How We Use the HEI

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Healthy Eating Index text as a logoThe Center for Nutrition Policy and Promotion (CNPP) uses the Healthy Eating Index (HEI) to provide a data-driven understanding of diet quality in the United States over time. The HEI-2015 can be used to see how well the diets of Americans align with the 2015-2020 Dietary Guidelines for Americans. The density scoring allows researchers to apply the HEI in a variety of research settings and a variety of calorie intake levels. The density approach is described on the How the HEI is Scored page.

Examples of various HEI applications published in scientific papers and federal reports are highlighted in the Journal of the Academy of Nutrition and Dietetics as a CNPP Corner article titled Healthy Eating Index-Beyond the Score. The CNPP Corner article provides additional information about how researchers use the HEI to study diet quality. Here is a closer look at the many ways that the HEI can be used to study diet quality:

Monitor Diet Quality of the U.S. Population

The HEI is used to assess how well diets in the United States align with the Dietary Guidelines for Americans. The HEI Scores for Americans page illustrates HEI-2015 scores for specific subgroups of the population, including children and older adults. HEI scores that reflect changes in diet quality of the overall U.S. population over a specific time period are also shown.

Study Associations Between Diet Quality and Health Outcomes

The HEI can be used to study whether diets that are associated with higher HEI scores may improve health outcomes. Health outcomes that have been studied include diet-related chronic diseases such as cardiovascular disease, cancer, and type 2 diabetes. These studies show that each step closer to a diet that aligns with the key messages of the Dietary Guidelines for Americans (as measured by the HEI) may help reduce the risk of these diseases among the populations studied. You can find details on the relationship between dietary patterns and health outcomes here.

Evaluate Federal Nutrition Programs

The HEI can be used to determine diet quality of foods made available through Federal nutrition programs, such as the foods offered through the United States Department of Agriculture (USDA) Food Distribution Program on Indian Reservations. Other evaluations provide HEI scores for participants in Federal nutrition programs such as the Supplemental Nutrition Assistance Program and the National School Lunch Program. The USDA Food and Nutrition Service Report Finder allows you to search for reports related to Federal nutrition programs and services offered by the USDA.

Examine the Food Supply

The HEI also can be used to evaluate diet quality in a variety of food settings, from foods available in the U.S. food supply, to restaurant menus, as well as foods purchased and sold at other institutions. This information can help to evaluate how well the mix of foods made available to consumers aligns with dietary recommendations.

Adapt to Global Settings

The components in the HEI reflect basic food groups that can be applied to any culture. While intended to reflect dietary guidance in the United States, the HEI can be a useful tool for assessing diet quality in countries that may not have their own index, or in instances where there is a desire to compare associations between a predetermined definition of diet quality and health outcomes. The HEI, or an adapted version, has been used to assess diet quality in many countries other than the United States. These countries include Brazil, Iran, China, Greece, Italy, Spain, Belgium, Sweden, France, and Malaysia.