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History of the HEI
The original Healthy Eating Index (HEI) was released by the United States Department of Agriculture's (USDA) Center for Nutrition Policy and Promotion in 1995. Changes made to the Dietary Guidelines for Americans (DGA) in 2005 necessitated revisions to the original HEI. At that time, the HEI was significantly updated through a collaboration between the National Cancer Institute (NCI) and the USDA. The HEI was updated every five years to assess alignment with the new DGA. In 2020, the first HEI for toddlers was introduced based on the dietary pattern for the second year of life (i.e. age 12 through 23 months) in the 2020-2025 DGA.
This webpage details information about versions of the HEI from 2005 to present. For each iteration of the HEI, all of the key Dietary Guidelines food choice recommendations that relate to diet quality are reflected in that index's components. Refer to the webpage comparing versions for more information on the similarities and differences between each version of the index.
HEI-Toddlers-2020
HEI-Toddlers-2020 Components & Scoring Standards1
| Component | Maximum points | Standard for maximum score | Standard for minimum score of zero |
|---|---|---|---|
| Adequacy: | |||
| Total Fruits2 | 5 | ≥0.7 cup equiv. per 1,000 kcal | No Fruits |
| Whole Fruits3 | 5 | ≥0.3 cup equiv. per 1,000 kcal | No Whole Fruits |
| Total Vegetables4 | 5 | ≥0.9 cup equiv. per 1,000 kcal | No Vegetables |
| Greens and Beans4 | 5 | ≥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 |
| Dairy5 | 10 | ≥2.0 cup equiv. per 1,000 kcal | No Dairy |
| Total Protein Foods6 | 5 | ≥2 oz equiv. per 1,000 kcal | No Protein Foods |
| Seafood and Plant Proteins6,7 | 5 | ≥0.5 oz equiv. per 1,000 kcal | No Seafood or Plant Proteins |
| Fatty Acids8 | 10 | (PUFAs + MUFAs)/SFAs ≥1.5 | (PUFAs + MUFAs)/SFAs ≤0.9 |
| Moderation: | |||
| Refined Grains | 10 | ≤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 | ≥1.7 grams per 1,000 kcal |
| Added Sugars | 10 | 0% of energy | ≥13.8% of energy |
| Saturated Fats | 10 | ≤12.2% of energy | ≥18.2% of energy |
1: 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 legumes (beans and peas).
5: Includes all milk products, such as fluid milk, yogurt, and cheese, and fortified soy beverages.
6: Includes legumes (beans and peas).
7: Includes seafood, nuts, seeds, soy products (other than beverages), and legumes (beans and peas).
8: Ratio of poly- and monounsaturated fatty acids (PUFAs and MUFAs) to saturated fatty acids (SFAs).
Reference: Pannucci TE, Lerman JL, Herrick KA, Shams-White MM, Zimmer M, Meyers Mathieu K, Stoody E, Reedy J. Development of the Healthy Eating Index-Toddlers-2020. J Acad Nutr Diet. 2023 May 18;S2212-2672(23)00244-7. Online ahead of print.
HEI-Toddlers-2020 Overview
The HEI-Toddlers-2020, like HEI-2020, has 13 components reflecting all constituents of complementary foods and beverages consumed by toddlers, with the exception of human milk, infant formula, or other nutritional formulas such as toddler milks or follow-on formula. Healthy dietary patterns for toddlers have unique considerations reflected in the scoring standards for Added Sugars and Saturated Fats. Toddlers have lower caloric intake relative to high nutrient needs, and added sugars should be avoided. Another distinctive difference is that there is no recommendation to limit saturated fats to less than 10 percent of energy intake in this age group, however, saturated fats cannot be unlimited without displacing the energy available to achieve other food group and subgroup goals.
HEI-2020 & HEI-2015
HEI-2020 & HEI–20151 Components & Scoring Standards
| Component | Maximum points | Standard for maximum score | Standard for minimum score of zero |
|---|---|---|---|
| Adequacy: | |||
| Total Fruits2 | 5 | ≥0.8 cup equiv. per 1,000 kcal | No Fruits |
| Whole Fruits3 | 5 | ≥0.4 cup equiv. per 1,000 kcal | No Whole Fruits |
| Total Vegetables4 | 5 | ≥1.1 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 |
| Whole Grains | 10 | ≥1.5 oz equiv. per 1,000 kcal | No Whole Grains |
| Dairy5 | 10 | ≥1.3 cup equiv. per 1,000 kcal | No Dairy |
| Total Protein Foods6 | 5 | ≥2.5 oz equiv. per 1,000 kcal | No Protein Foods |
| Seafood and Plant Proteins6,7 | 5 | ≥0.8 oz equiv. per 1,000 kcal | No Seafood or Plant Proteins |
| Fatty Acids7 | 10 | (PUFAs + MUFAs)/SFAs ≥2.5 | (PUFAs + MUFAs)/SFAs ≤1.2 |
| Moderation: | |||
| Refined Grains | 10 | ≤1.8 oz equiv. per 1,000 kcal | ≥4.3 oz equiv. per 1,000 kcal |
| Sodium | 10 | ≤1.1 gram per 1,000 kcal | ≥2.0 grams per 1,000 kcal |
| Added Sugars | 10 | ≤6.5% of energy | ≥26% of energy |
| Saturated Fats | 10 | ≤8% of energy | ≥16% 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 legumes (beans and peas).
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).
References:
Shams-White MM, Pannucci T, Lerman J, Herrick KA, Zimmer M, Meyers Mathieu K, Stoody E, Reedy J. Healthy Eating Index-2020: Review and Update Process to Reflect the Dietary Guidelines for Americans, 2020-2025. J Acad Nutr Diet. 2023 May 15;S2212-2672(23)00246-0. Online ahead of print.
Krebs-Smith SM, Pannucci TE, Subar AF, Kirkpatrick SI, Lerman JL, Tooze JA, Wilson MM, and Reedy J. Update of the Healthy Eating Index-2015. J Acad Nutr Diet. 2018 Sep;118(9):1591-1602.
HEI-2020 & HEI-2015 Overview
HEI-2020
The Healthy Eating Index-2020 is the latest iteration of the index and can be used to assess alignment with the 2020-2025 DGA. For the first time, the components and standards did not change between the HEI-2015 and HEI-2020 for the following reasons: the USDA Dietary Patterns remained virtually the same in the 2015-2020 and 2020-2025 DGA; there were no major changes in the key recommendations for children and adults ages 2 and older; and the state of the U.S. diet did not change significantly since 2015. Even though no changes were made, the index was renamed to clarify that it aligned with most current guidance (i.e., the HEI-2020 for the 2020-2025 DGA).
HEI-2015
The HEI-2015 was designed to align with the 2015-2020 DGA. As with the previous DGA, the 2015-2020 edition emphasizes a variety of food groups, nutrient density, and improving food and beverage choices within calorie needs.
A new aspect of the DGA introduced in 2015 is a specific recommendation on limiting intake of added sugars to less than 10% of total caloric intake.
As with the previous HEI versions, staff at the NCI and the USDA collaborated to revise the HEI to align with the recommendations in the 2015 DGA. Most of the HEI-2010 components were retained in HEI-2015; however, the "Empty Calories" component has been replaced by two separate components, "Added Sugars" and "Saturated Fats," to better align with the newly quantified added sugars recommendation while still retaining the concept that these components encompass remaining calories in the diet.
Previously, excessive calories from alcohol were included in the Empty Calories component. With the changes regarding the Empty Calories component, alcohol is no longer specifically addressed within a single component. However, overall calories contributed from alcohol in the diet continue to be included in the total energy used as the denominator to calculate HEI-2015 scores.
While the other dietary components remained the same with the HEI-2015 revision, a change was made to the method by which legumes are allocated to the components. In HEI-2015, legumes are now being allocated to four components: Total Protein Foods, Seafood and Plant Proteins, Total Vegetables, and Greens and Beans. Because legumes are consumed infrequently by many in the population, this change is expected to have little impact on total scores at the population level. However, for some subgroups, such as vegetarians, individual scores may improve substantially.
After revisions, the HEI-2015 contains 13 components that sum to a total maximum score of 100 points. The total score is the sum of the score of adequacy components (i.e. foods to eat more of for good health) and moderation components (i.e. foods to limit for good health).
As in HEI-2005 and HEI-2010, each of the components is scored on a density basis out of 1,000 calories, with the exception of Fatty Acids, which is a ratio of unsaturated to saturated fatty acids. The details of the scoring standards of the HEI-2015 are shown in the accompanying table.
HEI-2010
HEI–20101 Components & Scoring Standards
| Component | Maximum points | Standard for maximum score | Standard for minimum score of zero |
|---|---|---|---|
| Adequacy: | |||
| Total Fruit2 | 5 | ≥0.8 cup equiv. per 1,000 kcal | No Fruit |
| Whole Fruit3 | 5 | ≥0.4 cup equiv. per 1,000 kcal | No Whole Fruit |
| Total Vegetables4 | 5 | ≥1.1 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 Beans and Peas |
| Whole Grains | 10 | ≥1.5 oz equiv. per 1,000 kcal | No Whole Grains |
| Dairy5 | 10 | ≥1.3 cup equiv. per 1,000 kcal | No Dairy |
| Total Protein Foods6 | 5 | ≥2.5 oz equiv. per 1,000 kcal | No Protein Foods |
| Seafood and Plant Proteins6,7 | 5 | ≥0.8 oz equiv. per 1,000 kcal | No Seafood or Plant Proteins |
| Fatty Acids8 | 10 | (PUFAs + MUFAs)/SFAs ≥2.5 | (PUFAs + MUFAs)/SFAs ≤1.2 |
| Moderation: | |||
| Refined Grains | 10 | ≤1.8 oz equiv. per 1,000 kcal | ≥4.3 oz equiv. per 1,000 kcal |
| Sodium | 10 | ≤1.1 gram per 1,000 kcal | ≥2.0 grams per 1,000 kcal |
| Empty Calories9 | 20 | ≤19% of energy | ≥50% of energy |
1: 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 any beans and peas not counted as Total Protein Foods.
5: Includes all milk products, such as fluid milk, yogurt, and cheese, and fortified soy beverages.
6: Beans and peas are included here (and not with vegetables) when the Total Protein Foods standard is otherwise not met.
7: Includes seafood, nuts, seeds, soy products (other than beverages) as well as beans and peas counted as Total Protein Foods.
8: Ratio of poly- and monounsaturated fatty acids (PUFAs and MUFAs) to saturated fatty acids (SFAs).
9: Calories from solid fats, alcohol, and added sugars; threshold for counting alcohol is >13 grams/1000 kcal.
Reference: Guenther PM, Casavale KO, Reedy J, Kirkpatrick SI, Hiza HA, Kuczynski KJ, Kahle LL, Krebs-Smith SM. Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet. 2013 Apr; 113(4):569-80.
HEI-2010 Overview
The 2010 DGA continued the 2005 DGA emphasis on several important aspects of diet quality, including whole grains, various types of vegetables, and specific types of fat. The 2010 DGA also differed from the previous DGA in several respects, including an increased emphasis on seafood and plant proteins and on reducing consumption of refined grains. As a result, the HEI–2005 needed to be revised and updated.
Staff at the NCI and the USDA collaborated to revise the HEI, and a new version, the HEI–2010, was released in February 2013. A paper describing the HEI–2010 in detail is available.
This revision also provided an opportunity for the NCI and the USDA to evaluate the psychometric properties of the new index. Results from the evaluation can be found on the webpage, Evaluating the Healthy Eating Index.
The HEI–2010 is based in large part on USDA's 2010 food patterns, which translates recommendations in the 2010 DGA into specific, quantified dietary recommendations. All of the food groups contained in USDA's food patterns are represented in HEI–2010 components. Nine of the components focus on adequacy (dietary components to increase) and three focus on moderation (dietary components to decrease).
The HEI–2010 comprises 12 components that sum to a maximum total score of 100. Because USDA food pattern recommendations for amounts of food groups, oils, and empty calories are stated in terms of absolute amounts that vary according to energy level, the HEI–2010 scores use standards that are expressed as either a percent of calories or per 1,000 calories. This "density" approach uncouples diet quality from quantity. The one exception is fatty acids, which are expressed as a ratio of unsaturated fatty acids to saturated fatty acids. The HEI–2010 components and scoring standards are shown in the accompanying table.
HEI-2005
HEI–20051 Components & Standards for Scoring
| Component | Maximum points | Standard for maximum score | Standard for minimum score of zero |
|---|---|---|---|
| Total Fruit (includes 100% juice) | 5 | ≥0.8 cup equiv. per 1,000 kcal | No Fruit |
| Whole Fruit (not juice) | 5 | ≥0.4 cup equiv. per 1,000 kcal | No Whole Fruit |
| Total Vegetables | 5 | ≥1.1 cup equiv. per 1,000 kcal | No Vegetables |
| Dark Green and Orange Vegetables and Legumes2 | 5 | ≥0.4 cup equiv. per 1,000 kcal | No Dark Green or Orange Vegetables or Legumes |
| Total Grains | 5 | ≥3.0 oz equiv. per 1,000 kcal | No Grains |
| Whole Grains | 5 | ≥1.5 oz equiv. per 1,000 kcal | No Whole Grains |
| Milk3 | 10 | ≥1.3 cup equiv. per 1,000 kcal | No Milk |
| Meat and Beans | 10 | ≥2.5 oz equiv. per 1,000 kcal | No Meat or Beans |
| Oils4 | 10 | ≥12 grams equiv. per 1,000 kcal | No Oil |
| Saturated Fat | 10 | ≤7% of energy5 | ≥15% of energy |
| Sodium | 10 | ≤0.7 gram per 1,000 kcal5 | ≥2.0 grams per 1,000 kcal |
| Calories from Solid Fats, Alcoholic Beverages, and Added Sugars (SoFAAS) | 20 | ≤20% of energy | ≥50% of energy |
1: Intakes between the minimum and maximum levels are scored proportionately, except for Saturated Fat and Sodium (see note 5).
2: Legumes counted as vegetables only after Meat and Beans standard is met.
3: Includes all milk products, such as fluid milk, yogurt, and cheese.
4: Includes nonhydrogenated vegetable oils and oils in fish, nuts, and seeds.
5: Saturated Fat and Sodium get a score of 8 for the intake levels that reflect the 2005 DGA, <10% of calories from saturated fat and 1.1 grams of sodium/1,000 kcal, respectively.
Source: Guenther PM, Reedy J, Krebs-Smith SM. Development of the Healthy Eating Index–2005. J Am Diet Assoc. 2008 Nov;108(11):1896-901
HEI-2005 Overview
The 2005 DGA differed from earlier editions by increasing the emphasis on several important aspects of diet quality, including whole grains, various types of vegetables, and specific types of fat. The 2005 DGA also introduced the concept of "discretionary calories." As a result, the 1995 HEI needed to be revised and updated.
Staff at the NCI and the USDA collaborated to revise the HEI, and a new version, the HEI–2005, was published in November 2007. This revision also provided an opportunity for the NCI and USDA to evaluate the psychometric properties of the new index.
The HEI–2005 is based on MyPyramid, USDA's revised food guidance system, which translates recommendations in the 2005 DGA into specific, quantified dietary recommendations. All of the food groups contained in MyPyramid are represented in HEI–2005 components.
The HEI–2005 uses a scoring system, as did the original HEI. However, because MyPyramid recommendations for amounts of food groups, oils, and discretionary calories are stated in terms of absolute amounts that vary according to energy level, the NCI and USDA team developed the HEI–2005 scores using standards that are expressed as either a percent of calories or per 1,000 calories. The HEI–2005 components and scoring standards are shown in the accompanying table.