How Do You Score on the Healthy Eating Index?

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I like numbers. Naturally, I was intrigued when I came across the statistic that the average American score on the Healthy Eating Index is 59.

What is the Healthy Eating Index? How do you calculate your score? What does an eating pattern with a perfect score look like? These were some of the questions I had. So I did some research.

The Healthy Eating Index (HEI)

The Healthy Eating Index (HEI) is a measure for assessing dietary quality with respect to the Dietary Guidelines for Americans (DGA). The United States recently released their updated Dietary Guidelines on December 29, 2020. The government updates the guidelines every 5 years based on current scientific and medical knowledge. Part of this reporting includes monitoring changes in Americans’ eating patterns over time using the Healthy Eating Index.

As you can see, the average score over time has hovered between 56 and 60 points out of a possible 100 points.

Healthy Dietary Patterns

The Dietary Patterns take into account different age groups and different caloric needs. The American Guidelines consider the following age categories:

  • Infants and Toddlers
  • Children and Adolescents
  • Adults
  • Women who are pregnant or lactating
  • Older Adults

The daily intake amounts are based on how many calories you need overall. The daily intake amount is not as simple as saying everyone needs to eat 3 cups of vegetables a day. According to the guidelines, an adult requiring 1600 calories should have 2 cups of vegetables. An adult requiring 3000 calories needs 4 cups of vegetables.

Here is a chart of the recommended daily intakes for adults according to the DGA.

Dietary Pattern for Adults

What does a perfect score look like?

This is the chart that shows the components and scoring standards of the Healthy Eating Index (2015).

Healthy Eating Index (2105) Components and Scoring Standards

You can score 60 points if you eat more than or equal to the daily intake amount (required for your age and caloric needs) of the following:

  • Fruit (10 points)
  • Vegetables (5 points) and Green Vegetables (5 points)
  • Whole Grains (10 points)
  • Dairy (10 points)
  • Protein foods (5 points) and Seafood / Plant Proteins (5 points)
  • 2.5 times more unsaturated fatty acids than saturated fatty acids (10 points)

The point scale is on a sliding basis. If you eat half of the daily intake amount recommended for fruit, your score is 5 out of 10. If you eat no fruit, your score is 0. Higher consumption equals more points.

You can score 40 points if you eat LESS than the moderate amount (per 1000 calories) of the following:

  • Refined grains < 1.8 ounce (10 points)
  • Sodium < 1.1 gram (10 points)
  • Added sugars < 6.5 % of calories (10 points)
  • Saturated fats < 8% of calories (10 points)

This is also on a sliding scale up to a max limit. If you eat less than the moderate amounts you will score 10 points. If you eat slightly more than the moderate amount, you may score 5 points, but if you exceed the highest allowable amount, you will score 0 points. In other words, you score higher points for consuming smaller amounts of refined grains, sodium, added sugars and saturated fats.

Some General Results

The Healthy Eating Index shows, according to the Dietary Guidelines, that most Americans have “substantial room for improvement”.

  • 80% of the population have dietary patterns that are low in vegetables, fruits and dairy
  • More than 50% of the population consumes too much refined grains but but not enough whole grains
  • More than half of the population meets general protein requirements but does not consume adequate seafood amounts.
  • Over 60% of adults exceed limits for added sugars, saturated fat and sodium.

Canada’s Food Guide

How does this compare to the Canada’s Food Guide? Canada released its most recent version of the guidelines two years ago, on January 22, 2019.

Canadian dietary guidelines

Unlike the American Guidelines, Canada’s Food Guide no longer dictates recommended daily food group intakes and does not specifically name Dairy as a food group.

One other difference is that Canada’s food guide recommends drinking water as the beverage of choice, whereas the Healthy Eating Index gives points for drinking 100% fruit juice. What makes fruit juice less ideal than water is that fruit juice is high in natural sugars but does not contain the protective benefit of fibre. It is better to eat pieces of the whole fruit rather than its juice alone. (Note that juicing the entire fruit, like blending it in a smoothie, counts as eating the whole fruit.)

The nature of the guidelines for both are similar, however, in that the focus is on eating whole, nutrient-dense foods.

Canada’s Food Guide emphasizes regular consumption of vegetables, fruit, whole grains, and protein foods. Within protein foods, the Food Guide recommends “more regular consumption of plant-based protein foods (legumes, nuts, seeds, soy) as well as fish, shellfish, eggs, poultry, lean red meat including wild game, lower fat milk, lower fat yogurts, lower fat kefir, and cheeses lower in fat and sodium”. You can see that dairy is included as a source of protein, just not as a separate food group.

Canada’s Food Guide also emphasizes replacing saturated fats with healthier unsaturated fats. (I would put the emphasis on monounsaturated fats and Omega 3 fats – see my blog on Healthy Fats and Unhealthy Fats – What is the Difference?)

Like the DGA, Canada’s Guide advises against regularly consuming processed or prepared foods and beverages that contribute to excess sodium, free sugars, or saturated fat. This is consistent with the HEI section for consuming smaller amounts of the “moderation” category.

Summary

If you are interested in calculating the target amounts of each food group for your daily calorie intake according to the HEI in order to get an idea of the score for your dietary pattern, I can help.

I do think Canada’s food guide has it covered though. Most people are not going to tabulate and calculate the exact amounts of the food they eat. Rather, aim to regularly eat half your plate as vegetables and fruit, one quarter of your plate as quality protein including healthy fats, one quarter or your plate as whole grains, and reduce or minimize processed, refined grains and added sugars or sweeteners. Drink lots of water. For more information on how to use Canada’s food plate go to Canada’s Food Plate.

If we follow Canada’s Food Guide, I think we would score a 90 out of 90. (I would take away the 10 point tally for dairy since dairy is not a requirement in and of itself but it would contribute to the protein score.)

This is still a solid 100% for healthy eating.

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