Development and assessment of the reliability of the basic healthy eating index for the Russian population

Abstract

The conventional presentation of data on the actual average daily consumption of energy, nutrients, food products, as well as critically important risk factors complicates a holistic dietary assessment, consisting of at least a dozen indicators only for nutrients. The aim of the study was to develop a healthy eating index (HEI), based on epidemiological data on the actual nutrition of the Russian population and the criteria and principles of healthy nutrition adopted in the country. Material and methods. We used the data on the dietary intake of nutrients, energy and the main food groups obtained from the cross-sectional nutritional survey of members of 45 000 households over the age of 3 years conducted by Federal Statistics Service (Rosstat) in all regions of the Russian Federation in 2013. The criteria for scoring the indicator-components of the HEI were developed taking into account modern recommendations about the magnitudes of consumption of the most important food groups, as well as the levels of consumption of critical risk factors for chronic non-communicable diseases. Results and discussion. The HEI design included 5 indicators characterizing the adequacy of consumption of the main food groups, as well as 5 indicators of nutritional risk factors for chronic non-communicable diseases. Consumption of food groups (cereals, dairy, meat products, excluding sausages, vegetables, fruits) and added salt was calculated in g per 1000 kcal, and critical risk factors (total fat, saturated fat, added sugars) were estimated as a percentage of total energy. As a result of transformations of quantitative variables of consumption of macronutrients (risk factors) and food products, quantitative scores were obtained (0-10 points) for all 10 indicator-components of the HEI. The assessment of the reliability of the HEI (validation) showed that a statistically significant positive correlation can be traced between the integral HEI and the indicators. This is a sign of reliability and objectivity of the HEI design. At the same time, a negative correlation was found between the value of the HEI and the scores of meat products, including sausages, that was the basis for excluding sausages from calculating the amount of meat products. It has been shown that HEI is significantly higher in females in age groups older than 11 years. A pronounced dependence of HEI on the age of people of both sexes has been established, that may be an indicator of the high sensitivity of HEI to changes in dietary patterns. The maximum HEI values were noted in children, the minimum - in adults 19-60 years, with a subsequent increase in the age group over 60 years. There were no changes in HEI in obese men, but HEI in women with body mass index (BMI) above 30.0 was significantly higher than in those with normal body weight (BMI 18.5-24.9). Conclusion. Further research is needed on the sensitivity of the HEI in terms of assessing the dietary patterns and dependence on socio-economic and other variables, including a wide range of dietary modifications.