To assess the nutritional quality of food packages offered in the Food Distribution Program on Indian Reservations (FDPIR) using the Healthy Eating Index 2010 (HEI-2010).

Data were collected from the list of the food products provided by the US Department of Agriculture’s Food and Nutrition Handbook 501 for FDPIR. Nutritional quality was measured through a cross-sectional analysis of five randomly selected food packages offered through FDPIR. HEI-2010 component and total scores were calculated for each food package. ANOVA and t tests assessed significant differences between food packages and HEI-2010 maximum scores, respectively.

This study took place in the USA.

Study units included food products offered through FDPIR.

The mean total HEI-2010 score for the combined FDPIR food packages was significantly lower than the total HEI-2010 maximum score of 100 (66·38 (sd 11·60); P<0·01). Mean scores for total fruit (3·52 (sd 0·73); P<0·05), total vegetables (2·58 (sd 0·15); P<0·001), greens and beans (0·92 (sd 1·00); P<0·001), dairy (5·12 (sd 0·63); P<0·001), total protein foods (4·14 (sd 0·56); P<0·05) and refined grains (3·04 (sd 2·90); P<0·001) were all significantly lower than the maximum values.

The FDPIR food package HEI-2010 score was notably higher than other federal food assistance and nutrition programmes. Study findings highlight opportunities for the FDPIR to modify its offerings to best support lifestyles towards prevention of diet-related chronic disease.