15 research outputs found
Comparison of the dietary components of the Planetary Health Diet Index (PHDI), Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH).
Comparison of the dietary components of the Planetary Health Diet Index (PHDI), Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH).</p
Characteristics of eligible participants with two days of dietary recall data, NHANES 2015–2018<sup>b'*'</sup>.
Characteristics of eligible participants with two days of dietary recall data, NHANES 2015–2018b'*'.</p
S1 Methods -
BackgroundThe Planetary Health Diet Index (PHDI) measures adherence to the sustainable dietary guidance proposed by the EAT-Lancet Commission on Food, Planet, Health. To justify incorporating sustainable dietary guidance such as the PHDI in the US, the index needs to be compared to health-focused dietary recommendations already in use. The objectives of this study were to compare the how the Planetary Health Diet Index (PHDI), the Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to cardiometabolic risk factors.Methods and findingsParticipants from the National Health and Nutrition Examination Survey (2015–2018) were assigned a score for each dietary index. We examined disparities in dietary quality for each index. We used linear and logistic regression to assess the association of standardized dietary index values with waist circumference, blood pressure, HDL-C, fasting plasma glucose (FPG) and triglycerides (TG). We also dichotomized the cardiometabolic indicators using the cutoffs for the Metabolic Syndrome and used logistic regression to assess the relationship of the standardized dietary index values with binary cardiometabolic risk factors. We observed diet quality disparities for populations that were Black, Hispanic, low-income, and low-education. Higher diet quality was associated with improved continuous and binary cardiometabolic risk factors, although higher PHDI was not associated with high FPG and was the only index associated with lower TG. These patterns remained consistent in sensitivity analyses.ConclusionsSustainability-focused dietary recommendations such as the PHDI have similar cross-sectional associations with cardiometabolic risk as HEI-2015 or DASH. Health-focused dietary guidelines such as the forthcoming 2025–2030 Dietary Guidelines for Americans can consider the environmental impact of diet and still promote cardiometabolic health.</div
Predicted probability of cardiometabolic risk factor by quintile of Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension value among undiagnosed participants only, National Health and Nutrition Examination Survey 2003–2018*,<sup>†</sup>.
* Survey-weighted logistic regression models were adjusted for age, sex, income, education, race/ethnicity, and total energy intake.†* p‡ Contrast is from Stata’s postestimation margins, dydx command and represents percentage point reduction in predicted probability from Quintile 1 to Quintile 5. (DOCX)</p
Predicted change in continuous and binary cardiometabolic risk factors per one standard-deviation score in Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension score among undiagnosed participants only, National Health and Nutrition Examination Survey 2003–2018*.
* Survey-weighted regression models were adjusted for age, sex, income, education, race/ethnicity, and total energy intake. †mg/dL = milligrams per deciliter. (DOCX)</p
Criteria used to define binary cardiometabolic risk factor outcomes.
Criteria used to define binary cardiometabolic risk factor outcomes.</p
Radar plots of median component scores for Planetary Health Diet Index (PHDI), Healthy Eating Index-2015 (HEI-2015), and Dietary Approaches to Stop Hypertension (DASH), National Health and Nutrition Examination Survey 2015–2018.
* All dietary pattern component scores range 0–10 unless otherwise noted. †Component score range: 0–5. (TIF)</p
Predicted standardized PHDI, HEI-2015, and DASH value by sociodemographic characteristics, NHANES 2015–2018<sup>b'*'</sup>,<sup>†</sup>.
Predicted standardized PHDI, HEI-2015, and DASH value by sociodemographic characteristics, NHANES 2015–2018b'*',†.</p
Predicted change in continuous and binary cardiometabolic risk factors per one standard-deviation change in PHDI, HEI-2015, and DASH, NHANES 2003–2018<sup>b'*'</sup>.
Predicted change in continuous and binary cardiometabolic risk factors per one standard-deviation change in PHDI, HEI-2015, and DASH, NHANES 2003–2018b'*'.</p
Bland-Altman plots comparing rescaled PHDI, HEI-2015, and DASH values.
Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension scores were rescaled from 0 to 100 for comparability.</p