Dataset Information

Low Adherence to the EAT-Lancet Sustainable Reference Diet in the Brazilian Population: Findings from the National Dietary Survey 2017-2018.

ABSTRACT: Diets are simultaneously connected with population health and environment. The EAT-Lancet Commission proposed a sustainable reference diet to improve population health and respect the planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) has been developed to assess the adherence to this reference diet. In the present study, we aimed to evaluate the adherence to the EAT-Lancet diet through the PHDI in a nationwide population-based study carried out in Brazil. We used data from the National Dietary Survey conducted through the Household Budget Survey in 2017-2018, with 46,164 Brazilians aged over 10 years old. Food consumption was evaluated with a 24 h dietary recall. The average PHDI total score in the Brazilian population was 45.9 points (95% CI 45.6:46.1) on a total score that can range from 0 to 150 points. The adherence to EAT-Lancet diet was low among all Brazilian regions. Women, elderly, those overweighed/obese, with higher per capita income and living in the urban area had higher scores in the PHDI. In general, the Brazilian population presented low adherence to a healthy and sustainable dietary pattern and seems far from meeting the EAT-Lancet recommendations.

SUBMITTER: Marchioni DM

PROVIDER: S-EPMC8956109 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Low Adherence to the EAT-Lancet Sustainable Reference Diet in the Brazilian Population: Findings from the National Dietary Survey 2017-2018.

Marchioni Dirce Maria DM Cacau Leandro Teixeira LT De Carli Eduardo E Carvalho Aline Martins de AM Rulli Maria Cristina MC

Nutrients 20220311 6

Diets are simultaneously connected with population health and environment. The EAT-Lancet Commission proposed a sustainable reference diet to improve population health and respect the planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) has been developed to assess the adherence to this reference diet. In the present study, we aimed to evaluate the adherence to the EAT-Lancet diet through the PHDI in a nationwide population-based study carried out in Brazil. We used data from t ...[more]

PMID: 35334839

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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:BackgroundValidation of the EAT-Lancet reference diet (ELR-diet), recently proposed by the EAT-Lancet Commission, within the context of real-life studies is necessary to elucidate its feasibility, nutritional value, sustainability, and health effects.ObjectivesWe aimed to develop a dietary index (DI) score to measure adherence to the ELR-diet. We further aimed to study the association between the DI score and 1) nutritional characteristics, 2) indicators of ecological sustainability, and 3) anthropometric markers and biomarkers for cardiometabolic health.MethodsA DI score was constructed by comparing the categories defined by the ELR-diet with the dietary data of 2-5 sets of 3-d weighed dietary records from DONALD (Dortmund Nutritional and Anthropometric Longitudinal Designed) study participants (n = 298; ≥15 y of age). Prospective associations between the DI score and risk markers (anthropometric and cardiometabolic) in young adulthood (≥18 y old) were investigated using multivariate linear regression.ResultsAdherence to the DI score components was considerable (majority > 50%), but varied within the population (2%-100%). The highest tertile of the DI score was inversely associated with the intake of protein (tertile 3 compared with tertile 1: 13.5 compared with 14.5 energy %), added sugars (10.5 compared with 12.4 energy %), and cholesterol (100 compared with 116 mg/1000 kcal), but positively associated with fiber intake (10.0 compared with 8.82 g/1000 kcal) (all P < 0.05). The DI score was inversely associated with greenhouse-gas emissions (tertile 1 compared with tertile 3: 6.48 compared with 5.85 kg of carbon dioxide equivalents/2500 kcal; P < 0.001) and land use (8.24 compared with 7.16 m2 × y/2500 kcal; P < 0.001). Inverse associations between the DI score and anthropometric markers during young adulthood were observed (e.g., BMI: tertile 1 compared with tertile 3: 22.9 compared with 21.9 kg/m2; P = 0.03) (all P < 0.05). No associations between the DI score and cardiometabolic risk markers were found (all P ≥ 0.05).ConclusionsAdherence to the ELR-diet was associated with favorable nutritional characteristics and reduced environmental impact. Adherence to the DI score in adolescence was also beneficial with respect to anthropometric markers in early adulthood, although not for further cardiometabolic risk markers.

Dataset Information

Low Adherence to the EAT-Lancet Sustainable Reference Diet in the Brazilian Population: Findings from the National Dietary Survey 2017-2018.

Publications

Low Adherence to the EAT-Lancet Sustainable Reference Diet in the Brazilian Population: Findings from the National Dietary Survey 2017-2018.

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