Update of the Healthy Eating Index: HEI-2015

Overview

Journal J Acad Nutr Diet

Publisher Elsevier

Specialty Nutritional Sciences

Date 2018 Aug 28

PMID 30146071

Citations 973

Authors

Susan M Krebs-Smith

TusaRebecca E Pannucci

Amy F Subar

Sharon I Kirkpatrick

Jennifer L Lerman

Janet A Tooze

Magdalena M Wilson

Jill Reedy

Affiliations

Soon will be listed here.

Abstract

The Healthy Eating Index (HEI) is a measure for assessing whether a set of foods aligns with the Dietary Guidelines for Americans (DGA). An updated HEI is released to correspond to each new edition of the DGA, and this article introduces the latest version, which reflects the 2015-2020 DGA. The HEI-2015 components are the same as in the HEI-2010, except Saturated Fat and Added Sugars replace Empty Calories, with the result being 13 components. The 2015-2020 DGA include explicit recommendations to limit intakes of both Added Sugars and Saturated Fats to <10% of energy. HEI-2015 does not account for excessive energy from alcohol within a separate component, but continues to account for all energy from alcohol within total energy (the denominator for most components). All other components remain the same as for HEI-2010, except for a change in the allocation of legumes. Previous versions of the HEI accounted for legumes in either the two vegetable or the two protein foods components, whereas HEI-2015 counts legumes toward all four components. Weighting approaches are similar to those of previous versions, and scoring standards were maintained, refined, or developed to increase consistency across components; better ensure face validity; follow precedent; cover a range of intakes; and, when applicable, ensure the DGA level corresponds to a score >7 out of 10. HEI-2015 component scores can be examined collectively using radar graphs to reveal a pattern of diet quality and summed to represent overall diet quality.

Citing Articles

Insights into associations between Life's essential 8 and lung function from NHANES data.

Lin T, Xie Z, Huang S, Chen J, Mao H, Chen Z Sci Rep. 2025; 15(1):8243.

PMID: 40064953 PMC: 11894156. DOI: 10.1038/s41598-025-90923-2.

Associations between life's essential 8 and preserved ratio impaired spirometry.

Lai Y, Yang T, Zhang X, Li M Sci Rep. 2025; 15(1):8166.

PMID: 40059094 PMC: 11891325. DOI: 10.1038/s41598-025-90381-w.

An interpretable machine learning model with demographic variables and dietary patterns for ASCVD identification: from U.S. NHANES 1999-2018.

Tang Q, Wang Y, Luo Y BMC Med Inform Decis Mak. 2025; 25(1):105.

PMID: 40033349 PMC: 11874124. DOI: 10.1186/s12911-025-02937-5.

Food insecurity and risk of nutrition insecurity among Supplemental Nutrition Assistance Program participants in Rhode Island and Connecticut, USA.

Oddo V, Leider J, Tovar A, Powell L, Elenio E, Vadiveloo M Prev Med Rep. 2025; 51:103002.

PMID: 40028001 PMC: 11870204. DOI: 10.1016/j.pmedr.2025.103002.

Associations between asthma and Life's Essential 8: a cross-sectional study.

Xu J, Tang J Front Med (Lausanne). 2025; 12:1446900.

PMID: 40007591 PMC: 11851080. DOI: 10.3389/fmed.2025.1446900.

References

Guenther P, Kirkpatrick S, Reedy J, Krebs-Smith S, Buckman D, Dodd K . The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans. J Nutr. 2014; 144(3):399-407. PMC: 3927552. DOI: 10.3945/jn.113.183079. View

Reedy J, Lerman J, Krebs-Smith S, Kirkpatrick S, Pannucci T, Wilson M . Evaluation of the Healthy Eating Index-2015. J Acad Nutr Diet. 2018; 118(9):1622-1633. PMC: 6718954. DOI: 10.1016/j.jand.2018.05.019. View

Jahns L, Scheett A, Johnson L, Krebs-Smith S, Payne C, Whigham L . Diet Quality of Items Advertised in Supermarket Sales Circulars Compared to Diets of the US Population, as Assessed by the Healthy Eating Index-2010. J Acad Nutr Diet. 2015; 116(1):115-122.e1. DOI: 10.1016/j.jand.2015.09.016. View

Zhang F, Liu S, John E, Must A, Demark-Wahnefried W . Diet quality of cancer survivors and noncancer individuals: Results from a national survey. Cancer. 2015; 121(23):4212-21. PMC: 4667562. DOI: 10.1002/cncr.29488. View

Guenther P, Casavale K, Reedy J, Kirkpatrick S, Hiza H, Kuczynski K . Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet. 2013; 113(4):569-80. PMC: 3810369. DOI: 10.1016/j.jand.2012.12.016. View

Stampfer M, Colditz G, Willett W, Speizer F, Hennekens C . A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. N Engl J Med. 1988; 319(5):267-73. DOI: 10.1056/NEJM198808043190503. View

Guenther P, Reedy J, Krebs-Smith S, Reeve B . Evaluation of the Healthy Eating Index-2005. J Am Diet Assoc. 2008; 108(11):1854-64. DOI: 10.1016/j.jada.2008.08.011. View

Miller P, Reedy J, Kirkpatrick S, Krebs-Smith S . The United States food supply is not consistent with dietary guidance: evidence from an evaluation using the Healthy Eating Index-2010. J Acad Nutr Diet. 2014; 115(1):95-100. PMC: 4276446. DOI: 10.1016/j.jand.2014.08.030. View

Gronbaek M . The positive and negative health effects of alcohol- and the public health implications. J Intern Med. 2009; 265(4):407-20. DOI: 10.1111/j.1365-2796.2009.02082.x. View

10.

Kirkpatrick S, Reedy J, Krebs-Smith S, Pannucci T, Subar A, Wilson M . Applications of the Healthy Eating Index for Surveillance, Epidemiology, and Intervention Research: Considerations and Caveats. J Acad Nutr Diet. 2018; 118(9):1603-1621. PMC: 6730554. DOI: 10.1016/j.jand.2018.05.020. View

11.

Gu X, Tucker K . Dietary quality of the US child and adolescent population: trends from 1999 to 2012 and associations with the use of federal nutrition assistance programs. Am J Clin Nutr. 2016; 105(1):194-202. DOI: 10.3945/ajcn.116.135095. View

12.

Kirkpatrick S, Reedy J, Kahle L, Harris J, Ohri-Vachaspati P, Krebs-Smith S . Fast-food menu offerings vary in dietary quality, but are consistently poor. Public Health Nutr. 2013; 17(4):924-31. PMC: 3883949. DOI: 10.1017/S1368980012005563. View

13.

Ramsay S, Shriver L, Taylor C . Variety of fruit and vegetables is related to preschoolers' overall diet quality. Prev Med Rep. 2016; 5:112-117. PMC: 5157882. DOI: 10.1016/j.pmedr.2016.12.003. View

14.

Allen A, Fanelli Kuczmarski M, Evans M, Zonderman A, Waldstein S . Race Differences in Diet Quality of Urban Food-Insecure Blacks and Whites Reveals Resiliency in Blacks. J Racial Ethn Health Disparities. 2016; 3(4):706-712. PMC: 4911313. DOI: 10.1007/s40615-015-0189-5. View

15.

Yoshida Y, Scribner R, Chen L, Broyles S, Phillippi S, Tseng T . Diet quality and its relationship with central obesity among Mexican Americans: findings from National Health and Nutrition Examination Survey (NHANES) 1999-2012. Public Health Nutr. 2016; 20(7):1193-1202. PMC: 10261487. DOI: 10.1017/S1368980016003190. View

16.

Landy D, Lipsitz S, Kurtz J, Hinkle A, Constine L, Adams M . Dietary quality, caloric intake, and adiposity of childhood cancer survivors and their siblings: an analysis from the cardiac risk factors in childhood cancer survivors study. Nutr Cancer. 2013; 65(4):547-55. DOI: 10.1080/01635581.2013.770042. View

17.

McGuire S . U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, January 2011. Adv Nutr. 2012; 2(3):293-4. PMC: 3090168. DOI: 10.3945/an.111.000430. View

18.

Guenther P, Reedy J, Krebs-Smith S . Development of the Healthy Eating Index-2005. J Am Diet Assoc. 2008; 108(11):1896-901. DOI: 10.1016/j.jada.2008.08.016. View

19.

Onvani S, Haghighatdoost F, Surkan P, Larijani B, Azadbakht L . Adherence to the Healthy Eating Index and Alternative Healthy Eating Index dietary patterns and mortality from all causes, cardiovascular disease and cancer: a meta-analysis of observational studies. J Hum Nutr Diet. 2016; 30(2):216-226. DOI: 10.1111/jhn.12415. View

20.

Schap T, Kuczynski K, Hiza H . Healthy Eating Index-Beyond the Score. J Acad Nutr Diet. 2017; 117(4):519-521. DOI: 10.1016/j.jand.2017.02.002. View