Li Zeyu, Song Yiming, Huang Xiaojie, Dong Shengsheng, Chen Jinnan, Zhou Yujie, Wang Xinyuan, Li Zhao, Yang Liuyi, Liu Qingran, Ji Zhongge, Zhai Sijia, Zeng Ruitian, Xiao Yufei, Han Ruijie, Yang Yuxin, Lin Xiaolu, Zhang Qingwei, Li Xiaobo
Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Institute of Digestive Disease, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Gastroenterology, Affiliated Hospital of Putian University, Putian, Fujian, China.
Am J Clin Nutr. 2025 Jun 20. doi: 10.1016/j.ajcnut.2025.06.016.
Understanding global dietary patterns and their implications for human and planetary health has become increasingly critical. The Planetary Health Diet (PHD), introduced by the EAT-Lancet Commission in 2019, offers a framework to address nutrition-related diseases while mitigating environmental impacts.
We aimed to analyze adherence to a modified PHD (mPHD) among working-age population (WAP) across 185 countries between 1990 and 2018.
We conducted a serial cross-sectional analysis using data from the Global Dietary Database (GDD) 2018. The modified Planetary Health Diet Index (mPHDI) score was constructed based on consumption of 12 food groups. Each component was scored from 0-10, generating a composite score ranging from 0-120. Distributive inequalities were assessed using the slope index of inequality and concentration index, which are two standard metrics of absolute and relative gradient inequality.
Modest overall adherence to the mPHD recommendations [global mPHDI score: 75.2; 95% uncertainty interval (UI): 74.2, 76.3] was observed, with significant regional variations. Sub-Saharan Africa showed the highest adherence (84.5; 95% UI: 83.2, 85.5), while Latin America and the Caribbean showed the lowest (66.0; 95% UI: 64.5, 67.7). Excessive consumption of red/processed meat and added sugar was prevalent across various populations. Over the past 28 years, global improvement was minimal (+1.3; 95% UI: -0.1, 2.4), with concerning declines in South Asia (-4.0; 95% UI: -5.7, -2.2), despite substantial improvements in high-income countries (6.5; 95% UI: 4.0, 8.5). The slope index of inequality decreasing from -15.48 (95% confidential interval (CI): -19.2, -11.76) in 1990 to -8.49 (95% CI: -12.26, -4.72) in 2018.
Our findings reveal substantial global variations in mPHD adherence among WAP, with concerning trends in certain regions. These results provide crucial insights for developing targeted interventions that consider regional contexts while pursuing the dual objectives of promoting healthier diets and ensuring environmental sustainability.
了解全球饮食模式及其对人类健康和地球健康的影响变得越来越重要。2019年，EAT-柳叶刀委员会提出的“行星健康饮食”（PHD）提供了一个框架，以解决与营养相关的疾病，同时减轻对环境的影响。
我们旨在分析1990年至2018年期间185个国家工作年龄人口（WAP）对改良版“行星健康饮食”（mPHD）的依从性。
我们使用2018年全球饮食数据库（GDD）的数据进行了系列横断面分析。改良版行星健康饮食指数（mPHDI）得分基于12个食物组的消费量构建。每个成分的得分从0到10，生成一个综合得分，范围从0到120。使用不平等斜率指数和集中指数评估分布不平等，这是绝对和相对梯度不平等的两个标准指标。
观察到对mPHD建议的总体依从性适中[全球mPHDI得分：75.2；95%不确定区间（UI）：74.2，76.3]，存在显著的区域差异。撒哈拉以南非洲的依从性最高（84.5；95%UI：83.2，85.5），而拉丁美洲和加勒比地区的依从性最低（66.0；95%UI：64.5，67.7）。红肉/加工肉类和添加糖的过量消费在各人群中普遍存在。在过去28年中，全球改善甚微（+1.3；95%UI：-0.1，2.4），南亚出现了令人担忧的下降（-4.0；95%UI：-5.7，-2.2），尽管高收入国家有显著改善（6.5；95%UI：4.0，8.5）。不平等斜率指数从1990年的-15.48（95%置信区间（CI）：-19.2，-11.76）降至2018年的-8.49（95%CI：-12.26，-4.72）。
我们的研究结果揭示了WAP中全球mPHD依从性存在显著差异，某些地区出现了令人担忧的趋势。这些结果为制定有针对性的干预措施提供了关键见解，这些措施在追求促进更健康饮食和确保环境可持续性的双重目标时考虑了区域背景。
