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- Choosing a Version
- Comparing HEI-Toddlers-2020 vs. HEI-2020
- Comparing Versions of the HEI
- Similarities between HEI Versions
- Differences between HEI Versions
Choosing a Version
There are multiple versions of the HEI: HEI-2020, HEI-2020-Toddlers, HEI-2015, HEI-2010, HEI-2005. Each HEI can be used to assess compliance with the Dietary Guidelines for Americans (DGA) based on the corresponding years. For example, the HEI-2020 and HEI-2020-Toddlers reflect the 2020-2025 DGA and the HEI-2015 reflects the 2015-2020 DGA. Researchers should use the version that corresponds with the DGA in place during their dietary data collection.
Comparing HEI-2020 vs. HEI-Toddlers-20201
| Component | Maximum points | Standard for maximum score | Standard for minimum score of zero | Standard for maximum score | Standard for minimum score of zero |
|---|---|---|---|---|---|
| HEI-2020 For 2 Years and Older |
HEI-Toddlers-2020 For 12 through 23 months |
||||
| Adequacy components | |||||
| Total Fruits2 | 5 | ≥0.8 cup equiv. per 1,000 kcal | No Fruits | ≥0.7 cup equiv. per 1,000 kcal | No Fruits |
| Whole Fruits3 | 5 | ≥0.4 cup equiv. per 1,000 kcal | No Whole Fruits | ≥0.3 cup equiv. per 1,000 kcal | No Whole Fruits |
| Total Vegetables4 | 5 | ≥1.1 cup equiv. per 1,000 kcal | No Vegetables | ≥0.9 cup equiv. per 1,000 kcal | No Vegetables |
| Greens and Beans4 | 5 | ≥0.2 cup equiv. per 1,000 kcal | No Dark Green Vegetables or Legumes | ≥0.1 cup equiv. per 1,000 kcal | No Dark Green Vegetables or Legumes |
| Whole Grains | 10 | ≥1.5 oz equiv. per 1,000 kcal | No Whole Grains | ≥1.5 oz equiv. per 1,000 kcal | No Whole Grains |
| Dairy5 | 10 | ≥1.3 cup equiv. per 1,000 kcal | No Dairy | ≥2.0 cup equiv. per 1,000 kcal | No Dairy |
| Total Protein Foods4 | 5 | ≥2.5 oz equiv. per 1,000 kcal | No Protein Foods | ≥2 oz equiv. per 1,000 kcal | No Protein Foods |
| Seafood and Plant Proteins6 | 5 | ≥0.8 oz equiv. per 1,000 kcal | No Seafood or Plant Proteins | ≥0.5 oz equiv. per 1,000 kcal | No Seafood or Plant Proteins |
| Fatty Acids7 | 10 | (PUFAs + MUFAs)/SFAs ≥2.5 | (PUFAs + MUFAs)/SFAs ≤1.2 | (PUFAs + MUFAs)/SFAs ≥1.5 | (PUFAs + MUFAs)/SFAs ≤0.9 |
| Moderation components | |||||
| Refined Grains | 10 | ≤1.8 oz equiv. per 1,000 kcal | ≥4.3 oz equiv. per 1,000 kcal | ≤1.5 oz equiv. per 1,000 kcal | ≥3.4 oz equiv. per 1,000 kcal |
| Sodium | 10 | ≤1.1 gram per 1,000 kcal | ≥2.0 grams per 1,000 kcal | ≤1.1 gram per 1,000 kcal | ≥1.7 grams per 1,000 kcal |
| Added Sugars | 10 | ≤6.5% of energy | ≥26% of energy | 0% of energy | ≥13.8% of energy |
| Saturated Fats | 10 | ≤8% of energy | ≥16% of energy | ≤12.2% of energy | ≥18.2% of energy |
1:The HEI-2020 components and scoring standards are the same as the HEI-2015. Intakes between the minimum and maximum standards are scored proportionately. The total HEI score is the sum of the adequacy components (i.e., foods to eat more of for good health) and moderation components (i.e., foods to limit for good health).
2: Includes 100% fruit juice.
3: Includes all forms except juice.
4: Includes beans, peas, and lentils.
5: Includes all milk products, such as fluid milk, yogurt, and cheese, and fortified soy beverages.
6: Includes seafood, nuts, seeds, soy products (other than beverages), and beans, peas, and lentils.
7: Ratio of poly- and monounsaturated fatty acids (PUFAs and MUFAs) to saturated fatty acids (SFAs).
Comparing Versions of the HEI
Similarities between HEI Versions
The HEI–2005 through HEI-2020 and HEI-Toddlers-2020 have several features in common. They all:
- have both adequacy components (i.e. foods to eat more of for good health) and moderation components (i.e. foods to limit for good health). The total score is the sum of the scores for the adequacy and moderation components.
- reflect similar aspects of the diet, such as fruits, vegetables, key vegetable subgroups such as green vegetables and beans, dairy, grains, protein foods, fatty acids, and limits on sodium and empty calories.
- use a density approach to set standards, e.g., per 1000 calories or as a percent of calories.
- employ least-restrictive standards for recommendations that vary by energy level, sex, and/or age, namely standards that are easiest to achieve.
Differences between HEI Versions
The HEI-2005 through HEI-2020 and HEI-Toddlers-2020 also differ in several respects, reflecting changes between the 2020, 2015, 2010, and 2005 Dietary Guidelines for Americans. Some of the differences are noted below:
- In 2020, separate recommendations were included for infants and young children for the first time, so a new index (the HEI-Toddlers-2020) was developed for 12 through 23 months.
- For HEI-Toddlers-2020: Although the 13 components are the same as the HEI-2020, many of the scoring standards differ to align with the distinct guidance for this age group. For example, the 2020 Dietary Guidelines recommend that toddlers avoid Added Sugars but do not limit intake for Saturated Fats (more flexible standards).
- In 2020, the USDA Dietary Patterns did not change for children and adults 2 years and older so the standards for the HEI-2015 and HEI-2020 remain the same.
- In 2015, the Empty Calories component (called SoFAAS in 2005) was replaced with two discrete categories, Saturated Fat and Added Sugars, because the 2015 Dietary Guidelines emphasized limiting added sugars in the diet, and for the first time recommended that consumption of added sugars be kept to less than 10% of kcal. Additionally, with the replacement came two changes
- solid fats were replaced by saturated fatty acids for the purpose of calculating the standard; and
- alcohol was removed as an item that contributes an effect to a specific component. Though excessive calories from alcohol are now no longer included within a separate component, total alcohol calories are included in the total calories (the denominator by which almost all standards are calculated); thus these calories are still accounted for in that way.
- In 2010, Greens and Beans replaced Dark Green and Orange Vegetables and Legumes to emphasize that dark green vegetables and beans and peas (also known as legumes) are the two vegetable subgroups for which intakes are furthest from recommended levels. The Greens and Beans component remains an adequacy component in HEI-2015. However, in HEI-2015, legumes are no longer allocated to either the protein components or the vegetable components. Instead, legumes are allocated in all of these components, including Total Vegetables, Greens and Beans, Total Protein Foods, and Seafood and Plant Proteins.
- In 2010, Seafood and Plant Proteins were introduced to capture specific choices from the protein foods group. The Seafood and Plant Proteins component remains an adequacy component in HEI-2015.
- In 2010, Fatty Acids, a ratio of poly- and mono-unsaturated to saturated fatty acids, replaced the two components previously called Oils and Saturated Fat. This component recognizes the recommendation to replace saturated fat with mono- and polyunsaturated fatty acids and remains an adequacy component in HEI-2015.
- In 2010, a moderation component, Refined Grains, replaced the adequacy component, Total Grains, to assess over-consumption because the 2010 Dietary Guidelines emphasized that consumption of these foods is too high. Refined Grains remains a moderation component in HEI-2015.