Abstract
Background
The Healthy Eating Index (HEI), a measure of diet quality as specified by federal
dietary guidance, was revised to conform to the Dietary Guidelines for Americans 2005.
The HEI has several components, the scores of which are totaled.
Objective
The validity and reliability of the HEI-2005 were evaluated.
Design
Validity was assessed by answering four questions: Does the HEI-2005 1) give maximum
scores to menus developed by experts; 2) distinguish between groups with known differences
in diet quality—smokers and nonsmokers; 3) measure diet quality independently of energy
intake, a proxy for diet quantity; and 4) have more than one underlying dimension?
The relevant type of reliability, internal consistency, was also assessed.
Subjects
Twenty-four−hour recalls from 8,650 participants, aged 2 years and older, in the National
Health and Nutrition Examination Survey, 2001-2002 were analyzed to answer questions
2 to 4. Results were weighted to consider sample design and nonresponse.
Statistical analyses
T tests determined differences in scores between smokers and nonsmokers. Pearson correlation
coefficients determined the relationship between energy intake and scores. Principal
components analysis determined the number of factors that comprise the HEI-2005. Cronbach's
coefficient α tested internal consistency.
Results
HEI-2005 scores are at or very near the maximum levels for all sets of exemplary menus
with one exception; the Harvard menus scored low on the milk component because these
menus intentionally include only small amounts of milk products. Nine of 12 component
scores were lower for smokers than nonsmokers. The correlations of component scores
were virtually independent of energy intake (< ∣.22∣). Multiple factors underlie the
HEI-2005. Coefficient α was .43. The α value for all tests was .01.
Conclusions
The HEI-2005 is a valid measure of diet quality. Potential uses include population
monitoring, evaluation of interventions, and research. The individual component scores
provide essential information in addition to that provided by the total score.
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Biography
P. M. Guenther is a nutritionist at the Center for Nutrition Policy and Promotion, US Department of Agriculture, Alexandria, VA
Biography
J. Reedy is a nutritionist and S. M. Krebs-Smith is Chief in the Risk Factor Monitoring and Methods Branch and B. B. Reeve is a psychometrician in the Outcomes Research Branch of the Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
Article info
Publication history
Accepted:
May 6,
2008
Identification
Copyright
Published by Elsevier Inc.
