Evaluating the diet quality of elderly Japanese using the Healthy Eating Index-2020.

BACKGROUND AND OBJECTIVES: Globally, efforts are underway to evaluate foods and meals by their nutritional value. In Japan, however, there is no comprehensive system for evaluating overall diet quality. The aim of this study is to use the Healthy Eating Index (HEI)-2020, which is based on the American Dietary Guidelines, to evaluate the diet quality of independent elderly Japanese people to consider appropriate methods for evaluating the Japanese diet. METHODS AND STUDY DESIGN: The subjects were 71 individuals aged 60 years or older who participated in a health examination. HEI-2020 was used to evaluate diet quality, with 13 components scored based on intake per energy unit. Associations of HEI-2020 scores with nutrient intake, food group intake, and dietary reference intakes (DRIs) for Japanese were analysed using statistical methods. RESULTS: The median HEI-2020 score was 52/100 points. Among the components, the median score was the maximum for Saturated Fats and Added Sugars, but zero for Whole Grains and Refined Grains. The high-score group had significantly lower intake of saturated fatty acids and higher intake of dietary fiber, vitamin K, potassium, and magnesium. In comparison to DRIs, the high-score group had a significantly higher "% meeting the reference value" for several nutrients, including dietary fiber, magnesium, and potassium. CONCLUSIONS: This study shows that the HEI-2020 can identify nutrients such as dietary fiber and minerals that are lacking in the Japanese population. However, for more effective assessment, there is a need to adjust the reference values to match the intake of Japanese people.