Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA.
Department of Human Nutrition, Foods, and Exercise, Virginia Cooperative Extension, Virginia Tech, Blacksburg, VA, USA.
Am J Clin Nutr. 2023 Dec;118(6):1113-1122. doi: 10.1016/j.ajcnut.2023.09.009. Epub 2023 Sep 23.
Dietary choices are an important avenue for improving food system sustainability. The Planetary Health Diet was proposed by the EAT-Lancet Commission as a reference healthy and sustainable dietary pattern.
To assess adherence to the Planetary Health Diet among United States adults, this study developed and evaluated the Planetary Health Diet Index for the United States (PHDI-US), adapted from the original PHDI validated in the Brazilian population.
The PHDI-US has 16 components with scores ranging between 0 and 150, and higher scores indicate better adherence to the Planetary Health Diet. Cross-sectional dietary data from 4741 participants of the National Health and Nutrition Examination Survey 2017-2018 were used to assess the validity and reliability of the PHDI-US.
Validity and reliability tests were acceptable overall: principal component analysis identified 6 components; total PHDI-US and Healthy Eating Index-2015 scores were positively associated (β = 0.67, standard error = 0.03, P <0.0001; R = 0.39); concurrent-criterion validity analyses identified significantly lower scores among males, everyday smokers, and younger adults; and the Cronbach's α value was 0.54. The average PHDI-US score was 46.7 out of 150, indicating that the diets of United States adults were far from meeting Planetary Health Diet recommendations. Based on component PHDI-US scores, many United States adults may be able to enhance the quality and sustainability of their diets by increasing intake of plant-based foods, including whole grains, nuts and peanuts, legumes, fruits, and vegetables, and reducing intake of animal-based foods, including red and processed meats.
The PHDI-US is a new tool that can assess adherence to the Planetary Health Diet and identify key aspects of United States adults' diets that could be altered to potentially improve dietary sustainability and quality.
饮食选择是改善食物系统可持续性的重要途径。《行星健康饮食》是由 EAT-柳叶刀委员会提出的一种健康和可持续的饮食模式。
评估美国成年人对行星健康饮食的依从性，本研究开发并评估了适用于美国人群的行星健康饮食指数（PHDI-US），该指数改编自在巴西人群中验证的原始 PHDI。
PHDI-US 有 16 个组成部分，分数范围为 0 到 150，分数越高表示对行星健康饮食的依从性越好。本研究使用了 2017-2018 年全国健康和营养调查 4741 名参与者的横断面饮食数据，评估了 PHDI-US 的有效性和可靠性。
总体而言，有效性和可靠性测试是可以接受的：主成分分析确定了 6 个组成部分；PHDI-US 总分和健康饮食指数-2015 得分呈正相关（β=0.67，标准误=0.03，P<0.0001；R=0.39）；同时效性标准有效性分析表明，男性、每天吸烟和年轻成年人的得分明显较低；克朗巴赫α值为 0.54。美国成年人的平均 PHDI-US 得分为 150 分中的 46.7 分，表明美国成年人的饮食远远不符合行星健康饮食建议。根据 PHDI-US 各组成部分的得分，许多美国成年人可以通过增加植物性食物（包括全谷物、坚果和花生、豆类、水果和蔬菜）的摄入量，减少动物性食物（包括红色和加工肉类）的摄入量，来提高饮食质量和可持续性。
PHDI-US 是一种新的工具，可以评估对行星健康饮食的依从性，并确定美国成年人饮食中可能需要改变的关键方面，以潜在地改善饮食的可持续性和质量。
