Healthy eating index (HEI) as the predictor of asthma: Findings from NHANES
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Updated: Jul 26, 2025

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Published on: August 7, 2017
Yuebei Li1, Zhiqiang He2, Zichen Lin1
1Department of Respiratory & Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, China.
Background&Aims:
Previous studies have shown that the formation and development of asthma are closely related to diet. A proper diet can control asthma onset although the precise dietary components involved in preventing or delaying the onset of asthma remain unclear. The healthy eating index (HEI-2015) is a dietary score that measures the overall diet quality as well as the quality of several dietary components. We aimed to explore the relationship between HEI and asthma.
Methods:
This is a cross-sectional study that used data from the 2005 to 2018 National Health and Nutritional Examination Survey (NHANES) in adults (n = 26,567). Our inclusion criteria were adults ≥18 years, completion of asthma-related questionnaires and availability of HEI data. Weighted logistic regression was performed to assess the association between asthma and HEI after adjusting for several covariates.
Results:
Patients with asthma were more likely to be female, come from a poorer background, have a raised body mass index (BMI) and a lower HEI total score. Higher HEI total scores were associated with a lower risk of asthma in adults. In addition, eating more whole fruits, more greens and beans, more total protein foods, more seafood and plant proteins, and having a reduced dietary intake of added sugars reduces the risk of asthma. In asthmatic populations, higher HEI scores are associated with older age at onset of asthma.
Conclusion:
There is an inverse association between the HEI and asthma. This underlines the importance of improving adherence to healthy dietary patterns in the prevention of asthma.
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