet is a critical step toward long-term wellness and disease prevention.
