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Article

Healthy Eating Index-2015 Scores Vary by Types of Food Outlets in the United States

1
Epidemiology and Genomics Research Program, Risk Factor Assessment Branch, National Institutes of Health, National Cancer Institute, Bethesda, MD 20892, USA
2
Global Health and Family Medicine and Community Health, Duke University, Durham, NC 27708, USA
3
Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD 20740, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Ruopeng An
Nutrients 2021, 13(8), 2717; https://doi.org/10.3390/nu13082717
Received: 16 July 2021 / Revised: 2 August 2021 / Accepted: 3 August 2021 / Published: 7 August 2021
Diet quality in the United States is improving over time but remains poor. Food outlets influence diet quality and represent the environments in which individuals make choices about food purchases and intake. The objective of this study was to use the Healthy Eating Index-2015 (HEI-2015) to evaluate the quality of foods consumed from the four major outlets where food is obtained—stores, full-service restaurants, quick-services restaurants, and schools—and to assess changes over time. This cross-sectional study used 24 h dietary recall data from eight cycles (2003–2004 to 2017–2018) of the National Health and Nutrition Examination Survey (NHANES). Linear trend estimation was used to test for changes in HEI scores over time, and balanced repeated replicate weighted linear regression was used to test for differences in total and component scores between types of food outlets. Overall, Americans are not consuming a mix of foods from any major category of food outlet that aligns with dietary guidelines. The total score for schools (65/100 points) and stores (62/100 points) was significantly higher than full-service (51/100 points) and quick-service (39/100 points) restaurants (p < 0.0001). HEI scores significantly improved over time for schools (p < 0.001), including an increase in whole grains from less than 1 point in 2003–2004 to 7 out of 10 points in 2017–2018. In 2017–2018, schools received the maximum score for total fruits, whole fruits, and dairy. Continued research on strategies for improving the quality of foods consumed from restaurants and stores is warranted. View Full-Text
Keywords: HEI-2015; dietary patterns; food environment; nutrition policy; National Health and Nutrition Examination Survey (NHANES); What We Eat in America HEI-2015; dietary patterns; food environment; nutrition policy; National Health and Nutrition Examination Survey (NHANES); What We Eat in America
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MDPI and ACS Style

Vinyard, M.; Zimmer, M.; Herrick, K.A.; Story, M.; Juan, W.; Reedy, J. Healthy Eating Index-2015 Scores Vary by Types of Food Outlets in the United States. Nutrients 2021, 13, 2717. https://doi.org/10.3390/nu13082717

AMA Style

Vinyard M, Zimmer M, Herrick KA, Story M, Juan W, Reedy J. Healthy Eating Index-2015 Scores Vary by Types of Food Outlets in the United States. Nutrients. 2021; 13(8):2717. https://doi.org/10.3390/nu13082717

Chicago/Turabian Style

Vinyard, Magdalena, Meghan Zimmer, Kirsten A. Herrick, Mary Story, Wenyen Juan, and Jill Reedy. 2021. "Healthy Eating Index-2015 Scores Vary by Types of Food Outlets in the United States" Nutrients 13, no. 8: 2717. https://doi.org/10.3390/nu13082717

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