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

Author(s)

Cacau, Leandro Teixeira ^[1] ; De Carli, Eduardo ^[1] ; de Carvalho, Aline Martins ^[1] ; Lotufo, Paulo Andrade ^[2] ; Moreno, Luis A. ^{[3, 4, 5]} ; Bensenor, Isabela Martins ^[2] ; Marchioni, Dirce Maria ^[1]

Affiliation

^[1] Univ Sao Paulo, Sch Publ Hlth, Dept Nutr, BR-01246904 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Univ Hosp, Clin & Epidemiol Res Ctr, BR-05508000 Sao Paulo - Brazil

^[3] Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza 50009 - Spain

^[4] Inst Invest Sanitaria Aragon, Inst Agroalimentario Aragon IA2, Zaragoza 50013 - Spain

^[5] Inst Salud Carlos III, Ctr Invest Biomed Red Fisiopatol Obesidad & Nutr, Madrid 28040 - Spain

• Document type: Journal article
• Source: NUTRIENTS; v. 13, n. 5 MAY 2021.
• Web of Science Citations: 1

Abstract

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. (AU)

• FAPESP's process: 11/12256-4 - Calcium score and coronary atherosclerosis in an adult cohort
• Grantee: Paulo Andrade Lotufo
• Support Opportunities: Regular Research Grants
• FAPESP's process: 19/13424-0 - Progression of subclinical Atherosclerosis markers and a priori eating patterns: an analysis to the longitudinal study in adult health (ELSA-Brazil)
• Grantee: Leandro Teixeira Cacau
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)