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Development of an EAT-Lancet index and its relation to mortality in a Swedish population

Stubbendorff, Anna LU orcid ; Sonestedt, Emily LU orcid ; Ramne, Stina LU orcid ; Drake, Isabel LU ; Hallström, Elinor LU and Ericson, Ulrika LU (2021) In The American journal of clinical nutrition
Abstract

BACKGROUND: Current global food systems threaten human health and environmental sustainability. In 2019, the EAT-Lancet Commission on healthy diets from sustainable food systems defined the first global reference diet to improve both areas, but there is no consensus on how to quantify the EAT-Lancet reference diet as a diet index and its relation to mortality has not been widely studied.

OBJECTIVE: To develop a new dietary index to quantify adherence to the EAT-Lancet diet and assess its association with mortality in a large population-based Swedish cohort. We also examined food components included in the index and their individual associations with mortality.

DESIGN: We used the Malmö Diet and Cancer cohort (n = 22,421,... (More)

BACKGROUND: Current global food systems threaten human health and environmental sustainability. In 2019, the EAT-Lancet Commission on healthy diets from sustainable food systems defined the first global reference diet to improve both areas, but there is no consensus on how to quantify the EAT-Lancet reference diet as a diet index and its relation to mortality has not been widely studied.

OBJECTIVE: To develop a new dietary index to quantify adherence to the EAT-Lancet diet and assess its association with mortality in a large population-based Swedish cohort. We also examined food components included in the index and their individual associations with mortality.

DESIGN: We used the Malmö Diet and Cancer cohort (n = 22,421, 45-73 years at baseline). Dietary data were collected using a modified diet history method. The EAT-Lancet index was developed based on intake levels and reference intervals of 14 food components defined in the EAT-Lancet diet (0-3 points per component, 0-42 points in total). Associations with mortality were examined based on registers during a mean of 20 years of follow-up and were adjusted for potential confounders.

RESULTS: Divided into five adherence groups, the highest adherence to the EAT-Lancet diet (≥23 points) was associated with lower all-cause mortality (HR: 0.75; 95% CI: 0.67, 0.85), cancer mortality (HR 0.76; 95% CI: 0.63, 0.92) and cardiovascular mortality (HR 0.68; 95% CI: 0.54, 0.84) than the lowest adherence (≤13 points). Several food components included in the index contributed to the observed reductions in mortality.

CONCLUSIONS: We developed a new dietary index to investigate adherence to the EAT-Lancet diet. The findings indicate a 25% lower risk of mortality among those with the highest adherence to the EAT-Lancet diet, as defined using our index, which adds to the evidence base for the development of sustainable dietary guidelines.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The American journal of clinical nutrition
publisher
Oxford University Press
external identifiers
  • pmid:34791011
  • scopus:85123923025
ISSN
1938-3207
DOI
10.1093/ajcn/nqab369
project
Lund University Agenda 2030 Graduate School
Mat för människa och planet (inom forskarskolan Agenda 2030)
language
English
LU publication?
yes
additional info
© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.
id
a381e215-9559-426c-9b89-0687ef950879
date added to LUP
2021-11-22 10:48:35
date last changed
2024-06-14 12:44:44
@article{a381e215-9559-426c-9b89-0687ef950879,
  abstract     = {{<p>BACKGROUND: Current global food systems threaten human health and environmental sustainability. In 2019, the EAT-Lancet Commission on healthy diets from sustainable food systems defined the first global reference diet to improve both areas, but there is no consensus on how to quantify the EAT-Lancet reference diet as a diet index and its relation to mortality has not been widely studied.</p><p>OBJECTIVE: To develop a new dietary index to quantify adherence to the EAT-Lancet diet and assess its association with mortality in a large population-based Swedish cohort. We also examined food components included in the index and their individual associations with mortality.</p><p>DESIGN: We used the Malmö Diet and Cancer cohort (n = 22,421, 45-73 years at baseline). Dietary data were collected using a modified diet history method. The EAT-Lancet index was developed based on intake levels and reference intervals of 14 food components defined in the EAT-Lancet diet (0-3 points per component, 0-42 points in total). Associations with mortality were examined based on registers during a mean of 20 years of follow-up and were adjusted for potential confounders.</p><p>RESULTS: Divided into five adherence groups, the highest adherence to the EAT-Lancet diet (≥23 points) was associated with lower all-cause mortality (HR: 0.75; 95% CI: 0.67, 0.85), cancer mortality (HR 0.76; 95% CI: 0.63, 0.92) and cardiovascular mortality (HR 0.68; 95% CI: 0.54, 0.84) than the lowest adherence (≤13 points). Several food components included in the index contributed to the observed reductions in mortality.</p><p>CONCLUSIONS: We developed a new dietary index to investigate adherence to the EAT-Lancet diet. The findings indicate a 25% lower risk of mortality among those with the highest adherence to the EAT-Lancet diet, as defined using our index, which adds to the evidence base for the development of sustainable dietary guidelines.</p>}},
  author       = {{Stubbendorff, Anna and Sonestedt, Emily and Ramne, Stina and Drake, Isabel and Hallström, Elinor and Ericson, Ulrika}},
  issn         = {{1938-3207}},
  language     = {{eng}},
  month        = {{11}},
  publisher    = {{Oxford University Press}},
  series       = {{The American journal of clinical nutrition}},
  title        = {{Development of an EAT-Lancet index and its relation to mortality in a Swedish population}},
  url          = {{http://dx.doi.org/10.1093/ajcn/nqab369}},
  doi          = {{10.1093/ajcn/nqab369}},
  year         = {{2021}},
}