EAT–<i>Lancet</i>diet score requires minimum intake values to predict higher micronutrient adequacy of diets in rural women of reproductive age from five low- and middle-income countries

Hanley-Cook, Giles; Argaw, Alemayehu; Kok, Brenda de; Vanslambrouck, Katrien; Toe, Laeticia Celine; Kolsteren, Patrick; Jones, Andrew D.; Lachat, Carl

doi:10.1017/s0007114520003864

Cited by 38 publications

(52 citation statements)

References 59 publications

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“…However, this binary scoring system was shown to be negatively associated with nutrient adequacy in resource poor settings [32]. Hanley-Cook et al therefore suggest that minimum intake values (>0 g/d) should be used to avoid non-consumers of the nutrient dense dietary components score high on this index [32]. The WISH counteracts this drawback of the binary score by using a continuous scoring on a scale from 0 to 10, along with various sub-scores, rather than a binary scoring system.…”

Section: Discussionmentioning

confidence: 95%

“…This index showed inverse associations with NCDs in a UK based population. However, this binary scoring system was shown to be negatively associated with nutrient adequacy in resource poor settings [32]. Hanley-Cook et al therefore suggest that minimum intake values (>0 g/d) should be used to avoid non-consumers of the nutrient dense dietary components score high on this index [32].…”

Section: Discussionmentioning

confidence: 99%

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Method for the Development of WISH, a Globally Applicable Index for Healthy Diets from Sustainable Food Systems

et al. 2020

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Promoting both a healthy diet and at the same time considering the environmental sustainability aspects of production and consumption of the diet are urgent global issues. We developed the WISH (World Index for Sustainability and Health) to evaluate diets for healthiness and sustainability. The WISH seeks to measure two complex multidimensional concepts, diet quality and environmental sustainability, in one scoring system. The WISH is based on the EAT-Lancet recommendations for a healthy and sustainable diet in the general population with global applicability across multiple settings. Thirteen food groups are scored between 0 and 10, based on their association with disease and impact on environmental indicators. The scoring system was applied using a dataset of duplicate 24 h dietary recalls from 396 urban Vietnamese men and women. Out of a maximum score of 130, the mean total WISH score was 46 (SD 11), and scores for the healthy and high-environmental impact sub-scores were mean 25 (11) (out of 100) and mean 26 (8) (out of 70) respectively. A higher score was observed for the less-healthy (mean 20 (2) out of 30) sub-score. Our initial analysis shows that the WISH is able to differentiate between the healthiness and the environmental sustainability of a Vietnamese diet.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Method for the Development of WISH, a Globally Applicable Index for Healthy Diets from Sustainable Food Systems

et al. 2020

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“…We are familiar with the debate that has surrounded the EAT-Lancet diet due to methodological considerations, lack of adaptation to local contexts and different populations, and feasibility in terms of costs and missing environmental perspectives ( 12 , 30 , 46–49 ). Nevertheless, the considerable reductions in mortality shown in this study provide strong arguments for prioritizing healthy diets similar to the EAT-Lancet diet in policy, in education, and on the overall global agenda.…”

Section: Discussionmentioning

confidence: 99%

Development of an EAT-Lancet index and its relation to mortality in a Swedish population

Stubbendorff

Sonestedt

Ramne

et al. 2022

The American Journal of Clinical Nutrition

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Background Current global food systems threaten human health and environmental sustainability. In 2019, the EAT—Lancet Commission on healthy diets from sustainable food systems defined the first global reference diet to improve both areas, but there is no consensus on how to quantify the EAT-Lancet reference diet as a diet index and its relation to mortality has not been widely studied. Objective To develop a new dietary index to quantify adherence to the EAT-Lancet diet and assess its association with mortality in a large population-based Swedish cohort. We also examined food components included in the index and their individual associations with mortality. Design We used the Malmö Diet and Cancer cohort (n = 22,421, 45–73 years at baseline). Dietary data were collected using a modified diet history method. The EAT-Lancet index was developed based on intake levels and reference intervals of 14 food components defined in the EAT-Lancet diet (0–3 points per component, 0–42 points in total). Associations with mortality were examined based on registers during a mean of 20 years of follow-up and were adjusted for potential confounders. Results Divided into five adherence groups, the highest adherence to the EAT-Lancet diet (≥23 points) was associated with lower all-cause mortality (HR: 0.75; 95% CI: 0.67, 0.85), cancer mortality (HR 0.76; 95% CI: 0.63, 0.92) and cardiovascular mortality (HR 0.68; 95% CI: 0.54, 0.84) than the lowest adherence (≤13 points). Several food components included in the index contributed to the observed reductions in mortality. Conclusions We developed a new dietary index to investigate adherence to the EAT-Lancet diet. The findings indicate a 25% lower risk of mortality among those with the highest adherence to the EAT-Lancet diet, as defined using our index, which adds to the evidence base for the development of sustainable dietary guidelines.

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“…Despite being inversely associated with diabetes and ischemic heart disease [ 10 ], this index does not consider all the possibilities of the EAT-Lancet recommendations, such as the minimum and maximum values [ 35 ]. In addition, this index was negatively associated with micronutrients adequacy among women in five low- and middle-income countries (LMCC) [ 36 ]. The PHDI has a gradual score, which allows for a better distinction between the degrees of adherence of individuals, favoring an interpersonal distribution.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of an Index Based on EAT-Lancet Recommendations: The Planetary Health Diet Index

et al. 2021

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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.

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EAT–Lancetdiet score requires minimum intake values to predict higher micronutrient adequacy of diets in rural women of reproductive age from five low- and middle-income countries

Cited by 38 publications

References 59 publications

Method for the Development of WISH, a Globally Applicable Index for Healthy Diets from Sustainable Food Systems

Method for the Development of WISH, a Globally Applicable Index for Healthy Diets from Sustainable Food Systems

Development of an EAT-Lancet index and its relation to mortality in a Swedish population

Development and Validation of an Index Based on EAT-Lancet Recommendations: The Planetary Health Diet Index

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