Vegetarian Shepard’s Pie
People who improved their eating habits the most after a heart attack had a better chance of surviving, according to a study released in September 2013.
The results showed that after a nine years of follow-up, a diet lowest in red and processed meat products and sugar and highest in whole grains, fruits, and vegetables lowered the risk of death from heart disease by 40 percent, compared with no dietary changes.
Researchers assessed the diets of 4,098 women and men from both the Nurses’ Health Study and the Health Professionals Follow-up Study using the Alternative Healthy Eating Index 2010—a tool developed to determine chronic disease risk based on diet—before and after a heart attack.
Alternative Healthy Eating Index 2010
Center for Nutrition Policy and Promotion
CNPP Fact Sheet No. 2
The Healthy Eating Index (HEI) is a measure of diet quality in terms of conformance to Federal dietary guidance. It is used to monitor the quality of American diets; to examine relationships between diet and health-related outcomes and between diet cost and diet quality; to determine the effectiveness of nutrition intervention programs; and to assess the quality of food assistance packages, menus, and the U.S. food supply. The HEI is a scoring metric that can be applied to any defined set of foods, such as previously collected dietary data, a defined menu, or a market basket, to estimate a score. The HEI-2010, which assesses diet quality as specified by the 2010 Dietary Guidelines for Americans, is made up of 12 components, as shown below. The total HEI-2010 score is the sum of the component scores and has a maximum of 100 points.
HEI-2010 component Maximum Standard for maximum score Standard for minimum score of zero
Adequacy (higher score indicates higher consumption)
Total Fruit (2) 5 ≥ 0.8 cup equiv. / 1,000 kcal10 No fruit
Whole Fruit (3) 5 ≥ 0.4 cup equiv. / 1,000 kcal No whole fruit
Total Vegetables (4) 5 ≥ 1.1 cup equiv. / 1,000 kcal No vegetables
Greens and Beans (4) 5 ≥ 0.2 cup equiv. / 1,000 kcal No dark-green vegetables, beans, or peas
Whole Grains 10 ≥ 1.5 ounce equiv. / 1,000 kcal No whole grains
Dairy (5) 10 ≥ 1.3 cup equiv. / 1,000 kcal No dairy
Total Protein Foods (6) 5 ≥ 2.5 ounce equiv. / 1,000 kcal No protein foods
Seafood/Plant Proteins(6) 5 ≥ 0.8 ounce equiv. / 1,000 kcal No seafood or plant proteins
Fatty Acids (8) 10 (PUFAs + MUFAs) / SFAs > 2.5 (PUFAs + MUFAs) / SFAs < 1.2
HEI-20101 component Maximum Standard for maximum score Standard for minimum score of zero
Moderation (higher score indicates lower consumption)
Refined Grains 10 ≤ 1.8 ounce equiv. / 1,000 kcal ≥ 4.3 ounce equiv. / 1,000 kcal
Sodium 10 ≤ 1.1 gram / 1,000 kcal ≥ 2.0 grams / 1,000 kcal
Empty Calories (9) 20 ≤ 19% of energy ≥ 50% of energy
Intakes between the minimum and maximum standards are scored proportionately.
(2) Includes 100% fruit juice.
(3) Includes all forms except juice.
(4) Includes any beans and peas not counted as Total Protein Foods.
(5) Includes all milk products, such as fluid milk, yogurt, and cheese, and fortified soy beverages.
(6) Beans and peas are included here (and not with vegetables) when the Total Protein Foods standard is otherwise not met.
(7) Includes seafood, nuts, seeds, soy products (other than beverages) as well as beans and peas counted as Total Protein Foods.
(8) Ratio of poly- and monounsaturated fatty acids (PUFAs and MUFAs) to saturated fatty acids (SFAs).
(9) Calories from solid fats, alcohol, and added sugars; threshold for counting alcohol is > 13 grams/1,000 kcal.
Equiv. = equivalent, kcal = kilocalories.
Authors: Patricia M. Guenther, PhD, RD1; Kellie O. Casavale, PhD, RD2; Jill Reedy, PhD, RD3; Sharon I. Kirkpatrick, PhD, RD3; Hazel A.B. Hiza, PhD, RD1; Kevin J. Kuczynski, MS, RD1; Lisa L. Kahle, BA4; Susan M. Krebs-Smith, PhD, RD.3
Center for Nutrition Policy and Promotion, U.S. Department of Agriculture; Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services; National Cancer Institute, U.S. Department of Health and Human Services; 4Information Management Services, Inc.; United States Department of Agriculture