Adherence to different EAT-Lancet diet scores and subclinical atherosclerosis: results from ELSA-Brasil cohort study.

BACKGROUND AND AIMS

The EAT-Lancet Commission advocates a global reference diet for human health within planetary boundaries. Although the EAT-Lancet diet has been associated with health outcomes, its association with subclinical atherosclerosis is yet to be explored. Thus, our aim was to address this question.

METHODS AND RESULTS

This study used data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study that follows 15,105 male and female, aged between 35 to 74 years, from six different Brazilian cities. Subclinical atherosclerosis was assessed by measuring coronary artery calcification (CAC) at baseline (2008-2010) and second wave (2012-2014), and carotid intima-media thickness (cIMT) at baseline and at the third wave (2017-2019). Dietary intake was collected using a food frequency questionnaire. Adherence to the EAT-Lancet diet was evaluated throughout four diet scores: the Planetary Health Diet Index (PHDI), the EAT-Lancet diet index (ELDI), the World Index for Sustainability and Health (WISH), and the EAT-Lancet score (ELS). Poisson regression with robust variance and linear mixed-effects models were used to evaluate the association between the four EAT-Lancet diet scores with CAC incidence (n 2224), CAC progression (n 725), and changes in cIMT (n 7341) over time, respectively. After a 4-year and 8-year follow-up period, no significant associations were observed between adherence to the EAT-Lancet diet with CAC incidence and progression or cIMT changes, even in the adjusted models.

CONCLUSION

In this large Brazilian cohort with individuals without CVD, we found no discernible association between different diet scores aligned with the EAT-Lancet diet and subclinical atherosclerosis.