EAT-Lancet diet does not compromise nutritional adequacy

Aim

To assess the nutritional quality of French dietary habits with regard to degree of adherence to the EAT-Lancet reference diet recommendations.

Study design

Data was collected from the French web-based prospective cohort study of adults aged 18 years and older, NutriNet-Sante which commenced in 2009.

Dietary data: assessed at enrolment and twice yearly, via 3-day dietary records over a 2-week period.

EAT-Lancet diet adherence

To assess participants adherence to the EAT-Lancet diet, an EAT-Lancet Diet Index (ELD-I) was developed based on the 14 food group recommendations of the EAT-Lancet. The higher the ELD-I the greater the adherence to the EAT-Lancet diet.

Nutritional adequacy

To assess the nutritional adequacy, the Programme National Nutrition Sante-Guidelines 2 (PNNS-GS2) were used to assess adherence to the French food-based dietary guidelines. Additionally, the PANDiet score was used to estimate the prevalence of nutrient inadequacy based on the assessment of 27 key nutrients and penalty scores added for exceeding upper limits of negative nutrients. The higher the PANDiet score, the greater the nutrient inadequacy of the diet.

Results

98,465 participants (78% females) had an average ELD-I score of 41.2 (range, -161.5 to 428.6). Results are presented as quintiles of ELD-I score.

Compared to participants with lower ELD-I scores, participants with higher ELD-I scores had:

Lower intakes of:

• Energy

• Animal protein with higher in plant protein intakes

• Fat

• Cholesterol

• Heme-iron (although total iron was the same)

• vitamin B12

Higher intakes of :

• Fibre

• Vitamins: β-carotene, A, B9 and C

• Minerals: calcium, copper, total iron, iodine, potassium, magnesium, manganese and phosphorus

Polyunsaturated fats, vitamins B1, B2, B3, B6 and E, zinc, retinol, sodium and selenium were similar across all quintiles.

With regard to specific EAT-Lancet diet recommendations, legumes, nuts and wholegrains were poorly adhered to.

Nutrient inadequacy - PANDiet score

The higher the adherence to the EAT-Lancet diet the lower the prevalence of nutrient inadequacies across most macro- and micronutrients. The exceptions were zinc and vitamin B12, where those who least adhered to the EAT-Lancet diet had the lowest prevalence of inadequacy for these two nutrients.

Interestingly, prevalence of inadequacy was high across all quintiles particularly for fibre, vitamin B1, iodine and magnesium.

Adherence to the French food-based dietary guidelines - PNNS

Higher ELD-I scores were associated with better adherence to the PNNS recommendations.

Conclusion

For French adults, adherence to the EAT-Lancet diet recommendations resulted in better overall nutritional adequacy, although attention is needed to optimize intakes of a handful of nutrients.

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