Adherence to the EAT-Lancet diet and its association with micronutrient intake in the urban population of eight Latin American countries

The EAT-Lancet Commission proposed a dietary framework aimed at reducing the ecolog- ical footprint of diets worldwide, but research on adherence to this diet in Latin America is limited. This study aimed to describe the adherence of urban diets in 8 Latin American countries to the EAT-Lancet diet and its association with micronutrient intake inadequacy. This cross-sectional study analyzed baseline data from the Latin American Study of Nutri- tion and Health, involving 6835 participants from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Data collection included two 24-hour recalls, alongside socio-demographic variables. Usual dietary intake was estimated via the Multiple Source Method and micronutrient inadequacy was evaluated with the Nutrient Adequacy Ratio. The Planetary Health Diet Index (PHDI; ranged between 0 and 150) assessed adherence to the EAT-Lancet diet. Adherence was low (29.7%) across the region, with an average PHDI score of 44.6 ± 9.2 points. Costa Rica had the highest adherence (32.9%), while Argentina had the lowest (25.8%). Older participants, those with overweight/obesity, and with higher socioeconomic status, education, and physical activity had higher adherence. Higher adher- ence was associated with increased inadequacy risks for cobalamin, vitamin D, and calcium, but decreased risks for pyridoxine, folate, vitamin C, magnesium, and zinc. The study sug- gests that low adherence may stem from a disconnect between culturally ingrained dietary habits and the EAT-Lancet recommendations, which are primarily informed by nutritional epidemiology and environmental considerations. Recognizing and honoring diverse food cultures is crucial for promoting dietary practices that support human health and environ- mental sustainability.