Are the EAT-Lancet dietary recommendations associated with cardiometabolic health? - insights from the Generation XXI cohort from childhood into early adolescence

Am J Clin Nutr. 2024 Sep 27:S0002-9165(24)00798-6. doi: 10.1016/j.ajcnut.2024.09.023. Online ahead of print.

Authors

Beatriz Teixeira¹, Cláudia Afonso², Milton Severo³, Andreia Oliveira⁴

Affiliations

¹ Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre, 823 / 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal. Electronic address: beatrizteixeira.nutricao@gmail.com.
² Faculty of Nutrition and Food Sciences, University of Porto, Rua do Campo Alegre, 823 / 4150-180 Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
³ EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal.
⁴ EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal; Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.

PMID: 39343034
DOI: 10.1016/j.ajcnut.2024.09.023

Abstract

Background: The prospective effect of healthy and planetary diets on cardiometabolic health at young ages remains unclear.

Objective: This study aims to investigate the prospective associations between adherence to the EAT-Lancet dietary recommendations at age 7 and the prevalence of obesity and Metabolic Syndrome (MetS) at 7, 10, and 13 years old (y).

Methods: Participants are children from the Generation XXI birth cohort, who completed 3-day food diaries at age 7, with complete data in variables of interest (n 3564). Adherence to the EAT-Lancet dietary recommendations was evaluated using the World Index for Sustainability and Health (WISH); a higher score indicating a healthier and environmentally sustainable diet. At 7, 10 and 13y, anthropometrics (weight, height and waist circumference-WC), blood pressure (BP) and serum-fasting triglycerides, HDL-cholesterol and glucose were measured. Obesity and MetS prevalence were determined by the World Health Organization and the International Diabetes Federation criteria, respectively. Adjusted custom binomial log-linear models were used to calculate prevalence ratios (PR) and the respective 95% confidence intervals (95%CI) (covariates: mother's age, education, pre-pregnancy BMI, gestational diabetes, child's sex, age, tanner stage, sports practice and total grams of the remaining food).

Results: From 7 to 13y, obesity decreased from 14.1% to 9.3% and MetS increased from 1.0% to 5.1%. Higher WISH scores at 7y were associated with a lower prevalence of obesity, measured by both BMI (≥97^th percentile: PR=0.912, 95%CI: 0.839,0.991; PR=0.882, 95%CI: 0.79,0.938, respectively at 10 and 13y) and WC (≥90^th percentile: PR=0.899, 95%CI: 0.830,0.974; PR=0.858, 95%CI:0.782,0.942, respectively at 10 and 13y). For each 10-point increase in the WISH, a reduction of 16% in MetS prevalence at 13y was observed (PR=0.837, 95%CI: 0.732,0.957). No significant effects were found at younger ages.

Conclusions: The adherence to the EAT-Lancet diet from an early age may help reduce cardiometabolic risk in early adolescence.

Keywords: Adolescents; Cardiometabolic health; Children; Cohort studies; Feeding behavior; Metabolic Syndrome; Obesity.