Using the Healthy Eating Index (hei) to rate the Diets of First Year Medical Students

Abstract

LEARNING OUTCOME: To use the HEI to compare the dietary quality of first year medical students (MSI) with that of a representative sample of the US population participating in the Continuing Survey of Food Intake by Individuals.The first year of medical school is especially busy and stressful, and many MSI complain that they don't have the time to eat well in spite of their commitment to a good diet and a healthy lifestyle. The newly proposed 10 item HEI includes 5 Food Guide Pyramid (FGP) scores and 5 scores based on the US Dietary Guidelines (DG) (total fat, saturated fat, cholesterol, sodium, and variety). Subjects were MSI (n-52:♀ 20,♂ 32; x̄Age=25.1±3.9; x̄BMI=24.0±2.7) who completed a 3 day diet record and a computerized nutrient analysis (Food Processor Program) for a required medical nutrition course. These were reviewed by an RD who calculated the variety scores and the FGP scores using the students’ food records, the HEI recommended number of servings per day for women 11-50 years and men 19-50 years, and the FGP guidelines for serving sizes. Scores for the remaining 4 DG components were determined from the computerized nutrient analyses. The mean HEI score (76.4) for these MSI was about 12 points higher than that observed in the representative US population (63.9). On the HEI subscores, the MSI scored lower on vegetables, milk, and sodium, higher on fruits, meat, total fat, saturated fat, cholesterol, and variety, and about the same for grains. The distribution of the HEI for the MSI was skewed to the upper ranges (61-90), while the scores for the US population were more evenly distributed. Overall men tended to score slightly lower than women with absolute differences of about 4 points for total HEI scores in both groups: US representative population (:♀≈65.3;♂≈61.0)v.s. the MSI sample (:♀=78.3;♂ =74.1). The mean HEI score for this group of students (76.4) was about 8 points higher than that of a sub-group of the US population with >4 years of college (≈68.1). Therefore, in general, it appears that these students are able to maintain adequate dietary quality in spite of their very hectic schedules and long, stressful days and that the HEI is a relatively simple yet comprehensive means of assessment for these dietary “snapshots”.