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The USDA Healthy Eating Index (HEI) is used widely to measure diet quality because it allows a number of different applications. Although several evaluations of the HEI-2010 have already been carried out, there is lack of those which focus on associations between the HEI and nutrient intakes. This study updates and expands upon previous findings on these associations. Using German consumption data, where ∼12 million purchases from 13 131 households are recorded, HEI-2010 total and individual scores, as well as several energy and nutrient densities were calculated. Correlations between the HEI and individual energy and nutrient densities were carried out to identify which nutrients are more or less well represented by the HEI. The HEI had the highest correlations with energy density and the densities of water-soluble vitamins (e.g. folic acid) and minerals (e.g. calcium). Weaker associations were identified for the densities of fat-soluble vitamins (e.g. vitamin D) as well as of the vitamins B1 and B12. Negligible correlations were detected for the densities of trace elements (e.g. fluoride and iodine), salt and fat composition. Given that energy intake and the intake of plant-based foods are relevant dietary issues, the HEI-2010 can be defined as a meaningful index to describe diet quality. However, because the intakes of salt, trace elements (e.g. fluoride and iodine) and fat-soluble vitamins, as well as the fat composition may be less reflected, they should be analyzed separately when using the HEI for measuring diet quality.

Association between the Healthy Eating Index-2010 and nutrient and energy densities of German households’ food purchases