Associations of EAT-<em>Lancet</em> Planetary Health Diet or Finnish Nutrition Recommendations with changes in obesity measures: a follow-up study in adults

Tiina Suikki; Mirkka Maukonen; Niina E. Kaartinen; Kennet Harald; Sari Bäck; Laura Sares-Jäske; Tommi Härkänen; Seppo Koskinen; Pekka Jousilahti; Anne-Maria Pajari; Satu Männistö

doi:10.29219/fnr.v67.9107

Tiina Suikki Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
Mirkka Maukonen Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
Niina E. Kaartinen Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
Kennet Harald Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
Sari Bäck University of Helsinki, Department of Food and Nutrition, Helsinki, Finland
Laura Sares-Jäske Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
Tommi Härkänen Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
Seppo Koskinen Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
Pekka Jousilahti Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
Anne-Maria Pajari University of Helsinki, Department of Food and Nutrition, Helsinki, Finland
Satu Männistö Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland

DOI: https://doi.org/10.29219/fnr.v67.9107

Keywords: dietary index, overall diet quality, food-based dietary guidelines, sustainable diet, sustainability, weight changes, anthropometrics

Abstract

Background: Knowledge on the association between the EAT-Lancet Planetary Health Diet (PHD) or the Finnish Nutrition recommendations (FNR) and anthropometric changes is scarce. Especially, the role of the overall diet quality, distinct from energy intake, on weight changes needs further examination.

Objectives: To examine the association between diet quality and weight change indicators and to develop a dietary index based on the PHD adapted for the Finnish food culture.

Methods: The study population consisted of participants of two Finnish population-based studies (n = 4,371, 56% of women, aged 30−74 years at baseline). Dietary habits at the baseline were assessed with a validated food frequency questionnaire including 128−130 food items. We developed a Planetary Health Diet Score (PHDS) (including 13 components) and updated the pre-existing Recommended Finnish Diet Score (uRFDS) (including nine components) with energy density values to measure overall diet quality. Weight, height, and waist circumference (WC), and the body mass index (BMI) were measured at the baseline and follow-up, and their percentual changes during a 7-year follow-up were calculated. Two-staged random effects linear regression was used to evaluate β-estimates with 95% confidence intervals.

Results: Adherence to both indices was relatively low (PHDS: mean 3.6 points (standard deviation [SD] 1.2) in the range of 0−13; uRFDS: mean 12.7 points (SD 3.9) in the range of 0−27). We did not find statistically significant associations between either of the dietary indices and anthropometric changes during the follow-up (PHDS, weight: β −0.04 (95% CI −0.19, 0.11), BMI: β 0.05 (−0.20, 0.10), WC: β −0.08 (−0.22, 0.06); uRFDS, weight: β 0.01 (−0.04, 0.06), BMI: β 0.01 (−0.04, 0.06), WC: β −0.02 (−0.07, 0.03)).

Conclusion: No associations between overall diet quality and anthropometric changes were found, which may be at least partly explained by low adherence to the PHD and the FNR in the Finnish adult population.

Downloads

Download data is not yet available.

References

1.
World Health Organization. Obesity and overweight. Version current June 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight [cited 20 August 2022].

2.
Lobstein T, Brinsden H, Neveux M; World Obesity Federation. World Obesity Atlas 2022; 2022. London. Available from: World_Obesity_Atlas_2022.pdf [cited 20 August 2022].

3.
Koponen P, Borodulin K, Lundqvist A, Sääksjärvi K, Koskinen S, eds. Health, functional capacity and welfare in Finland – FinHealth 2017 study. Report 4/2018. Helsinki: National Institute for Health and Welfare (THL).

4.
Tolonen H, Reinikainen J, Zhou Z, Härkänen T, Männistö S, Jousilahti P, et al. Development of non-communicable disease risk factors in Finland: projections up to 2040. Scand J Public Health 2022; 26: 1–8. doi: 10.1177/14034948221110025

5.
Serafini M, Toti E. Unsustainability of obesity: metabolic food waste. Front Nutr 2016; 3: 40. doi: 10.3389/fnut.2016.00040

6.
Schlesinger S, Neuenschwander M, Schwedhelm C, Hoffmann G, Bechthold A, Boeing H, et al. Food groups and risk of overweight, obesity, and weight gain: a systematic review and dose-responsemeta-analysis of prospective studies. Adv Nutr 2019; 10: 205–18. doi: 10.1093/advances/nmy092

7.
Waijers PMCM, Feskens EJM, Ocké MC. A critical review of predefined diet quality scores. Br J Nutr 2007; 97(2): 219–31. doi: 10.1017/S0007114507250421

8.
Asghari G, Mirmiran P, Yuzbashian E, Azizi F. A systematic review of diet quality indices in relation to obesity. Br J Nutr 2017; 117: 1055–65. doi: 10.1017/S0007114517000915

9.
Borges LPSL, de Santana NL, da Costa THM. Adherence to national food guide recommendations: can it slow the obesity epidemic? A systematic review. Curr Nutr Rep 2020; 9(4): 316–28. doi: 10.1007/s13668-020-00339-9

10.
Kanerva N, Kaartinen NE, Ovaskainen ML, Konttinen H, Kontto J, Männistö S. A diet following Finnish nutrition recommendations does not contribute to the current epidemic of obesity. Public Health Nutr 2013; 16(5): 786–94. doi: 10.1017/S1368980012005356

11.
Springmann M, Spajic L, Clark MA, Poore J, Herforth A, Webb P, et al. The healthiness and sustainability of national and global food based dietary guidelines: modelling study. BMJ 2020; 370: m2322. doi: 10.1136/bmj.m2322

12.
Willett W, Rockström J, Loken B, Springmann M, Lang T, Vermeulen S, et al. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet 2019; 393: 447–92. doi: 10.1016/S0140-6736(18)31788-4

13.
Knuppel A, Papier K, Key TJ, Travis RC. EAT-Lancet score and major health outcomes: the EPIC-Oxford study. Lancet 2019; 394: 213. doi: 10.1016/S0140-6736(19)31236-X

14.
Cacau LT, Benseñor IM, Goulart AC, Cardoso LO, Lotufo PA, Moreno LA, et al. Adherence to the planetary health diet and obesity indicators in the Brazilian Longitudional Study of Adult Health (ELSA-Brasil). Nutrients 2021; 13(11): 3691. doi: 10.3390/nu13113691

15.
Stubbendorff A, Sonestedt E, Ramne S, Drake I, Hallström E, Ericson U. Development of an EAT-Lancet index and its relation to mortality in a Swedish population. Am J Clin Nutr 2022; 115(3): 705–16. doi: 10.1093/ajcn/nqab369

16.
Ibsen DB, Christiansen AH, Olsen A, Tjønneland A, Overvad K, Wolk A, et al. Adherence to the EAT-Lancet diet and risk of stroke and stroke subtypes: a cohort study. Stroke 2022; 53: 154–63. doi: 10.1161/STROKEAHA.121.036738

17.
Xu C, Cao Z, Yang H, Hou Y, Wang X, Wang Y. Association between the EAT-Lancet diet pattern and risk of type 2 diabetes: a prospective cohort study. Front Nutr 2022; 14: 784018. doi: 10.3389/fnut.2021.784018

18.
Lazarova SV, Sutherland JM, Jessri M. Adherence to emerging plant-based dietary patterns and its association with cardiovascular disease risk in a nationally representative sample of Canadian adults. Am J Clin Nutr 2022; 10: nqac062. doi: 10.1093/ajcn/nqac062

19.
Heistaro S, ed. Methodology report. Health 2000 survey. Publications of the National Public Health Institute. Report B26/2008. Helsinki: National Public Health Institute. Available from: https://urn.fi/URN:NBN:fi-fe201204193320 [cited 9 November 2022].

20.
Konttinen, H, Männistö, S, Sarlio-Lähteenkorva, S, Silventoinen K, Haukkala A. Emotional eating, depressive symptoms and self-reported food consumption. A population-based study. Appetite 2010; 54: 473–9. doi: 10.1016/j.appet.2010.01.014

21.
Lundqvist A, Mäki-Opas T, eds. Health 2011 survey – methods. Finnish National Institute for Health and Welfare. Report 8/2016. Tampere. Available from: https://urn.fi/URN:ISBN:978-952-302-669-8 [cited 9 November 2022].

22.
Kanerva N, Harald K, Männistö S, Kaartinen NE, Maukonen M, Haukkala A, et al. Adherence to the healthy Nordic diet is associated with weight change during 7 years of follow-up. Br J Nutr 2018; 120(1): 101–10. doi: 10.1017/S0007114518001344

23.
Borodulin K, Vartiainen E, Peltonen M, Jousilahti P, Juolevi A, Laatikainen T, et al. Forty-year trends in cardiovascular risk factors in Finland. Eur J Public Health 2014; 25(3): 539–46. doi: 10.1093/eurpub/cku174

24.
Meltzer HM, Brantsaeter AL, Ydersbond TA, Alexander J, Haugen M. Methodological challenges when monitoring the diet of pregnant women in a large study: experiences from the Norwegian Mother and Child Cohort Study (MoBa). Matern Child Nutr 2008; 4(1): 14–27. doi: 10.1111/j.1740-8709.2007.00104.x

25.
Männistö S, Virtanen M, Mikkonen T, Pietinen P. Reproducibility and validity of a food frequency questionnaire in a case-control study on breast cancer. J Clin Epidemiol 1996; 49: 401–9. doi: 10.1016/0895-4356(95)00551-x

26.
Paalanen L, Männistö S, Virtanen MJ, Knekt P, Räsänen L, Montonen J, et al. Validity of a food frequency questionnaire varied by age and body mass index. J Clin Epidemiol 2006; 59: 994–1001. doi: 10.1016/j.jclinepi.2006.01.002

27.
Kaartinen NE, Tapanainen H, Valsta LM, Similä ME, Reinivuo H, Korhonen T, et al. Relative validity of a FFQ in measuring carbohydrate fractions, dietary glycaemic index and load: exploring the effects of subject characteristics. Br J Nutr 2012; 107(9): 1367–75. doi: 10.1017/S0007114511004296

28.
Reinivuo H, Hirvonen T, Ovaskainen ML, Korhonen T, Valsta LM. Dietary survey methodology of FINDIET 2007 with a risk assessment perspective. Public Health Nutr 2010; 13(6A): 915–9. doi: 10.1017/S1368980010001096

29.
Finnish National Nutrition Council. Terveyttä ruoasta – Suomalaiset ravitsemussuositukset 2014 / Finnish nutrition and food recommendations 2014. 5th ed. Helsinki: Punamusta Oy; 2018. Available from: ravitsemussuositukset_2014_fi_web_versio_5.pdf [cited 9 November 2022].

30.
Tammi R, Männistö S, Reinivuo H, Tapanainen H, Rautanen J, Kaartinen NE. The relation of whole grain surrogate estimates and food definition to total whole grain intake in the Finnish adult population. Eur J Nutr 2023 Feb 27. doi: 10.1007/s00394-023-03119-7

31.
Trijsburg L, Talsma EF, Crispim SP, Garrett J, Kennedy J, de Vries JHM, et al. Method for the Development of WISH, a globally applicable index for healthy diets from sustainable food systems. Nutrients 2020; 30; 13(1): 93. doi: 10.3390/nu13010093

32.
Clark M.A., Springmann M, Hill, J, Tilman D. Multiple health and environmental impacts of foods. Proc Natl Acad Sci USA 2019; 116: 23357–62. doi: 10.1073/pnas.1906908116

33.
Tolonen H, Koponen P, Aromaa A, Conti S, Graff-Iversen S, Grøtvedt L, et al. Recommendations for the health examination surveys in Europe, B21/2008. Helsinki: The National Public Health Institute. Available from: https://urn.fi/URN:ISBN:978-951-740-838-7 [cited 9 November 2022].

34.
Smith-Warner SA, Spiegelman D, Ritz J, Albanes D, Beeson WL, Bernstein L, et al. Methods for pooling results of epidemiologic studies: the pooling project of prospective studies of diet and cancer. Am J Epidemiol 2006; 163: 1053–64. doi: 10.1093/aje/kwj127

35.
Vierboom YC, Preston SH, Stokes A. Patterns of weight change associated with disease diagnosis in a national sample. PLoS One 2018; 13(11): e0207795. doi: 10.1371/journal.pone.0207795

36.
Carey M, Small H, Yoong SL, Boyes A, Bisquera A, Sanson-Fisher R. Prevalence of comorbid depression and obesity in general practice: a cross-sectional survey. Br J Gen Pract 2014; 64(620): e122–7. doi: 10.3399/bjgp14X677482

37.
World Health Organization. Energy and protein requirements. Report of a Joint WHO/FAO/UNU Expert Consultation. WHO Technical Report Series no. 724. Geneva: WHO; 1985. Available from: WHO_TRS_724_(chp1-chp6).pdf [cited 9 November 2022].

38.
Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA, et al. Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 1991; 45(12): 569–81.

39.
Balduzzi S, Rücker G, Schwarzer G. How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health 2019; 22: 153–60. doi: 10.1136/ebmental-2019-300117

40.
Cacau LT, De Carli E, de Carvalho AM, Lotufo PA, Moreno LA, Bensenor IM, et al. Development and validation of an index based on EAT-Lancet recommendations: the planetary health diet index. Nutrients 2021; 17; 13(5): 1698. doi: 10.3390/nu13051698

41.
Ramezani-Jolfaie N, Mohammadi M, Salehi-Abargouei A. Effects of a healthy Nordic diet on weight loss in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Eat Weight Disord 2020; 25(5): 1141–50. doi: 10.1007/s40519-019-00773-x

42.
Härkänen T, Karvanen J, Tolonen H, Lehtonen R, Djerf K, Juntunen T, et al. Systematic handling of missing data in complex study designs: experiences from the Health 2000 and 2011 Surveys. J Appl Stat 2016; 43: 2772–90. doi: 10.1080/02664763.2016.1144725

43.
Hanley-Cook GT, Argaw AA, de Kok BP, Vanslambrouck KW, Toe LC, Kolsteren PW, et al. EAT-Lancet diet score requires minimum intake values to predict higher micronutrient adequacy of diets in rural women of reproductive age from five low- and middle -income countries. Br J Nutr 2021; 14; 126: 92−100. doi: 10.1017/S0007114520003864

44.
Burlingame B, Dernini S, eds.; Nutrition and Consumer Protection Division, FAO. Sustainable diets and biodiversity – directions and solutions for policy, research and action. Rome; 2010. E-ISBN 978-92-5-107288-2. Available from: https://www.fao.org/3/i3004e/i3004e.pdf [cited 9 November 2022].

45.
Hirvonen K, Bai Y, Headey D, Masters WA. Affordability of the EAT-Lancet reference diet: a global analysis. Lancet Glob Health 2020; 8(1): e59–66. doi: 10.1016/S2214-109X(19)30447-4

46.
Meltzer HM, Brantsæter AL, Trolle E, Eneroth H, Fogelholm M, Ydersbond TA, et al. Environmental sustainability perspectives of the Nordic diet. Nutrients 2019; 18: 11(9): 2248. doi: 10.3390/nu11092248

47.
Wood A, Gordon LJ, Röös E, Karlsson JO, Häyhä T, Bignet V, et al. Nordic food systems for improved health and sustainability – baseline assessment to inform transformation. Report 2019 Mar. Available from: SRC_Report Nordic Food Systems.pdf [cited 9 November 2022].

48.
Saarinen M, Kaljonen M, Niemi J, Antikainen R, Hakala K, Hartikainen H, et al. Effect of dietary change and policy mix supporting the change – end report of the FoodMin project. Prime Minister’s Office 2019. Publications of the Government’s analysis, assessment and research activities 2019; p. 47. Available from: http://urn.fi/URN:ISBN:978-952-287-773-4 [cited 9 November 2022].

49.
Valsta L, Kaartinen N, Tapanainen H, Männistö S, Sääksjärvi K. Nutrition in Finland – the National FinDiet 2017 survey. Report 12/2018. Helsinki: National Institute for Health and Welfare (THL). Available from: https://urn.fi/URN:ISBN:978-952-343-238-3 [cited 9 November 2022].

Associations of EAT-Lancet Planetary Health Diet or Finnish Nutrition Recommendations with changes in obesity measures: a follow-up study in adults

Abstract

Downloads

References