Public Health Nutrition

Biological and behavioural determinants

Healthy Eating Index and abdominal obesity

Desiree L Tandea1 c1, Rhonda Magela2 and Bradford N Stranda1

a1 Department of Health, Nutrition and Exercise Sciences, North Dakota State University, PO Box 6050, Fargo, ND 58108-6050, USA

a2 Department of Statistics, North Dakota State University, Fargo, ND, USA


Objective Although diet is a modifiable lifestyle factor to reduce abdominal obesity risk, the relationship between the Health Eating Index (HEI) and waist circumference (WC) has not been studied. The present study aimed to describe relationships between the HEI and abdominal obesity among adults.

Design Secondary data analysis of a cross-sectional national survey, the Third National Health and Nutrition Examination Survey (NHANES III). The HEI data, including the total HEI score and HEI component scores, were collected with a 24 h recall. WC measures were taken during a physical examination. Abdominal obesity was defined as WC ≥ 102 cm for men and WC ≥ 88 cm for women. Other covariates were collected during an interview.

Subjects In total 15 658 US adults, men (n 7470) and non-pregnant women (n 8188).

Results The odds of abdominal obesity was 8·3 % (95 % CI 1·8, 14·9 %, P = 0·014) lower for women and 14·5 % (95 % CI 6·8, 21·9 %, P ≤ 0·001) lower for men with each 10-unit increase in total HEI score (HEI scale, 0–100). For each point increase for the fruit score, abdominal obesity risk decreased by 2·6 % (95 % CI 0·8, 4·4 %, P = 0·007) for women. Abdominal obesity risk decreased for men with each point increase in saturated fat and variety scores, by 3·1 % (95 % CI 0·1, 6·0 %, P = 0·042) and 4·0 % (95 % CI 0·1, 7·7 %, P = 0·043) respectively.

Conclusions Dietary consumption that follows the HEI is associated with a lower risk for abdominal obesity.

(Received February 26 2008)

(Accepted July 01 2009)

(Online publication August 04 2009)


c1 Corresponding author: Email