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Community and International Nutrition

The Healthy Eating Index and Youth Healthy Eating Index Are Unique, Nonredundant Measures of Diet Quality among Low-Income, African American Adolescents^1,2

³ Department of Pediatrics, University of Maryland School of Medicine, Baltimore MD 21201 and ⁴ Department of Health, Behavior, and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205

Chronic disease is related to poor diet quality. The Healthy Eating Index (HEI) was developed to assess diet quality. The Youth HEI (YHEI) is an adaptation of the HEI for use with children and adolescents. The objectives were to compare HEI and YHEI scores among adolescents at risk for chronic disease and to compare associations between the scores and health indicators. This cross-sectional study included 2 low-income, urban African American adolescent samples (Challenge, n = 196; Three Generation, n = 121). HEI and YHEI scores were calculated from a FFQ and compared with BMI, body composition, and micronutrient, energy, and dietary intakes. YHEI scores were lower than HEI scores across both adolescent samples (Challenge, 48.94 ± 9.31 vs. 62.83 ± 11.75; Three Generation, 47.08 ± 9.65 vs. 59.93 ± 11.27; P < 0.001). Females (64.47 ± 11.70) had higher HEI scores than males (61.15 ± 11.61) (P < 0.05), but there was no gender difference in YHEI scores. HEI and YHEI scores were associated with higher micronutrient and total energy intakes (r = 0.19–0.76; P < 0.05). Higher percent body/abdominal fat was associated with lower HEI scores (r = –0.17 to –0.19; P < 0.05) but not with YHEI scores. BMI was not associated with either HEI or YHEI scores. In conclusion, many adolescents were consuming diets that placed them at risk for developing chronic disease. Although both the HEI and YHEI are useful in assessing diet quality, the HEI is inversely associated with body composition, a predictor of chronic disease, and accounts for gender differences in the Dietary Guidelines, whereas the YHEI discounts nutrient-poor, energy-dense foods.

^* To whom correspondence should be addressed. E-mail: khurley{at}peds.umaryland.edu.

Manuscript received 29 July 2008. Initial review completed 27 August 2008. Revision accepted 10 November 2008.

Published online 11 December 2008.