Development of Phil-HEI and its evaluation of the Filipino diet: 2018 Expanded National Nutrition Survey

Abstract

Objective: To validate the application of the developed Philippine Healthy Eating Index (Phil-HEI) by exemplifying in a 2-week cycle menu plans and its application on the diet quality of Filipino adults using the 2018 ENNS dietary data. Methods: The study analyzed data from 31,218 adult Filipinos aged 20 to 59 who participated in the 2018 Expanded National Nutrition Survey (ENNS). Dietary intake was obtained using 24 h food recall, used to calculate the Philippine Healthy Eating Index. To establish the efficiency of the index, the following aspects were evaluated: (1) content validity, (2) construct validity, (3) discriminating validity, (4) sensitivity analysis, and (5) internal consistency reliability. Results: The Philippine Healthy Eating Index (Phil-HEI) was developed using local guidelines, Philippine Food Pyramid, Philippine Dietary Reference Intakes, World Health Organization international guidelines, and the adapted AHEI-2010. The study found a significant association between Phil-HEI scores and age, wealth quintile, education, smoking, and BMI. The correlation between the Phil-HEI scores and energy/nutrient intake was significant but weak, with a trend across the Phil-HEI score tertiles. The discrimination validity showed large differences in mean scores based on usual diet versus three cycle menu plans. A sensitivity analysis revealed that higher Phil-HEI scores were associated with lower risk of chronic energy deficiency. The reliability of the Phil-HEI components was low (α = 0.26) due to the complex nature of assessing diet quality. Conclusions: The Philippine Healthy Eating Index showed itself to be structurally valid when used to evaluate and monitor the diet quality of Filipino adults.

Keywords

• Healthy Eating Index
• Dietary pattern
• Philippines
• Phil-HEI