Application of the Healthy Eating Index-2010 to the hunger relief system

Abstract

Objective: To demonstrate the feasibility of applying the Healthy Eating Index-2010 (HEI-2010) to the hunger relief setting, specifically by assessing the nutritional quality of foods ordered by food shelves (front-line food provider) from food banks (warehouse of foods).

Design: This Healthy FOOD (Feedback On Ordering Decisions) observational study used electronic invoices detailing orders made by 269 food shelves in 2013 and analysed in 2015 from two large Minnesota, USA food banks to generate HEI-2010 scores. Initial development and processing procedures are described.

Results: The average total HEI-2010 score for the 269 food shelves was 62·7 out of 100 with a range from 28 to 82. Mean component scores for total protein foods, total vegetables, fatty acids, and seafood and plant proteins were the highest. Mean component score for whole grains was the lowest followed by dairy, total fruits, refined grains and sodium. Food shelves located in micropolitan areas and the largest food shelves had the highest HEI-2010 scores. Town/rural and smaller food shelves had the lowest scores. Monthly and seasonal differences in scores were detected. Limitations to this approach are identified.

Conclusions: Calculating HEI-2010 for food shelves using electronic invoice data is novel and feasible, albeit with limitations. HEI-2010 scores for 2013 identify room for improvement in nearly all food shelves, especially the smallest agencies. The utility of providing HEI-2010 scores to decision makers in the hunger relief setting is an issue requiring urgent study.

Keywords: Emergency food; Food bank measurement; Food evaluation; Healthy Eating Index; Healthy food access.

Fig. 1

Description of the Healthy FOOD (Feedback On Ordering Decisions) Heathy Eating Index-2010 (HEI-2010) scoring process. *Products listed in liquid ounces were converted to grams using the US Department of Agriculture’s National Nutrient Database for Standard Reference^{( 23 )} (FNDDS 5.0, Food and Nutrient Database for Dietary Studies version 5.0; FPED 2009–10, Food Patterns Equivalent Database 2009–10; MPED 2·0, MyPyramid Equivalents Food Database version 2.0)

Fig. 2

Heathy Eating Index-2010 (HEI-2010) total score for 269 Minnesota and Wisconsin (USA) food shelves by month () and quarter (), 2013. ^aQuarter 1 (Jan, Feb, Mar) is significantly lower than quarter 2 (Apr, May, Jun; 59·5 v. 62·7, P=0·0035) and quarter 3 (Jul, Aug, Sep; 59·5 v. 63·1, P=0·0007). ^bQuarter 3 (Jul, Aug, Sep) is significantly higher than quarter 4 (Oct, Nov, Dec; 63·1 v. 60·1, P=0·0221)