Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, 9000Ghent, Belgium.
Department of Population and Family Health, Institute of Health, Jimma University, PO Box 378 Jimma, Ethiopia.
Br J Nutr. 2021 Jul 14;126(1):92-100. doi: 10.1017/S0007114520003864. Epub 2020 Sep 30.
The EAT-Lancet Commission promulgated a universal reference diet. Subsequently, researchers constructed an EAT-Lancet diet score (0-14 points), with minimum intake values for various dietary components set at 0 g/d, and reported inverse associations with risks of major health outcomes in a high-income population. We assessed associations between EAT-Lancet diet scores, without or with lower bound values, and the mean probability of micronutrient adequacy (MPA) among nutrition-insecure women of reproductive age (WRA) from low- and middle-income countries (LMIC). We analysed single 24-h diet recall data (n 1950) from studies in rural DRC, Ecuador, Kenya, Sri Lanka and Vietnam. Associations between EAT-Lancet diet scores and MPA were assessed by fitting linear mixed-effects models. Mean EAT-Lancet diet scores were 8·8 (SD 1·3) and 1·9 (SD 1·1) without or with minimum intake values, respectively. Pooled MPA was 0·58 (SD 0·22) and energy intake was 10·5 (SD 4·6) MJ/d. A one-point increase in the EAT-Lancet diet score, without minimum intake values, was associated with a 2·6 (SD 0·7) percentage points decrease in MPA (P < 0·001). In contrast, the EAT-Lancet diet score, with minimum intake values, was associated with a 2·4 (SD 1·3) percentage points increase in MPA (P = 0·07). Further analysis indicated positive associations between EAT-Lancet diet scores and MPA adjusted for energy intake (P < 0·05). Our findings indicate that the EAT-Lancet diet score requires minimum intake values for nutrient-dense dietary components to avoid positively scoring non-consumption of food groups and subsequently predicting lower MPA of diets, when applied to rural WRA in LMIC.
EAT 柳叶刀委员会颁布了一种普遍适用的参考饮食。随后，研究人员构建了 EAT 柳叶刀饮食评分（0-14 分），将各种饮食成分的最低摄入量设定为 0 g/d，并报告称在高收入人群中，与主要健康结果的风险呈反比。我们评估了 EAT 柳叶刀饮食评分（不包括或包括下限值）与营养不安全的育龄妇女（WRA）的平均微量营养素充足率（MPA）之间的关联，这些妇女来自中低收入国家（LMIC）。我们分析了来自刚果民主共和国、厄瓜多尔、肯尼亚、斯里兰卡和越南的农村研究中单次 24 小时饮食回忆数据（n 1950）。通过拟合线性混合效应模型来评估 EAT 柳叶刀饮食评分与 MPA 之间的关联。没有或使用最低摄入量时，EAT 柳叶刀饮食评分的平均值分别为 8.8（SD 1.3）和 1.9（SD 1.1）。平均 MPA 为 0.58（SD 0.22），能量摄入量为 10.5（SD 4.6）MJ/d。EAT 柳叶刀饮食评分每增加 1 分，MPA 就会降低 2.6（SD 0.7）个百分点（P < 0.001）。相比之下，EAT 柳叶刀饮食评分（包括最低摄入量）与 MPA 增加 2.4（SD 1.3）个百分点相关（P = 0.07）。进一步的分析表明，EAT 柳叶刀饮食评分与调整能量摄入后的 MPA 之间存在正相关（P < 0.05）。我们的研究结果表明，当应用于中低收入国家的农村育龄妇女时，EAT 柳叶刀饮食评分需要对营养密集型饮食成分设定最低摄入量，以避免对食物组的非消费进行正向评分，从而预测饮食的 MPA 较低。
