JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION

1. Evaluation of the Healthy Eating Index-2005 Patricia M. Guenther, PhD, RD: US Department of Agriculture, Center for Nutrition Policy and Promotion Jill Reedy, PhD, RD: National Cancer Institute (NCI) Susan M. Krebs-Smith, PhD, RD: NCI Bryce B. Reeve, PhD: NCI JOURNAL OF THEAMERICAN DIETETICASSOCIATION

2. Evaluation of the Healthy Eating Index-2005 Tests • Content validity • Construct validity • Internal consistency (reliability)

3. Evaluation of the Healthy Eating Index-2005 Content validity • Extent to which the measure captures the variety of attributes that make up the construct • Includes face validity • Test • Check against Dietary Guidelines

4. Evaluation of the Healthy Eating Index-2005 Construct validity • Extent to which the measure is consistent with theoretical hypotheses • Tests • Exemplary menus • Smokers vs nonsmokers • Correlations with energy • Principal components analysis

5. Evaluation of the Healthy Eating Index-2005 Sources of exemplary menus • MyPyramid.gov • Dietary Approaches to Stop Hypertension (DASH) Eating Plan • Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating • American Heart Association No-Fad Diet

6. Evaluation of the Healthy Eating Index-2005 Healthy Eating Index-2005 scores for exemplary menus SoFAAS: Solid Fats, Alcoholic beverages, and Added Sugars

7. Evaluation of the Healthy Eating Index-2005 Population data used • National Health and Nutrition Examination Survey, 2001-2002 • N = 8650 • One 24-hour recall per respondent • Nutrients • MyPyramid food groups

8. Evaluation of the Healthy Eating Index-2005 Concurrent criterion validity • Distinguishes between groups with known differences in the quality of their diets • Test • Smokers vs nonsmokers

9. Evaluation of the Healthy Eating Index-2005 Smokers vs nonsmokers • Number of differences in mean component scores • Original Healthy Eating Index 5 of 10 • Healthy Eating Index-2005 9 of 12 • Differences in mean total score • Original Healthy Eating Index 5.5 points • Healthy Eating Index-2005 8.6 points • Conclusion: Healthy Eating Index-2005 distinguishes between smokers and nonsmokers better than original Healthy Eating Index

10. Evaluation of the Healthy Eating Index-2005 Correlations of original Healthy Eating Index scores and energy intake • Component scores • Fruit .05 • Vegetables, Milk, Variety, Meat, Grains .29 to .44 • Fat, Saturated fat (% calories) -.08 to .09 • Cholesterol -.43 • Sodium -.69 • Total score .09 • Low because some food-group correlations are positive and others negative

11. Evaluation of the Healthy Eating Index-2005 Correlations of Healthy Eating Index-2005 scores and energy intake • Component scores • Calories from SoFAAS -.22 • Sodium, Saturated Fat -.08 to -.11 • Vegetables, Grains, Fruit -.05 to -.10 • Milk 0 • Oils, Meat and Beans .06 to .08 • Total score -.14 • Low because all component correlations are low • Conclusion: Healthy Eating Index-2005 successfully uncouples diet quantity and diet quality SoFAAS: Solid Fats, Alcoholic beverages, and Added Sugars

12. Evaluation of the Healthy Eating Index-2005    Eigenvalue          Number of factors Principal component analysis scree plot Variance accounted for by each factor Conclusion: Multiple factors underlie the Healthy Eating Index-2005

13. Evaluation of the Healthy Eating Index-2005 Types of reliability • Test-retest reliability does not apply • All sources of error attributable to • Respondent recall • Data collection and coding • Inter-rater reliability does not apply • No judgment required • Internal consistency • Only type that could be tested

14. Evaluation of the Healthy Eating Index-2005 Internal consistency • Degree of association among the components of an index • Test • Cronbach’s alpha coefficient

15. Evaluation of the Healthy Eating Index-2005 Internal consistency • Cronbach’s coefficient alpha = 0.43 • Anticipated to be low because • Healthy Eating Index-2005 components • Do not all measure the same thing • Relationships among them vary • Conclusion: Healthy Eating Index-2005 is best used as a set of profile scores; otherwise, much information will be lost

16. Evaluation of the Healthy Eating Index-2005 Conclusions The Healthy Eating Index-2005 • Is a valid measure of compliance with the 2005 Dietary Guidelines for Americans • Yields high scores for exemplary menus • Distinguishes between groups with known differences in diet quality • Uncouples diet quality and diet quantity by using a density approach • Provides a valid set of profile scores for assessing diet quality