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Multicenter Study
. 2021 May 17;13(5):1698.
doi: 10.3390/nu13051698.

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

Leandro Teixeira Cacau  1 , Eduardo De Carli  1 , Aline Martins de Carvalho  1 , Paulo Andrade Lotufo  2 , Luis A Moreno  3   4   5 , Isabela Martins Bensenor  2 , Dirce Maria Marchioni  1
Affiliations
Multicenter Study

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

Leandro Teixeira Cacau et al. Nutrients. .

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.

Keywords: EAT-Lancet diet; diet indexes; diet quality; sustainable diet.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Scree plot from principal components analysis (PCA) of Planetary Health Diet Index. ELSA-Brasil, 2008–2009.
See this image and copyright information in PMC

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