Exploring dietary patterns and their association with environmental sustainability and body mass index in children and adolescents: Insights from the National Food, Nutrition and Physical Activity Survey 2015-2016.

Sci Total Environ

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), Porto [Laboratory for Integrative and Translational Research in Population Health (ITR)], Rua das Taipas 135, 4050-600 Porto, Portugal; Faculdade de Medicina da Universidade do Porto [Faculty of Medicine, University of Porto], Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal. Electronic address:

Published: October 2024

AI Article Synopsis

  • The study aimed to adapt four dietary patterns for children and adolescents and examine their links to sustainability (greenhouse-gas emissions and land use) and health (body mass index).
  • Dietary intake was assessed using interviews involving food diaries and 24-hour recalls for a sample of 1,153 children and adolescents in Portugal.
  • Results indicated that while all dietary patterns had lower environmental impacts, only the Mediterranean diet was significantly associated with both better health outcomes and sustainability metrics, especially in children.

Article Abstract

Objective: To adapt four dietary patterns for children and adolescents, and study their associations with sustainability (greenhouse-gas emissions-GHGE and land use-LU), and health (body mass index-BMI) indicators.

Research Methods & Procedures: Dietary intake of children (3-9y) and adolescents (10-17y) from the National Food, Nutrition and Physical Activity Survey 2015-2016, Portugal (n = 1153) was assessed through two non-consecutive interviews: one-day food diaries (children), and 24-h recalls (adolescents), using an automated multiple-pass method, including a picture book for portion sizes estimation. Adherence to the Eat-Lancet and World Health Organization (WHO) recommendations, Mediterranean and Atlantic diets were evaluated using adapted versions for pediatrics of the World Index for Sustainability and Health (WISH), Diet Quality Index (DQI), Mediterranean Diet Score (MDS) and Southern-European Atlantic Diet (SEAD), respectively. Diet-related GHGE and LU were estimated using the SHARP-Indicators database. BMI (measured) z-scores were classified according to WHO criteria. A standardized weighted health-sustainability composite index was created (BMI + 0.5*GHGE+0.5*LU). Adjusted linear regression models were computed.

Results: WISH, DQI, MDS, and SEAD had weighted mean scores (range) of 50 (0-130), 24 (9-36), 20 (8-32), and 17 (8-32), respectively. All dietary patterns were associated with lower environmental impact, particularly in children, but not with BMI. Only MDS explained both health and sustainability indicators in childhood (composite index: sd.β = -0·223,95%CI:-0·347,-0·072,R = 25.1 %), and adolescence (composite index: sd.β = -0·159,95%CI:-0·315,-0·003,R = 31.3 %).

Conclusion: The Mediterranean diet was the most related to (higher) environmental sustainability and (lower) BMI. However, in children (not adolescents), the WISH, DQI, and SEAD showed then same associations.

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http://dx.doi.org/10.1016/j.scitotenv.2024.174051DOI Listing

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