Use of the Healthy Eating Index in Intervention Studies for Cardiometabolic Risk Conditions: A Systematic Review

Area of Science:

• Nutrition Science
• Public Health
• Behavioral Medicine

Background:

• Dietary assessment tools are crucial for evaluating diet counseling and coaching interventions.
• The Healthy Eating Index (HEI) is a validated tool of interest for cardiometabolic treatment.
• Existing literature lacks a systematic review on HEI's utility in diet interventions for chronic diseases.

Purpose of the Study:

• To systematically review intervention studies utilizing the HEI and its adaptations.
• To determine if dietary interventions improve diet quality as measured by the HEI.
• To assess the magnitude of change in diet quality scores post-intervention.

Main Methods:

• Systematic literature search of CINAHL and PubMed (1995-2019).
• Inclusion of intervention studies in adults with overweight/obesity and related chronic diseases.
• Quality assessment using Cochrane risk of bias tools (RCTs and non-randomized studies).

Main Results:

• Twenty-five studies were included (15 RCTs, 3 quasi-experimental, 7 pre-post).
• Eight different HEI versions were employed.
• Diet quality, assessed by HEI, showed clinically relevant improvements, especially with intensive, long-term, multi-behavior interventions.

Conclusions:

• The HEI and its adaptations show promise for characterizing diet counseling interventions.
• Interventions focusing on multiple food behaviors yield better results.
• Further development of HEI and similar tools is recommended for enhanced diet assessment.