HEI Analysis of NHANES Dietary Data: Exploring the Diet Quality of Americans with R Package heiscore

Abstract

Connections between subpar dietary choices and negative health consequences are well established in the field of nutritional epidemiology. Consequently, in the United States, there is a standard practice of conducting regular surveys to evaluate dietary habits. One notable example is the National Health and Nutrition Examination Survey (NHANES) conducted every two years by the Center for Disease Control (CDC). Several scoring methods have been developed to assess the quality of diet in the overall population as well as different pertinent subgroups using dietary recall data collected in these surveys. The Healthy Eating Index (HEI) is one such metric, developed based on recommendations from the United States Department of Health and Human Services (HHS) and Department of Agriculture (USDA) and widely used by nutritionists. Presently, there is a scarcity of user-friendly statistical software tools implementing the scoring of these standard scoring metrics. Herein, we develop an R package heiscore to address this need. Our carefully designed package, with its many user-friendly features, increases the accessibility of the HEI scoring using three different methods outlined by the National Cancer Institute (NCI). Additionally, we provide functions to visualize multidimensional diet quality data via various graphing techniques, including bar charts and radar charts. Its utility is illustrated with many examples, including comparisons between different demographic groups.