Positive Change in Healthy Eating Scores Among Adults With Low Income After Expanded Food and Nutrition Education Program Participation

Abstract

Objective: Using 24-hour dietary recalls, compare Healthy Eating Index (HEI)-2005 scores of Expanded Food and Nutrition Education Program participants before and after 8-12 weekly lessons.

Design: Analysis of preexisting 24-hour dietary recalls information collected from October, 2012 through September, 2014.

Participants: Participants with complete pre-post dietary data (n = 122,961); subset of those with complete demographic data (n = 97,522).

Main outcome measures: Change in HEI-2005 scores (total and components).

Statistical analysis: Linear regression model fit separately for total HEI and 12 components. The response variable was changed in the HEI-2005 score; predictor variables included age, education, sex, and race/ethnicity.

Results: The mean total HEI scores were 51.1 (SD, 13.7) at entry and 56.5 (SD, 13.7) at exit, with a change of 5.4 (SD, 16.2). Nine of 12 component scores increased. Changes were greater as age increased, with increasing education, and in women. Hispanics had the greatest improvement (mean ± SE) in total HEI score (8.3 ± 0.1).

Conclusions and implications: Although diet quality remained poor, participation in the Expanded Food and Nutrition Education Program resulted in improvement in dietary quality. The degree of improvements varied among demographic groups, but all groups improved.

Keywords: EFNEP; HEI-2005; diet quality; low-income.