{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:39:26Z","timestamp":1793180366175,"version":"4.5.0"},"reference-count":60,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/tdm\/tdmrep-policy.json"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Nutr"],"published-print":{"date-parts":[[2026,10,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The Healthy Eating Index (HEI) is widely used to assess diet quality, but certain contexts (e.g. pregnancy) may benefit from tailored versions. We evaluated whether the HEI\u2019s current approach of assigning approximately equal weights to all components to compute the total score is appropriate when studying diet quality around conception. Data were from a US prospective cohort of individuals who had not delivered a previous pregnancy past 20 weeks\u2019 gestation (2010\u20132013,\n                    <jats:italic>n<\/jats:italic>\n                    7882). Usual dietary intake around conception was estimated from FFQ. Select adverse pregnancy outcomes (gestational diabetes, pre-eclampsia, preterm delivery and small-for-gestational age birth) were abstracted from the medical record. We regressed each outcome on the thirteen HEI-2015 component scores using SuperLearner, an ensemble machine learning method that combines predictions from multiple algorithms and avoids relying on parametric assumptions that characterise standard regression. We assessed the relative importance of each component using two permutation-based metrics: change in negative log likelihood (global influence) and absolute difference in the predicted probabilities (individual-level influence). Six of the thirteen components (Greens and Beans, Saturated Fats, Total Protein Foods, Seafood and Plant Proteins, Fatty Acids and Added Sugars) were important according to at least one metric for at least two of the four outcomes. In contrast, the Refined Grains component was not appreciably important for any outcome. These findings suggest that equal weighting of the HEI components may not be appropriate when evaluating diet quality for studies of pregnancy.\n                  <\/jats:p>","DOI":"10.1017\/s0007114526107223","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T09:49:23Z","timestamp":1779097763000},"page":"877-885","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["From single conventional regression to ensemble modelling: relative importance of the Healthy Eating Index-2015 components in relation to adverse pregnancy outcomes"],"prefix":"10.1017","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7845-4545","authenticated-orcid":false,"given":"Julie M.","family":"Petersen","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00thqtb16","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Nebraska Medical Center"},{"id":[{"id":"https:\/\/ror.org\/01an3r305","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pittsburgh School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M.","family":"Bodnar","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01an3r305","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Pittsburgh School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9896-5975","authenticated-orcid":false,"given":"Sharon I.","family":"Kirkpatrick","sequence":"additional","affiliation":[{"name":"University of Waterloo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley I.","family":"Naimi","sequence":"additional","affiliation":[{"name":"Emory University Rollins School of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"S0007114526107223_ref58","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1408630"},{"key":"S0007114526107223_ref29","volume-title":"Issues in Analysis and Presentation of Dietary Data. Nutritional Epidemiology","author":"Willett","year":"2013"},{"key":"S0007114526107223_ref45","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003891"},{"key":"S0007114526107223_ref3","unstructured":"3. U.S. Department of Agriculture & Center for Nutrition Policy and Promotion (1995) The Healthy Eating Index (CNPP-1). https:\/\/fns-prod.azureedge.us\/sites\/default\/files\/healthy_eating_index\/HEI89-90report.pdf (accessed March 2026)."},{"key":"S0007114526107223_ref54","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/80.2.396"},{"key":"S0007114526107223_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy353"},{"key":"S0007114526107223_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxac120"},{"key":"S0007114526107223_ref51","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.08.010"},{"key":"S0007114526107223_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-022-03469-4"},{"key":"S0007114526107223_ref38","doi-asserted-by":"publisher","DOI":"10.1198\/016214506000000771"},{"key":"S0007114526107223_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30311-8"},{"key":"S0007114526107223_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfca.2004.02.007"},{"key":"S0007114526107223_ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2012.12.016"},{"key":"S0007114526107223_ref26","doi-asserted-by":"publisher","DOI":"10.1524\/stnd.2006.24.3.373"},{"key":"S0007114526107223_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqaa027"},{"key":"S0007114526107223_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2023.04.017"},{"key":"S0007114526107223_ref53","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/78.3.517S"},{"key":"S0007114526107223_ref32","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2021.1956425"},{"key":"S0007114526107223_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2008.08.016"},{"key":"S0007114526107223_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2019.12.011"},{"key":"S0007114526107223_ref46","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"},{"key":"S0007114526107223_ref44","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001805"},{"key":"S0007114526107223_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2023.09.018"},{"key":"S0007114526107223_ref15","unstructured":"15. Radwan, A , Gil, JM & Variyam, JN (2015) Obesity-Specific Healthy Eating Index (OS-HEI). Consumer Behavior in a Changing World: Food, Culture, Society. Naples, Italy: European Association of Agricultural Economists (EAAE) and Agricultural & Applied Economics Association (AAEA) Joint Seminar."},{"key":"S0007114526107223_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyy285"},{"key":"S0007114526107223_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2008.02.026"},{"key":"S0007114526107223_ref24","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018046112532"},{"key":"S0007114526107223_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2021.02.025"},{"key":"S0007114526107223_ref50","first-page":"307","volume-title":"Contributions to the Theory of Game","author":"Shapley","year":"1953"},{"key":"S0007114526107223_ref55","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.117.153635"},{"key":"S0007114526107223_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980022001392"},{"key":"S0007114526107223_ref56","doi-asserted-by":"publisher","DOI":"10.52570\/NESR.PB242018.SR0101"},{"key":"S0007114526107223_ref47","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(85)90298-4"},{"key":"S0007114526107223_ref25","volume-title":"Targeted Learning: Causal Inference for Observational and Experimental Data","author":"Polley","year":"2011"},{"key":"S0007114526107223_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2023.05.020"},{"key":"S0007114526107223_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2018.05.021"},{"key":"S0007114526107223_ref42","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1988.tb00233.x"},{"key":"S0007114526107223_ref13","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114507250421"},{"key":"S0007114526107223_ref49","doi-asserted-by":"publisher","DOI":"10.1038\/s42256-023-00657-x"},{"key":"S0007114526107223_ref11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.13771"},{"key":"S0007114526107223_ref52","volume-title":"Vitamins C and E and Other Antioxidants in Pregnancy and Breastfeeding. Nutrition and Lifestyle for Pregnancy and Breastfeeding","author":"Gluckman","year":"2015"},{"key":"S0007114526107223_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0893-6080(05)80023-1"},{"key":"S0007114526107223_ref48","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9868.2005.00503.x"},{"key":"S0007114526107223_ref1","unstructured":"1. U.S. Department of Agriculture & U.S. Department of Health and Human Services (2020) Dietary Guidelines for Americans, 2020\u20132025. https:\/\/www.dietaryguidelines.gov\/sites\/default\/files\/2021-03\/Dietary_Guidelines_for_Americans-2020-2025.pdf (accessed March 2026)."},{"key":"S0007114526107223_ref34","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116965"},{"key":"S0007114526107223_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy216"},{"key":"S0007114526107223_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwac062"},{"key":"S0007114526107223_ref5","doi-asserted-by":"publisher","DOI":"10.1080\/01969727408546059"},{"key":"S0007114526107223_ref35","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a114416"},{"key":"S0007114526107223_ref57","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmy123"},{"key":"S0007114526107223_ref22","doi-asserted-by":"publisher","DOI":"10.1177\/0260106020903926"},{"key":"S0007114526107223_ref39","doi-asserted-by":"publisher","DOI":"10.1186\/s12859-022-04675-1"},{"key":"S0007114526107223_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980016002937"},{"key":"S0007114526107223_ref59","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2023.05.015"},{"key":"S0007114526107223_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2018.05.020"},{"key":"S0007114526107223_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(95)00300-2"},{"key":"S0007114526107223_ref27","doi-asserted-by":"publisher","DOI":"10.2202\/1544-6115.1309"},{"key":"S0007114526107223_ref60","doi-asserted-by":"publisher","DOI":"10.3945\/jn.115.219634"},{"key":"S0007114526107223_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.01.019"},{"key":"S0007114526107223_ref40","unstructured":"40. Food Surveys Research Group, Beltsville Human Nutrition Research Center & Agricultural Research Service (2014) Food Patterns Equivalents Database 2011\u20132012. Beltsville, MD: U.S. Department of Agriculture."}],"updated-by":[{"DOI":"10.1017\/s0007114526107946","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000}}],"container-title":["British Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007114526107223","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007114526107223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:24:57Z","timestamp":1793179497000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007114526107223\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,18]]},"references-count":60,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,10,14]]}},"alternative-id":["S0007114526107223"],"URL":"https:\/\/doi.org\/10.1017\/s0007114526107223","relation":{},"ISSN":["0007-1145","1475-2662"],"issn-type":[{"value":"0007-1145","type":"print"},{"value":"1475-2662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,18]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}