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Interpreting alignment to the EAT-Lancet diet using dietary intakes of lactating mothers in rural Western Kenya.

ABSTRACT: The EAT-Lancet reference diet intends to be good for planetary and human health. We compared single multiple pass method 24-h dietary intake of mothers (n = 242) from a cross-sectional study in Western Kenya to the recommended range of intake of 11 EAT-Lancet food groups (e.g., 0-100 g/day legumes; maximum score 11), defining alignment two ways: daily intake among food groups where a minimum intake of 0 g was either acceptable or unacceptable. Ordinal logistic regression models assessed associations between alignment and body mass index (BMI). Cost of mothers' diets and hypothetical diets within recommended ranges (lower bounds >0 g) were estimated using food price data from markets within the mothers' locality. Mean energy intake was 1827 (95% confidence interval [CI]: 1731-1924) kcal/day. Relative to the EAT-Lancet diet, mothers' diets were on average higher for grains; within recommendations for tubers, fish, beef and dairy; closer to lower bounds for chicken, eggs, legumes and nuts; and lower for fruits and vegetables. Mean (95% CI) alignment scores were 8.2 (8.0-8.3) when 0 g intakes were acceptable and 1.7 (1.6-1.9) otherwise. No significant associations were found between alignment and BMI. Mothers' diets and hypothetical diets within recommended ranges averaged 184.6 KES (1.6 USD) and 357.5 KES (3.0 USD)/person/day, respectively. Lactating mothers' diets were not diverse and diverged from the reference diet when an intake of 0 g was considered unacceptable. Lower bound intakes of 0 g for micronutrient-dense food groups are inappropriate in food-insecure populations. It would likely cost more than mothers currently spend to tailor their diets to the EAT-Lancet reference diet.

SUBMITTER: Quarpong W

PROVIDER: S-EPMC10262880 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Interpreting alignment to the EAT-Lancet diet using dietary intakes of lactating mothers in rural Western Kenya.

Quarpong Wilhemina W Wakoli Samson S Oiye Shadrack S Williams Anne M AM

Maternal & child nutrition 20230330 3

The EAT-Lancet reference diet intends to be good for planetary and human health. We compared single multiple pass method 24-h dietary intake of mothers (n = 242) from a cross-sectional study in Western Kenya to the recommended range of intake of 11 EAT-Lancet food groups (e.g., 0-100 g/day legumes; maximum score 11), defining alignment two ways: daily intake among food groups where a minimum intake of 0 g was either acceptable or unacceptable. Ordinal logistic regression models assessed associat ...[more]

PMID: 36999246

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Project description:Background/objectivesFood prices are a crucial factor in food choices, especially for more vulnerable populations. To estimate the association between diet cost and quality, as measured by the EAT-Lancet score, across demographic groups in Brazil.MethodsData from the 2017/18 Household Budget Survey were used to calculate the EAT-Lancet score, comprising 14 components. Scores ranged from 0 (low adherence) to 42 (high adherence), with emphasized components (e.g., vegetables, fruits, legumes) and limited components (e.g., red meat, sugar, eggs). Results were stratified by per capita income, geographic region, and area of residence and compared using linear regression adjusted for high and low costs. In addition, the association between the EAT-Lancet score (and its emphasized and limited components) and diet cost (continuous) was analyzed for the total population and for income tertiles.ResultsThe mean EAT-Lancet score was 18.65 points (range: 7 to 25) and the mean diet cost was BRL$0.65/100 kcal. Total scores showed no significant difference between low- and high-cost diets. However, limited intake was more pronounced in low-cost diets, while high-cost diets featured emphasized foods such as fruits, vegetables, and seafood. High-cost diets also included sugars and red meat, while unsaturated fats scored higher in low-cost diets. Each one-point increase in the EAT-Lancet score was associated with a BRL$0.38 reduction in cost, driven by lower costs in the Limited component, especially among the lowest-income strata (reductions of BRL$1.58 and BRL$1.55 in the lowest income and middle income tertiles, respectively). However, higher scores for emphasized foods increased costs (BRL$0.89) in the lowest tertile.ConclusionsHigher EAT-Lancet scores were associated with reduced diet costs, likely influenced by the lower Limited component costs in low-income groups. Emphasized foods, however, tended to increase costs, particularly among the lowest-income group. These findings suggest that the role of diet composition plays a significant role in cost differences and underscore the challenges that low-income groups face in accessing affordable, healthy diets.

Project description:BackgroundBreast milk is the sole source of nutrition for exclusively breastfed infants in the first 6 mo of life, yet few studies have measured micronutrient concentrations in breast milk in light of maternal diet and subsequent infant micronutrient intakes.ObjectivesWe evaluated the adequacy of micronutrient intakes of exclusively breastfed Indonesian infants by measuring milk volume and micronutrient concentrations and assessed maternal micronutrient intakes and their relationship with milk concentrations.MethodsMother-infant (2-5.3 mo) dyads (n = 113) were recruited for this cross-sectional study. Volume of breast-milk intake via the deuterium dose-to-mother technique over 14 d and analyzed micronutrient concentrations were used to calculate micronutrient intakes of exclusively breastfed infants. Maternal 3-d weighed food records were collected to assess median (IQR) micronutrient intakes. Multivariate regression analyses examined the association of usual maternal micronutrient intakes with milk micronutrient concentrations after adjustment for confounding variables.ResultsMean ± SD intake of breast-milk volume was 787 ± 148 mL/d. Median daily infant intakes of iron, zinc, selenium, magnesium, sodium, and B-vitamins (thiamin, riboflavin, niacin, pantothenic acid, B-6, and B-12) were below their respective Adequate Intakes. Inadequacies in maternal intakes (as % < estimated average requirements) were >40% for calcium, niacin, and vitamins A, B-6, and B-12. Significant positive associations existed between maternal usual intakes of vitamin A, niacin and riboflavin and milk retinol, nicotinamide, and free riboflavin concentrations in both unadjusted and adjusted (for infant age, milk volume, and parity) analyses (all P < 0.05).ConclusionsThe majority of micronutrient intakes for these exclusively breastfed infants and their mothers fell below recommendations, with associations between maternal intakes and breast-milk concentrations for 3 nutrients. Data on nutrient requirements of exclusively breastfed infants are limited, and a better understanding of the influence of maternal nutritional status on milk nutrient concentrations and its impact on the breastfed infant is needed.

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Project description:Information on micronutrient adequacy of diets of rural Indonesian lactating women is lacking, despite their high nutrient requirements. This is of concern because deficits in micronutrient intakes may compromise the health of both mothers and infants. This study aimed to assess micronutrient adequacy and dietary diversity (DD) among rural lactating women and explore relationships between micronutrient adequacy, DD, and intakes of energy and food groups consumed. We measured in-home 12-h weighed food records and 12-h recalls over three non-consecutive days from 121 exclusively breastfeeding women at 2-5 months postpartum. Next, we calculated intakes of energy and 11 micronutrients and estimated probability of adequacy (PA) for usual intakes of 11 micronutrients for each women taking into account national fortification of wheat flour with thiamin, riboflavin, folate, zinc, and iron. We assessed DD from nine food groups consumed. Energy and macronutrient balance were within recommended ranges, yet population prevalence of adequacy was less than 50% for niacin, vitamins B6 and C, and less than 60% for calcium, vitamin B12 and vitamin A, all micronutrients not targeted by the national wheat flour fortification program. In contrast, population prevalence of adequacy for the fortified micronutrients was at least 60%, with iron and zinc attaining 79% and 97%, respectively. Overall mean population prevalence of micronutrient adequacy was 57% and mean (±SD) DD score was 4.3±1.2. Mean PAs, a composite measure based on individual PAs over 11 micronutrients, were strongly correlated with energy intakes and with DD scores. In the multivariate models with maternal education and wealth index as covariates, organ meats were the most important determinant of mean PA after controlling for energy intake. In conclusion, despite wheat flour fortification, lactating mothers remained at risk of multiple micronutrient inadequacies. Increasing intakes of animal source foods including organ meats, and fruits and vegetables should be considered.

Dataset Information

Interpreting alignment to the EAT-Lancet diet using dietary intakes of lactating mothers in rural Western Kenya.

Publications

Interpreting alignment to the EAT-Lancet diet using dietary intakes of lactating mothers in rural Western Kenya.

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