The Journal of nutrition · 2026
Longitudinal Changes in Healthy Eating Index-2020 Score and Impacts on Body Mass Index among Adolescents in the Growing Up Today Study: A Prospective Cohort Study.
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Lee Matthew M, Poole Mary Kathryn, Chen Jarvis T, Gortmaker Steven L, Stephenson Briana Joy K, Haines Jess, Chavarro Jorge E, Diamantis Dimitrios V, Kenney Erica L
Аннотация
BACKGROUND: The Dietary Guidelines for Americans informs the design of nutrition programs targeted at improving health across the life course, including for adolescents, a population with suboptimal diet quality. The associations between adherence to the Guidelines and longitudinal health outcomes among adolescents, however, are unclear.
OBJECTIVES: We leveraged 7 y of data from the Growing Up Today Study, a prospective cohort study, to evaluate associations between concurrent changes in total or component Healthy Eating Index-2020 (HEI-2020) scores, a measure of adherence to the Guidelines, and changes in body mass index [BMI (in kg/m2)], a targeted outcome of the Guidelines, in United States adolescents.
METHODS: We analyzed data from a prospective longitudinal cohort with enrollment cycles in 1996 (n = 14,233) and 2004 (n = 7898). We calculated HEI-2020 and BMI from validated food frequency questionnaires and self-reported height/weight. Multivariate fixed-effects regression models, stratified by sex, were used to estimate associations between within-child changes in HEI-2020 and changes in BMI. We assessed interactions by concurrent adolescent BMI category and age.
RESULTS: After covariate adjustment, a 10-point increase in total HEI-2020 was associated with 0.09 [95% confidence interval (CI): 0.051, 0.121] and 0.04 (95% CI: 0.011, 0.066) decreases in BMI for boys and girls, respectively. Of the 13 HEI-2020 components, only the greens/beans, fatty acids adequacy scores, and saturated fatty acid moderation scores were inversely related to BMI. A 1-point increase in the dairy component was associated with mean increases of 0.02 for boys and girls. Associations between total HEI-2020 and BMI were stronger for youth classified as overweight/obese and for older age, although associations were still relatively small.
CONCLUSIONS: Improved adherence to the Dietary Guidelines, 2020-2025, was associated with small, though clinically insignificant, decreases in mean BMI among adolescents. Relationships for specific HEI components were heterogeneous and warrant further study.
OBJECTIVES: We leveraged 7 y of data from the Growing Up Today Study, a prospective cohort study, to evaluate associations between concurrent changes in total or component Healthy Eating Index-2020 (HEI-2020) scores, a measure of adherence to the Guidelines, and changes in body mass index [BMI (in kg/m2)], a targeted outcome of the Guidelines, in United States adolescents.
METHODS: We analyzed data from a prospective longitudinal cohort with enrollment cycles in 1996 (n = 14,233) and 2004 (n = 7898). We calculated HEI-2020 and BMI from validated food frequency questionnaires and self-reported height/weight. Multivariate fixed-effects regression models, stratified by sex, were used to estimate associations between within-child changes in HEI-2020 and changes in BMI. We assessed interactions by concurrent adolescent BMI category and age.
RESULTS: After covariate adjustment, a 10-point increase in total HEI-2020 was associated with 0.09 [95% confidence interval (CI): 0.051, 0.121] and 0.04 (95% CI: 0.011, 0.066) decreases in BMI for boys and girls, respectively. Of the 13 HEI-2020 components, only the greens/beans, fatty acids adequacy scores, and saturated fatty acid moderation scores were inversely related to BMI. A 1-point increase in the dairy component was associated with mean increases of 0.02 for boys and girls. Associations between total HEI-2020 and BMI were stronger for youth classified as overweight/obese and for older age, although associations were still relatively small.
CONCLUSIONS: Improved adherence to the Dietary Guidelines, 2020-2025, was associated with small, though clinically insignificant, decreases in mean BMI among adolescents. Relationships for specific HEI components were heterogeneous and warrant further study.