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. 2023 Jan 23:12:e9.
doi: 10.1017/jns.2022.120. eCollection 2023.

Development of the Ethiopian Healthy Eating Index (Et-HEI) and evaluation in women of reproductive age

Tesfaye Hailu Bekele  1   2 , Jeanne H M de Vries  2 , Edith J M Feskens  2 , Anneloes de Weijer  2 , Inge D Brouwer  2 , Namukolo Covic  3 , Laura Trijsburg  2
Affiliations

Development of the Ethiopian Healthy Eating Index (Et-HEI) and evaluation in women of reproductive age

Tesfaye Hailu Bekele et al. J Nutr Sci. .

Abstract

Ethiopia announced its first food-based dietary guidelines (FBDGs) on 15 March 2022. The present study aims to develop and evaluate the Ethiopian Healthy Eating Index (Et-HEI) based on the FBDG. Data were collected from 494 Ethiopian women of reproductive age sampled from households in five different regions. The Et-HEI consists of eleven components, and each component was scored between 0 and 10 points, the total score ranging from 0 to 110, with maximum adherence to the FBDG. The Et-HEI score was evaluated against the Minimum Dietary Diversity for Women (MDD-W) and the probability of nutrient adequacy. The average Et-HEI score for women of reproductive age was 49 out of 110. Adherence to the recommendations for grains, vegetables, legumes, fat and oils, salt, sugar and alcohol contributed the most to this score. Most women had low scores for fruits, nuts and seeds, and animal-sourced foods, indicating low intake. The Cronbach's alpha coefficient, indicating the reliability of the Et-HEI to assess its diet quality, was 0⋅53. The low mean Et-HEI score agreed with a low mean score of the MDD-W (3⋅5 out of 10). Also, low nutrient adequacies confirmed poor adherence to nutrient-dense components of the FBDG. The Et-HEI was not associated with the intake of vitamin B12, vitamin C and calcium in this study population. Women who completed secondary school and above had relatively lower Et-HEI scores. The newly developed Et-HEI is able to estimate nutrient adequacy while also assessing adherence to the Ethiopian FBDG though there is room for improvement.

Keywords: Diet quality; Dietary guidelines; Dietary index; Healthy diet.

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Figures

Fig. 1.
Fig. 1.
Ethiopian food guide, healthy plate (in Amharic Teenama MaĒD).
Fig. 2.
Fig. 2.
The formulas and graphic presentation of scoring for the Et-HEI for the different components: adequacy component (a), moderation component (b) and optimum component (c).
Fig. 3.
Fig. 3.
The scoring of 11 dietary components of the Et-HEI in women of reproductive age scored between 0 and 10 points.
See this image and copyright information in PMC

References

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