Evaluation of the Saudi Healthy Eating Index

The Saudi Healthy Eating Index (SHEI) was developed to evaluate adherence to the Saudi Healthy Plate Guide 2024. This study aimed to conduct a preliminary assessment of the psychometric properties of the SHEI.

A secondary analysis was conducted using data from a cross-sectional study on 702 Saudi adults in Riyadh and Al-Madinah regions. Dietary data were collected using multiple-pass 24-h recalls, along with anthropometric and sociodemographic information. The SHEI was evaluated for content validity, concurrent validity, construct validity, internal consistency reliability, and component correlations.

The SHEI showed strong concurrent validity with the HEI-2015 (r = 0.867, p < 0.001). The SHEI also demonstrated evidence of construct validity, with total scores averaging 52.64 ± 11.05 and clear variation across individuals and score quintiles (p < 0.001). Smokers had significantly lower scores (48.8 ± 0.1) compared to non-smokers (53.3 ± 0.5), while differences by sex, education level, and family income were modest and non-significant. The index correlated weakly with energy intake (r = -0.103, p = 0.006) and yielded moderate to high scores for exemplary menus. It also revealed five underlying dietary dimensions, accounting for 57.39% of total variance. However, internal consistency was low (Cronbach's α = 0.237), and correlations among components ranged from moderate to weak.

The findings support the validity of the SHEI but indicate limited reliability. Future validity and reliability studies of the SHEI should aim for better representation by addressing sample size and food database limitations.