Evaluation of the Healthy Eating Food Index (HEFI)-2019 measuring adherence to Canada's Food Guide 2019 recommendations on healthy food choices.

The objective of this study was to evaluate the construct validity and reliability of the Healthy Eating Food Index-2019 (HEFI-2019), which was developed to measure adherence to Canada's Food Guide 2019 (CFG-2019) recommendations on healthy food choices. Dietary intake data from 24-hour dietary recalls in the 2015 Canadian Community Health Survey-Nutrition were used for that purpose. Multidimensionality was examined using principal component analysis. Mean scores were compared among subgroups of the population. The association between scores and energy intake was assessed using Pearson correlations. Cronbach's alpha was calculated to assess reliability. The estimated mean HEFI-2019 score (/80) was 43.1 (95% CI, 42.7 to 43.6) among Canadians aged 2 years and older. The first and 99th percentiles were 22.1 and 62.9 points. The mean HEFI-2019 score for smokers was 7.2 points lower than for non-smokers (95% CI, -8.5 to -5.9). The HEFI-2019 was weakly correlated with energy intake (