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Topical Area: Dietary Patterns

Dietary Patterns (Poster Session)

(P14-036-23) One Score To Rule Them All? – Comparison of EAT-Lancet Diet Scores and Their Associations With Disease Risk and Greenhouse Gas Emissions in Three Cohorts

Sunday, July 23, 2023
11:45 AM – 12:45 PM ET
Location: Poster Board 36
PRAC

    Presenting Author(s)

  • Daniel B. Ibsen, PhD

    Postdoc
    Department of Public Health, Aarhus University
    Aarhus C, Midtjylland, Denmark

    • Co-Author(s)

  • AS

    Anna Stubbendorff

    Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden

  • DS

    Dalia Stern, PhD

    CONACyT- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
    Cuernavaca, Morelos, Mexico

  • UE

    Ulrika Ericson

    Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden

  • ES

    Emily Sonestedt

    Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden

  • EH

    Elinor Hallström, PhD

    Researcher
    Department of Agriculture and Food, Research Institutes of Sweden (RISE), Lund, Sweden
    Lund, Skane Lan, Sweden

  • YB

    Yan Borné

    Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden

  • ML

    Martin Lajous, PhD

    Principal Investigator and Scientific Director. ESMaestras (Mexican Teachers' Cohort)
    Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
    Cuernavaca, Morelos, Mexico

  • NF

    Nita G. Forouhi, PhD

    MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
    Cambridge, England, United Kingdom

  • AO

    Anja Olsen, PhD

    Danish Cancer Society, Copenhagen, Denmark
    Copenhagen, Hovedstaden, Denmark

  • CD

    Christina C. Dahm, PhD

    Department of Public Health, Aarhus University, Aarhus, Denmark
    Aarhus, Midtjylland, Denmark

Disclosure(s):
Daniel B. Ibsen, PhD: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Differences in the operationalization and application of the EAT-Lancet reference diet into dietary scores may lead to differing policy recommendations. Our aim was to compare existing versions of EAT-Lancet diet scores, and to estimate their associations with all-cause mortality, stroke, and greenhouse gas emissions (GHGE).

Methods: A systematic review was performed to identify different versions of the EAT-Lancet dietary scores. Dietary and health outcome data were assessed in two Nordic and one Latin American cohort: the Diet, Cancer and Health cohort (DCH, n=52,452), the Malmö Diet and Cancer cohort (MDC, n=20,973) and the Mexican Teacher’s Cohort (MTC, n=30,151). Food frequency questionnaires (DCH, MTC) and a modified diet history method (MDC) were used to assess dietary intake. GHGE from life cycle assessment data were mapped to individual foods in MDC.

Results: The seven identified scores had notable differences in construction, interpretation, and relation to disease risk and GHGE. Point estimates ranged from hazard ratios of 0.99 to 0.80 for all-cause mortality (data from three cohorts) and 0.97 to 0.73 for stroke (data from DCH and MDC) for each 10% increase in diet scores. The assessment of GHGE in MDC revealed a higher predicted GHGE when comparing those with the maximum to the minimum adherence score of two of six scores (largest contrast: 0.51, 95% confidence interval (CI): 0.38, 0.65, kg CO2-eq/day), whereas the rest lowered GHGEs (largest contrast: -3.87, 95% CI: -3.64, -4.10, kg CO2-eq/day). Two of the seven scores consistently grouped participants according to EAT-Lancet recommendations and were associated with lower risks of mortality and stroke, and lower GHGE.

Conclusions: These findings highlight the importance of the derivation method and that studies should scrutinize the selection of an EAT-Lancet diet score. The consistent performance of two EAT-Lancet diet scores suggests their potential use for public health policy recommendations, though which score to use may depend on specific context.

Funding Sources: DBI was supported by a research grant from the Independent Research Fund Denmark (1057-00016B).