The diet quality of children and adolescents is of concern. Poor eating patterns in childhood are major contributors to childhood obesity (see HEALTH 7) and contribute to chronic diseases starting in childhood, such as type 2 diabetes,132 and those that emerge throughout the life cycle, such as cardiovascular disease.133 The Healthy Eating Index-2005 (HEI-2005) is a dietary assessment tool comprising the 12 components shown below. The HEI-2005 measures quality in terms of how well diets meet the recommendations of the 2005 Dietary Guidelines for Americans and MyPyramid, USDA's food guidance system (http://www.MyPyramid.gov).134, 135, 136 The HEI-2005 component scores are averages across all children and reflect usual dietary intakes.137 Nine components of the HEI-2005 address nutrient adequacy. The remaining three components assess saturated fat, sodium, and extra calories, all of which should be consumed in moderation. The diet quality scores of children would be improved by increasing the intake of vegetables, especially dark green and orange vegetables (DGOV) and beans and peas (legumes); fruits; and whole grains and by decreasing the intake of saturated fat, sodium (salt), and extra calories from solid fats and added sugars.
NOTE: HEI-2005 scores are expressed as percentages of recommended dietary intake levels. A score corresponding to 100 percent indicates that the recommendation was met or exceeded on average. A score below 100 percent indicates that average intake does not meet the recommendations for that component. For the adequacy components, higher scores reflect higher intakes. For the moderation components, higher scores reflect lower intakes because lower intakes are more desirable. For all components, a higher percentage indicates a higher quality diet. "Extra calories" refers to calories from solid fats (i.e., sources of saturated fats and trans fats) and added sugars (i.e., sugars not naturally occurring).
SOURCE: National Center for Health Statistics, National Health and Nutrition Examination Survey, 2007–2008 and U.S. Department of Agriculture, Center for Nutrition Policy and Promotion MyPyramid Equivalents Database 2007–2008 (preliminary).
132 Daniels, S.R., Jacobson, M.S., McCrindle, B.W., Eckel, R.H., and Sanner, B.M. (2009). American Heart Association Childhood Obesity Research Summit: Executive summary. Circulation, 119, 2114 –2123.
133 Wilson, P.W., D'Agostino, R.B., Sullivan, L., Parise, H., and Kannel, W.B. (2002). Overweight and obesity as determinants of cardiovascular risk: The Framingham Experience. Arch Intern Med, 162, 1867–1872.
134 U.S. Health and Human Services and U.S. Department of Agriculture. (2005). Dietary Guidelines for Americans (6th ed.). Washington, DC: U.S. Government Printing Office.
135 Guenther, P.M., Reedy, J., and Krebs-Smith, S.M. (2008). Development of the Healthy Eating Index-2005. Journal of the American Dietetic Association, 108, 1896–1901.
136 Guenther, P.M., Reedy, J., Krebs-Smith, S.M., and Reeve, B.B. (2008). Evaluation of the Healthy Eating Index-2005. Journal of the American Dietetic Association, 108, 1854–1864.
137 Freedman, L.S., Guenther, P.M., Krebs-Smith, S.M., and Kott, P.S. (2008). A population's mean Healthy Eating Index-2005 scores are best estimated by the score of the population ratio when one 24-hour recall is available. Journal of Nutrition, 138, 1725–1729.