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Alternative Healthy Eating Index
Also known as: AHEI, Alternate Healthy Eating Index, Alternative Healthy Eating Index, Alternative Healthy Eating Index-2010, Alternative Healthy Eating Index 2010
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Global dietary quality in 185 countries from 1990 to 2018 show wide ... nature.com Sep 19, 2022 46 facts
claimThe study assessed three validated metrics of diet quality: the Alternative Healthy Eating Index (AHEI), the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean Diet Score (MED).
measurementAmong the components of the AHEI score, polyunsaturated fatty acid (PUFA) and non-starchy vegetable scores varied the least across the world's 25 most populous countries in 2018, with two-fold and three-fold differences respectively.
measurementThe largest differences in AHEI scores by education level were found in Central/Eastern Europe and Central Asia (+3.6), Latin America and the Caribbean (+3.5), and South Asia (+2.9).
claimA moderate increase (20-percentile increase) in the AHEI score during follow-up was associated with a significantly lower risk of cardiovascular disease mortality and cancer mortality.
claimThe Alternate Healthy Eating Index (AHEI), Mediterranean Diet Score (MED), and Dietary Approaches to Stop Hypertension (DASH) diet scores may be inadequately correlated with nutrients of concern, particularly among children and in low- and middle-income countries.
measurementIn 2018, the global mean AHEI (Alternative Healthy Eating Index) score was 40.3, with a 95% uncertainty interval of 39.4 to 41.3.
claimIn the study of global dietary quality, most regions exhibited J- or U-shaped relationships between age and Alternative Healthy Eating Index (AHEI) scores, with the highest scores observed among the youngest (≤5 years) and oldest (≥75 years) age groups.
measurementGlobally, women had modestly higher AHEI scores than men for fruit (+0.2), non-starchy vegetables (+0.3), and whole grains (+0.4).
claimThe Alternate Healthy Eating Index (AHEI), Mediterranean Diet Score (MED), and Dietary Approaches to Stop Hypertension (DASH) are considered appropriate metrics for assessing dietary quality across populations in the absence of validated metrics for the double burden of malnutrition.
measurementBetween 1990 and 2018, dietary quality trends as measured by the Alternate Healthy Eating Index (AHEI) increased in five of seven global regions: Central/Eastern Europe and Central Asia (+4.6), high-income countries (+3.2), Southeast and East Asia (+2.7), the Middle East and Northern Africa (+2.2), and Latin America and the Caribbean (+1.3).
measurementGlobally, between 1990 and 2018, AHEI scores increased for non-starchy vegetables (+1.1), legumes/nuts (+1.1), and fruit (+0.1); decreased for red/processed meat (−1.4), sugar-sweetened beverages (−0.6), and sodium (−0.4); and remained stable for whole grains (+0.1), PUFAs (0), and seafood omega-3 (0).
measurementGlobally, more educated individuals had lower AHEI scores (less favorable consumption levels) for red/processed meat (-0.6), sugar-sweetened beverages (-0.6), and nuts and legumes (-0.1).
referenceDiet quality scores, such as the Healthy Eating Index, Alternate Healthy Eating Index, and Dietary Approaches to Stop Hypertension (DASH) score, are associated with health outcomes.
measurementOnly ten countries, representing less than 1% of the world’s population, had AHEI scores of 50 or greater in 2018.
measurementIn 2018, the inter-correlations of dietary pattern scores were 0.8 for AHEI and DASH, 0.5 for AHEI and MED, and 0.6 for DASH and MED.
measurementAmong the most populous countries, the largest absolute improvement in the AHEI score between 1990 and 2018 occurred in Iran (+12.0), the United States (+4.6), Vietnam (+4.5), and China (+4.3).
measurementIn 2018, the highest global AHEI component scores for unhealthier items (indicating lowest or most favourable intakes) were for sugar-sweetened beverages (5.8) and red/processed meat (4.8).
measurementGlobally in 2018, the mean AHEI score was similar among children (39.2) versus adults (40.8).
measurementAmong the world’s 25 most populous countries in 2018, the mean AHEI score was highest in Vietnam, Iran, Indonesia, and India (ranging from 54.5 to 48.2) and lowest in Brazil, Mexico, the United States, and Egypt (ranging from 27.1 to 33.5).
measurementGlobally, children had higher AHEI component scores than adults for polyunsaturated fatty acids (2.1 vs 1.4) and sodium (4.6 vs 3.2).
measurementUrban residents had higher AHEI scores than rural residents in Central/Eastern Europe and Central Asia (+2.2) and Southeast and East Asia (+1.4), but lower scores in the Middle East and Northern Africa (-3.8).
measurementAmong the most populous countries, the largest declines in the AHEI score between 1990 and 2018 occurred in Tanzania (−3.7), Nigeria (−3.0), Japan (−2.7), and the Philippines (−1.8).
measurementGlobally and regionally, women generally had higher mean AHEI scores than men, with the largest differences observed in high-income countries (+4.4) and in Central/Eastern Europe and Central Asia (+3.6).
measurementBetween 1990 and 2018, dietary quality trends as measured by the Alternate Healthy Eating Index (AHEI) showed no significant change in South Asia (0) and a decreasing trend in Sub-Saharan Africa (−1.1).
measurementThe global mean AHEI score in the study 'Global dietary quality in 185 countries from 1990 to 2018' was 40.3 (95% UI 39.4, 41.3).
measurementGlobally, children had lower AHEI component scores than adults for fruit (2.2 vs 2.5), non-starchy vegetables (3.1 vs 4.3), sugar-sweetened beverages (5.3 vs 6.1), and seafood omega-3 (3.3 vs 4.7).
measurementGlobally, urban residents had higher AHEI scores for fruit (+0.2) and whole grains (+0.2), but lower scores for sugar-sweetened beverages (-0.5), red/processed meat (-0.4), and legumes/nuts (-0.1).
claimGlobally, AHEI scores did not significantly vary by urban versus rural residence.
claimThe dietary patterns selected for the study (AHEI, MED, and DASH) were originally developed and validated for adult populations in high-income countries but have been used to characterize dietary quality among children and seniors.
imageExtended Data Fig. 1 in the study displays the mean Alternative Healthy Eating Index (AHEI) scores, ranging from 0 to 100, across global and regional populations categorized by sex, education level, and urban or rural residence in 2018.
measurementIn 2018, the mean AHEI score was substantially higher among adults compared with children in Central/Eastern Europe, Central Asia, high-income countries, and the Middle East and Northern Africa region.
procedureFor the calculation of AHEI, DASH, and MED scores, consumption levels of dietary factors in each stratum were standardized to 2,000 kcal per day to ensure consistency based on usual adult intakes.
claimThe study lacked information on trans fat (for the AHEI metric) and alcohol use (for the AHEI and MED metrics), meaning findings should be interpreted as dietary quality based on the other components of these scores.
measurementIn 2018, the mean global Alternative Healthy Eating Index score was 40.3.
claimGlobally and in most regions, individuals with higher education levels had greater AHEI scores, with the exception of the Middle East and Northern Africa and Sub-Saharan Africa, where no differences were evident.
measurementIn 2018, regional mean AHEI scores ranged from 30.3 (95% UI 28.7, 32.2) in Latin America and the Caribbean to 45.7 (95% UI 43.8, 49.3) in South Asia.
measurementGlobally, more educated individuals had higher AHEI scores for fruit (+0.8), sodium (+0.7), whole grains (+0.6), and non-starchy vegetables (+0.5).
referenceA 2017 study by Shivappa et al. published in the British Journal of Nutrition analyzed the relationship between the Alternative Healthy Eating Index 2010, the Dietary Inflammatory Index, and mortality risk using data from the Whitehall II cohort study and a meta-analysis.
measurementRegional mean Alternative Healthy Eating Index scores in 2018 ranged from 30.3 in Latin America and the Caribbean to 45.7 in South Asia.
claimIn the AHEI, DASH, and MED dietary pattern scores, higher scores represent healthier diets because they are assigned for higher intakes of healthier foods or nutrients and lower intakes of unhealthier foods or nutrients.
measurementBetween 1990 and 2018, the mean global AHEI score, standardized to 2018 population distributions, increased by +1.5.
claimThe researchers characterized three established metrics for diet quality (AHEI, MED, and DASH), each validated against major health outcomes, to analyze similarities and differences in global, regional, and national dietary quality.
measurementIn 2018, the highest global AHEI component scores for healthier items were for legumes/nuts (5.0), followed by whole grains (4.7), seafood omega-3 fat (4.2), and non-starchy vegetables (3.9).
referenceThe study 'Global dietary quality in 185 countries from 1990 to 2018' compared three validated dietary patterns: the Alternative Healthy Eating Index (AHEI), the Dietary Approaches to Stop Hypertension (DASH) diet, and the Mediterranean Diet Score (MED17).
claimThe Alternative Healthy Eating Index (AHEI) is a validated score of diet quality ranging from 0 (least healthy) to 100 (most healthy).
measurementPooled findings from two US cohorts found that the highest AHEI quintile (median 64.5) compared with the lowest quintile (median 36.9) was associated with a 24% reduction in cardiovascular disease, a 33% reduction in diabetes mellitus, and a 6% reduction in cancer incidence.
Diet Quality Indices: Measures for Bridging Nutrition and Public Health link.springer.com 2 days ago 7 facts
referenceThe abbreviation AHEI stands for Alternative Healthy Eating Index.
referenceHlaing-Hlaing H, Dolja-Gore X, Tavener M et al. (2022) analyzed the association between the Alternative Healthy Eating Index-2010 and incident non-communicable diseases in a 15-year follow-up of women from the 1973–78 cohort of the Australian longitudinal study on women’s health, published in Nutrients 14(20):4403.
referenceWu PY, Lin MY, and Tsai PS conducted a meta-analysis and systematic review published in 2020 in Nutritional Neuroscience, which examined the relationship between the Alternate Healthy Eating Index and the risk of depression.
referenceMorze J, Danielewicz A, Hoffmann G, Schwingshackl L (2020) published a systematic review and meta-analysis in the Journal of the Academy of Nutrition and Dietetics titled 'Diet quality as assessed by the Healthy Eating Index, Alternate Healthy Eating Index, dietary approaches to stop hypertension score, and health outcomes: a second update of a systematic review and meta-analysis of cohort studies'.
referenceSchwingshackl, Bogensberger, and Hoffmann (2018) performed an updated systematic review and meta-analysis of cohort studies assessing diet quality via the Healthy Eating Index, Alternate Healthy Eating Index, and the Dietary Approaches to Stop Hypertension (DASH) score in relation to health outcomes.
referenceNeelakantan N, Naidoo N, Koh WP et al. (2016) published a study in the Journal of Nutrition titled 'The Alternative Healthy Eating Index is associated with a lower risk of fatal and nonfatal acute myocardial infarction in a Chinese adult population'.
referenceOnvani S, Haghighatdoost F, Surkan PJ et al. (2017) published a meta-analysis in the Journal of Human Nutrition and Dietetics titled 'Adherence to the Healthy Eating Index and Alternative Healthy Eating Index dietary patterns and mortality from all causes, cardiovascular disease, and cancer: a meta-analysis of observational studies'.
Dietary Guidelines and Quality - Principles of Nutritional Assessment nutritionalassessment.org 6 facts
claimUnlike the Alternate Healthy Eating Index, which has a single definition, there are numerous Mediterranean Diet Scores (MDSs) that vary widely in their scoring range, rationale, and methodology, and they are generally based only on foods and beverages rather than a mix of foods and nutrients.
referenceThe Alternate Healthy Eating Index emphasizes the consumption of whole grains, a favorable ratio of fish and poultry to red and processed meats, the intake of nuts and soy foods, and a favorable ratio of polyunsaturated to saturated fats, while excluding dairy from the scoring.
claimThe Alternate Healthy Eating Index showed stronger associations with cardiovascular disease outcomes for both men and women compared to the original Healthy Eating Index, according to research by McCullough et al. (2000).
referenceThe Alternate Healthy Eating Index was developed by McCullough et al. (2002) to reflect evidence related to non-communicable diseases that had not been incorporated into U.S. national dietary guidance at the time.
claimThe Alternate Healthy Eating Index (AHEI) measures the consumption of a literature-based selection of foods and nutrients that are consistently associated with a decreased risk of non-communicable diseases (NCDs).
claimThe development of the Global Diet Quality Score (GDQS) involved selecting food groups based on a literature review of relationships between food group intakes and health outcomes, similar to the development of the Alternative Healthy Eating Index (AHEI).
a synthesis of dietary quality metrics and their validity for the double ... research.manchester.ac.uk 1 fact
claimFour non-communicable disease (NCD) dietary metrics—the Mediterranean Diet Score, Alternative Healthy Eating Index, Healthy Eating Index, and Dietary Approaches to Stop Hypertension—have convincing evidence of protective associations with specific NCD outcomes, including mortality, cardiovascular disease, type 2 diabetes, and total cancer.
(PDF) Defining diet quality: a synthesis of dietary quality metrics and ... researchgate.net Aug 4, 2020 1 fact
claimThe Mediterranean Diet Score, the Alternative Healthy Eating Index, the Healthy Eating Index, and the Dietary Approaches to Stop [Hypertension] are identified as four dietary metrics used for non-communicable disease (NCD) research.