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Daily Healthy Eating Index (HEI-2020) scoring reveals diet quality patterns masked by aggregation

Singh, R.; Salathe, M.

2026-06-16 nutrition
10.64898/2026.06.08.26355152 medRxiv
Show abstract

The Healthy Eating Index (HEI-2020) is conventionally computed by aggregating intake across days before scoring. Digital food logging enables an alternative: scoring each day and averaging daily scores. These methods are not equivalent. The HEI's density-based structure and component caps cause aggregation to inflate adequacy scores when intake is irregular. Using Food & You data, we show daily HEI correlates more strongly with microbiome diversity, and recommend co-reporting both metrics.

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