The Healthy Eating Index-2015 score measures adherence to recommendations from the 2015-2020 Dietary Guidelines for Americans, which emphasize the importance of healthy eating patterns. The new guidelines emphasize the totality of foods and beverages habitually consumed, rather than individual dietary components and nutrients. While previous studies have assessed the associations between earlier versions of the Healthy Eating Index (2005 version) and chronic diseases and mortality, it was not yet known whether the new version is associated with cardiovascular disease, mortality, or all-cause mortality risks. However, results from a new study published in The Journal of Nutrition confirm that higher adherence to the 2015-2020 Dietary Guidelines for Americans is associated with lower risks of incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality among US adults.

This prospective analysis of 12,413 adult men and women aged 45-64 y from the Atherosclerosis Risk in Communities Study was conducted by Dr. Casey Rebholz (Johns Hopkins University) and colleagues.  Scores from the Alternative Healthy Eating Index-2010, Alternate Mediterranean Diet, and Dietary Approaches to Stop Hypertension diet were computed using the average dietary intakes of visits 1 (1987-1989) and 3 (1993-1995) and used to assess adherence to healthy dietary patterns. Incident cardiovascular disease, cardiovascular disease mortality, and all-cause mortality date were ascertained from baseline through December 2017.

Associations were strongest for cardiovascular mortality, in which the highest adherence to the healthy dietary patterns were associated with 21-34% reductions in risk, compared to participants with the lowest adherence. These results are consistent with previous studies that reported inverse associations between healthy dietary patterns and cardiovascular disease, cardiovascular disease mortality, and all-cause mortality. 

According to the study authors, “all 4 indices performed similarly with regard to study outcomes, suggesting that each of these health dietary patterns can be recommended and incorporated into healthy lifestyles, despite some differences in scoring criteria.” These indices all reflect healthy dietary patterns that consist of higher intake of vegetables, fruits, and whole grains. Study results add further evidence to the protective associations for the Healthy Eating Index score, as well as corroborate previous literature on the 3 other dietary indices.

Reference  Hu, EA, Steffen LM, Coresh J, Appel LJ, Rebholz CM. Adherence to the Healthy Eating Index-2015 and Other Dietary Patterns May Reduce Risk of Cardiovascular Disease, Cardiovascular Mortality, and All-Cause Mortality. The Journal of Nutrition, DOI:

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