The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans.
The Healthy Eating Index (HEI), a measure of diet quality, was updated to reflect the 2010 Dietary Guidelines for Americans and the accompanying USDA Food Patterns. To assess the validity and reliability of the HEI-2010, exemplary menus were scored and 2 24-h dietary recalls from individuals aged ≥2 y from the 2003-2004 NHANES were used to estimate multivariate usual intake distributions and assess whether the HEI-2010 1) has a distribution wide enough to detect meaningful differences in diet quality among individuals, 2) distinguishes between groups with known differences in diet quality by using t tests, 3) measures diet quality independently of energy intake by using Pearson correlation coefficients, 4) has >1 underlying dimension by using principal components analysis (PCA), and 5) is internally consistent by calculating Cronbach's coefficient α. HEI-2010 scores were at or near the maximum levels for the exemplary menus. The distribution of scores among the population was wide (5th percentile = 31.7; 95th percentile = 70.4). As predicted, men's diet quality (mean HEI-2010 total score = 49.8) was poorer than women's (52.7), younger adults' diet quality (45.4) was poorer than older adults' (56.1), and smokers' diet quality (45.7) was poorer than nonsmokers' (53.3) (P < 0.01). Low correlations with energy were observed for HEI-2010 total and component scores (|r| ≤ 0.21). Cronbach's coefficient α was 0.68, supporting the reliability of the HEI-2010 total score as an indicator of overall diet quality. Nonetheless, PCA indicated multiple underlying dimensions, highlighting the fact that the component scores are equally as important as the total. A comparable reevaluation of the HEI-2005 yielded similar results. This study supports the validity and the reliability of both versions of the HEI.
Center for Nutrition Policy and Promotion, USDA, Alexandria, VA.
Patricia M
PM
Guenther
Sharon I
SI
Kirkpatrick
Jill
J
Reedy
Susan M
SM
Krebs-Smith
Dennis W
DW
Buckman
Kevin W
KW
Dodd
Kellie O
KO
Casavale
Raymond J
RJ
Carroll
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage; D002523:Edible Grain; D005247:Feeding Behavior; D005260:Female; D058870:Food, Organic; D005638:Fruit; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D009752:Nutritional Status; D009753:Nutritive Value; D064167:Recommended Dietary Allowances; D015203:Reproducibility of Results; D014481:United States; D014675:Vegetables; D055815:Young Adult
D004044:Dietary Proteins