Adherence to the modified Planetary Health Diet among the working-age population in 185 countries from 1990 to 2018:
Zeyu Li1, Yiming Song1, Xiaojie Huang2
1Division 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.
Background:
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.
Objectives:
We aimed to analyze adherence to a modified PHD (mPHD) among working-age population (WAP) across 185 countries between 1990 and 2018.
Methods:
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 to 10, generating a composite score ranging from 0 to 120. Distributive inequalities were assessed using the slope index of inequality and concentration index, which are 2 standard metrics of absolute and relative gradient inequality.
Results:
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), whereas 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 y, 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 decreased from -15.48 (95% confidence interval [CI]: -19.2, -11.76) in 1990 to -8.49 (95% CI: -12.26, -4.72) in 2018.
Conclusions:
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.
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