Adherence to the EAT-Lancet Diet Among Urban and Rural Latin American Adolescents: Associations with Micronutrient Intake and Ultra-Processed Food Consumption

Abstract

Background/Objectives: Adolescents in Latin America are experiencing rising rates of overweight/obesity and non-communicable diseases, while public health nutrition efforts targeting this group remain limited. This study explores adherence to the EAT-Lancet diet and its relationship with micronutrient adequacy and ultra-processed food (UPF) consumption. Methods: Cross-sectional data from national nutrition surveys of 19,601 adolescents across six Latin American countries were analyzed. Data on sociodemographics, anthropometrics, and dietary habits were collected using standardized questionnaires and 24 h dietary recalls or food records. Nutrient intake was estimated via statistical modeling, and nutrient adequacy ratios were based on age- and sex-specific requirements. UPF intake was classified using the NOVA system, and adherence to the EAT-Lancet diet was assessed with the Planetary Health Diet Index. Results: Overall adherence to the EAT-Lancet diet was low (mean score: 28.3%). Rural adolescents had higher adherence than urban adolescents, and those aged 10-13 and 17-19 showed better adherence compared to adolescents aged 14-16. Adolescents from lower socioeconomic backgrounds adhered more than those from higher socioeconomic backgrounds. Adherence varied from 20.2% in Argentina to 30.2% in Brazil and Chile. Higher adherence was associated with lower UPF intake. Among urban adolescents, greater adherence was linked to a higher risk of inadequate riboflavin, niacin, and cobalamin intake, a trend not observed in rural adolescents. Conclusions: Adherence to the EAT-Lancet diet is low among Latin American adolescents, particularly in urban areas. Public health efforts should prioritize reducing UPF consumption, improving access to nutrient-dense, culturally appropriate foods, and supporting fortified staple foods.

Keywords: EAT-Lancet diet; Latin America; adolescents; micronutrient intake; ultra-processed foods.

Figure 1

Mean relative contribution ¹ of each Planetary Health Diet Index component among adolescents in the study (A) and according to their area of residence (B). PHDI: Planetary Health Diet Index; DGV: dark green leafy vegetables; ReV: red and orange vegetables. * PHDI components with significant differences between urban and rural areas (p < 0.05). Argentina does not include rural participants. ¹ Determined using survey weights.