The EAT-Lancet Commission has proposed a planetary health diet. We propose the development of the Planetary Health Diet Index (PHDI) based on this proposed reference diet. We used baseline dietary data obtained through a 114-item FFQ from 14,779 participants of the Longitudinal Study on Adult Health, a multicenter cohort study conducted in Brazil. The PHDI has 16 components and a score from 0 to 150 points. Validation and reliability analyses were performed, including principal component analyses, association with selected nutrients, differences in means between groups (for example, smokers vs. non-smokers), correlations between components and total energy intake, Cronbach’s alpha, item-item correlations, and linear regression analysis between PHDI with carbon footprint and overall dietary quality. The mean PHDI was 60.4 (95% CI 60.2:60.5). The PHDI had six dimensions, was associated in an expected direction with the selected nutrients and was significantly (p < 0.001) lower in smokers (59.0) than in non-smokers (60.6). Cronbach’s alpha value was 0.51. All correlations between components were low, as well as between components and PHDI with total energy intake. After adjustment for age and sex, the PHDI score remained associated (p < 0.001) with a higher overall dietary quality and lower carbon footprint. Thus, we confirmed the PHDI validity and reliability.

The EAT-Lancet Commission has proposed a model diet to improve the health of human beings and that of the planet. Recently, we proposed the Planetary Health Diet Index (PHDI) to assess adherence of the population to this model diet. In this study, we aimed to evaluate adherence to the PHDI and obesity outcomes using baseline data from 14,515 participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The dietary data were assessed using a 114-item FFQ. Body mass index (BMI) and waist circumference (WC) were both used continuously and categorized. Linear and multinomial regression models adjusted for potential confounding factors were performed to assess the relationship between adherence to PHDI and outcomes. An inverse association was observed between adherence to PHDI and obesity indicators. Individuals with high adherence to the PHDI had lower BMI (β−0.50 95% CI−0.73:−0.27) and WC (β−1.70 95% CI−2.28:−1.12) values. They were also 24% less likely to be overweight (OR 0.76 95% CI 0.67:0.85) or obese (OR 0.76 95% CI 0.65:0.88), and they were 14% and 27% less likely to have increased WC (OR 0.86 95% CI 0.75:0.98) or substantially increased WC (OR 0.73 95% CI 0.64:0.83) than those with lower adherence. Our results showed that higher adherence to the PHDI may decrease obesity indicators.

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.

Obesity in children and adolescents is a public health problem and diet can play a major role in this condition. We aimed to identify sex-specific dietary patterns (DP) and to evaluate the association with overweight/obesity in European adolescents. We conducted a cross-sectional analysis with 2327 adolescents aged between 12.5 to 17.5 years from a multicenter study across Europe. The body mass index was categorized in “normal weight” and “overweight/obesity”. Two non-consecutive 24-h dietary recalls were collected with a computerized self-reported software. Principal component factor analysis was used to identify DP. Mixed-effect logistic regression models were used to evaluate the association between the sex-specific DP and overweight/obesity outcome. As a result, we found three DP in boys (snacking and bread, Mediterranean diet, and breakfast) and four DP in girls (convenience, plant-based and eggs, Western, and breakfast). The association between DP and overweight/obesity highlights that those adolescents with higher adherence to the breakfast DP had lower odds for overweight/obesity, even after the inclusion of covariables in the adjustments. In European adolescents, the breakfast DP positively characterized by breakfast cereals, fruit, milk, and dairy and negatively characterized by sugar-sweetened beverages in boys and negatively characterized by cereals (pasta, rice, and others) in girls, was inversely associated with overweight/obesity.

No abstract

No abstract

Aceito para publicação 14 de setembro de 2019 RESUMO Introdução: As inadequações na ingestão de micronutrientes são um problema emergente em termos de saúde pública. Recentemente, o papel dos macronutrientes foi proposto como fator relacionado à adequação do consumo de vitaminas e minerais. O objetivo deste estudo foi avaliar se a qualidade dos carboidratos da dieta está associada com o consumo adequado de minerais. Método: Estudo transversal realizado com mulheres acompanhadas em um serviço de mastologia do SUS, situado na capital do estado do Ceará. A coleta de dados foi realizada entre os anos de 2016 e 2017. Neste trabalho, foram analisados os dados de consumo alimentar investigados por meio da aplicação em duplicata do recordatório de 24 horas, sendo um deles referente a um dia de final de semana. Os dados obtidos foram digitados na Plataforma Brasil Nutri e lançados no Statistical Analysis System. Os dados foram corrigidos para variância intrapessoal no programa estatístico Multiple Source Method para predição da ingestão habitual. Foram avaliados o consumo de zinco (Zn), selênio (Se), cobre (Cu), manganês (Mn), magnésio (Mg), ferro (Fe) e fósforo (P). Para avaliar a qualidade dos carboidratos, calculou-se o Índice de Qualidade do Carboidrato (IQC). As análises estatísticas foram realizadas no SPPS 20.0 e considerou-se significante valores de p<0,05. O projeto foi aprovado pelo Comitê de Ética em Pesquisas da instituição de origem. Resultados: No total, 648 mulheres foram avaliadas, com idade média de 52,4 ± 9,3 anos. A média do IQC foi de 12 ± 3,1. Maiores pontuações do IQC foram associadas com maior adequação de consumo de Zn (p<0,001), Mn (p<0,001), Mg (p<0,001), Cu (p<0,001), P (p=0,002) e de Fe (p=0,006), mas não para Se (p=0,711). Conclusões: Os achados deste estudo demonstraram que maiores valores de IQC estão associados com maior adequação do consumo dos minerais avaliados, com exceção do selênio.

Objetivo: Descrever o processo de construção e validação de uma cartilha sobre chás com propriedades medicinais, destinada a mulheres sobreviventes de câncer de mama, elaborada segundo os fundamentos do letramento em saúde. Método: Estudo metodológico realizado em três etapas: 1) entrevista com mulheres sobreviventes de câncer de mama para identificação dos chás mais utilizados por elas; 2) desenvolvimento da cartilha e 3) validação da cartilha por especialistas e público-alvo. A partir das informações das 203 mulheres entrevistadas, foram selecionadas cinco plantas para integrar a cartilha: Graviola (folha), Camomila, Hortelã, Gengibre e Romã. O conteúdo da cartilha foi desenvolvido segundo o conhecimento científico sobre o tema e orientações de publicações específicas sobre letramento em saúde, com o intuito de viabilizar maior empoderamento das informações por parte das mulheres. A validação foi realizada por seis especialistas, os quais usaram o instrumento Suitability Assessment of Material (SAM), destinado à avaliação de materiais escritos de acordo com os fundamentos do letramento em saúde. A validação pelo público-alvo se deu por grupo focal. Resultados: Os especialistas atribuíram à cartilha pontuação percentual média de 91,4%, o que a enquadra como material superior quanto ao letramento em saúde (70-100%). O público-alvo aprovou a cartilha, sem sugestão de mudanças. Conclusão: A cartilha está validada e atende aos fundamentos do letramento em saúde, podendo ser utilizada nos atendimentos realizados com mulheres sobreviventes de câncer de mama como um material educativo auxiliar em seu tratamento.