A Healthy Eating Index already measures how people’s diets size up to federal dietary guidance, but there is currently no such tool for measuring beverage intake quality.
Outlined in the Journal of the Academy of Nutrition and Dietetics, the healthy beverage index (HBI) considers total energy from beverages, fluid requirements, and consumption limits for certain drinks.
The authors say that a great deal of attention has been given to sugar-sweetened beverages – but a broader focus beyond these drinks is needed.
They want to see the technique developed into a rapid assessment tool so that patients, doctors, and dieticians can encourage better drinking behaviors.
Aim high
A higher HBI score represents a healthier beverage intake. The 10-item scoring index weighs some items such as water more heavily. Recommended limits in some beverage subgroups, such as alcohol, low-fat milk, and fruit juice are accounted for.
The ideal daily beverage consumption would attract a HBI score of 100, with 2.65l of fluids consumed and 196 kcals in energy.
However, the average US consumer only has a HBI score of 56: drinking 1.74l and consuming 490 kcal from beverages in a day (out of the 2,000 kcal required). These figures were compiled by using the HBI with data from the National Health and Nutrition Examination Survey (NHANES).
“Our sample ‘healthy consumption pattern’ shows water as the major source of total fluids, with skim milk and red wine as beverages contributing energy,” wrote Kiyah Duffey and Brenda Davy, authors of the research based at Virginia Tech.
“The sample ‘typical consumption pattern’ shows water and soda as the primary sources of fluids, with soda and a vanilla latte contributing to beverage energy.”
In the typical diet, there are three factors that commonly lower the HBI score. SSB consumption (such as soda or vanilla latte) lowers the score by 15 points. If more than 10% of daily energy requirements come from beverages, the score drops by 20 points. If total fluid requirements are not met, 3 points are lost.
Beverage consumption
Healthy beverage pattern: HBI score of 100, 2.65L of fluids consumed, and 196 kcal from beverages
Typical beverage pattern: HBI score of 56, 1.74L of fluids consumed, and 490 kcal from beverages
Evaluating the validity of the HBI was done by applying it to NHANES data for 2005 – 2010. Researchers found that people with higher HBI scores had more favorable cardiometabolic outcomes.
Among normal weight males, for example, a 10-point higher HBI score was associated with 36% lower odds of a high waist circumference. Among overweight and obese males, a 10-point increase was associated with 3% lower odds of having high total cholesterol.
No tools currently measure overall beverage quality
“Beverage intake guidelines have been suggested, and although the 2010 US Dietary Guidelines for Americans recommend ‘drink water instead of sugary drinks,' no tools currently exist that measure overall beverage intake quality,” said Duffey and Davy.
“A great deal of attention has been directed at SSB intake, albeit with some controversy, and a broader focus (ie, moving beyond just SSBs) has been suggested. Yet water and other beverages have received less attention in part due to methodologic challenges.”
Nutrition and dietetics practitioners could use the HBI as a counseling tool to promote healthy beverage choices, added the authors.
“Modeled after the Healthy Eating Index, we demonstrate that the HBI could serve as a measure of the overall healthfulness of an individual’s beverage intake,” continued the authors. “These findings could serve as an initial step in developing interventions aimed at improving beverage intake patterns.
“Our findings demonstrate the potential health benefits of achieving specific beverage intake recommendations, especially because consumers report that dietary guidelines are often confusing and that guidelines should be specific about the types/amounts of foods to consume. The HBI would provide quantifiable beverage intake guidelines that are linked to improvements in several important health outcomes.”
Source: Journal of the Academy of Nutrition and Dietetics, July 9, 2015. DOI: 2010.1016/j.jand.2015.05.005.
Title: “The Healthy Beverage Index Is Associated with Reduced Cardiometabolic Risk in US Adults: A Preliminary Analysis”
Authors: K.J. Duffey; B.M. Davy.