Modifications to the Healthy Eating Index and its ability to predict obesity: the Multi-Ethnic Study of Atherosclerosis.
BACKGROUND
The Healthy Eating Index (HEI) is a measure of diet quality developed based on the Dietary Guidelines for Americans (DGA).


OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Gao
Sue K
SK
Department of Epidemiology, University of Washington, Seattle, WA, USA. sgao@amgen.com
Beresford
Shirley A A
SA
Frank
Laura L
LL
Schreiner
Pamela J
PJ
Burke
Gregory L
GL
Fitzpatrick
Annette L
AL
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D015992:Body Mass Index; D004032:Diet / Q000208:ethnology / Q000592:standards*; D004034:Diet Surveys; D005006:Ethnicity / Q000706:statistics & numerical data*; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D058870:Food, Organic; D006305:Health Status Indicators; D006306:Health Surveys; D006630:Hispanic or Latino; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D009747:Nutritional Physiological Phenomena / Q000502:physiology*; D009765:Obesity / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D049629:Waist-Hip Ratio; D044465:White People