Abstract P226: HEalth Nutritional Index (HENI) A Health Burden Based Tool for Food and Diet Nutritional Evaluation

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Introduction: The role of diets on human health is crucial and depends on the quality of the food we eat. A number of indexes help rank food items and evaluate diets based on their nutrient profiling and meeting dietary guidelines, respectively. Existing nutritional indexes fail to quantify the varying effects of major food groups and nutrients on human health. We introduce the HEalth Nutritional Index (HENI), a health burden-based scoring system in disability adjusted life years (DALYs) that uses epidemiological evidence from the Global Burden of Disease (GBD) to rank and evaluate food items and diets.Methods: HENI accounts for the health effects of 8 major food groups (nuts and seeds, whole grains, fruits, vegetables, milk, sugar-sweetened beverages, red meat, and processed meat) and 6 nutrients (omega-3, calcium, fiber, polyunsaturated fatty acids, trans fat, and sodium), identified by the GBD as dietary risk factors. The HENI factors are estimated by coupling age- and gender-adjusted outcome-specific incidence rates with risk ratios (RR) and severity factors, measuring positive or detrimental effects in avoided μDALY/g. We determine the food group and nutrient profile for each of the 5000+ consumed food items in the What We Eat in America 2009-2014 dataset, using multiple databases such as the Food Patterns Equivalents Database (FPED), the Food and Nutrient Database for Dietary Studies (FNDDS), and the USDA National Nutrient Database for Standard Reference (SR). We then derive the HENI scores for 100 kcal, 100 grams or 1 serving of each food item by multiplying the food group and nutrient composition by their respective HENI factors.Results: HENI factors for food group and nutrient range between -8 μDALY/g for sodium, up to 57 μDALY/g for omega-3 from fish and seafood. HENI score typically ranges from -30 avoided μDALY/100kcal for e.g. soft drinks, up to +50 avoided μDALY/100kcal, for beneficial food items such as fish, fruits, vegetables, and nuts. The majority of the health effect is associated with cardiovascular diseases, with some food items affecting certain cancers (e.g. health benefit for colorectal cancer with milk). Absolute HENI scores and ranking of food items vary substantially when using 100 kcal, 100 grams or 1 serving as a basis for comparison. In a sensitivity study, we consider the indirect effect of saturated fat via total blood cholesterol is considered which can play an important role for animal-based food items, requiring further investigation. The HENI factors are applicable under the assumption that the overall dietary intake of each GBD food group and nutrient is within the effective intake range, below the theoretical risk level limit.Conclusion: The proposed HENI index enables to quantify the human health impact of thousands of food items, bringing on the same scale different nutritional impacts, allowing for a comprehensive assessment of food items and diets.

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