medRxiv (Medicine)
2026-06-16 00:00
DOI:
HASH:26dbc55e1b694ceee03bffba6bd73d69
Daily Healthy Eating Index (HEI-2020) scoring reveals diet quality patterns masked by aggregation
Authors:
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.