Association between an index based on planetary health diet and cardiovascular risk outcomes: analysis of epidemiological studies

Abstract

Introduction: A sustainable diet is defined as the combination of a food system that promotes health for the population, reducing the environmental impacts caused by food production and respecting the limits of the planet. Recently, the Planetary Health Diet (PHD) was proposed as a model of diet that follows these characteristics. PHD was thought of as a way to improve human health, prevent chronic non-communicable diseases, decrease mortality rates from these diseases and reduce the environmental impacts caused by food production. Dietary indices are proposed to assess the population's adherence to diet models or specific dietary recommendations. Thus, the purpose of this study is to evaluate the association between a PHD-based index with cardiovascular risk markers in adolescents in Europe and in adults in Brazil, both from multicenter studies. Methods: Data from adults and elderly participants in the Longitudinal Study on Adult Health (ELSA-Brasil) and adolescents participating in Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) will be used. ELSA-Brasil is a cohort study conducted in six cities in Brazil with 15.105 participants. HELENA is a cross-sectional study carried out in ten cities in Europe with 3.358 adolescents. The PHD-based index, previously validated in the ELSA-Brasil population, will be validated in HELENA adolescents using concentration biomarkers. After validation, analyzes of the association between the index (exposure variable) and cardiovascular risk markers (outcome variables) will be performed. The cardiovascular risk markers will be the lipid profile, blood pressure, HOMA index and Ideal Cardiovascular Health, that were collected in both studies. Multiple regression models will be used to validate the index and test the associations between exposure and outcomes. All analyzes will be performed using STATA software version 14.0 and p <0.05 will be considered statistically significant. (AU)