The cross-sectional association between a sustainable diet index and obesity among US adults.

Abstract

Adopting multidimensional sustainable dietary patterns may be beneficial to human and planetary health. The cross-sectional association between a multidimensional sustainable diet index-US (SDI-US) and obesity in US adults was examined. This study used National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2018 (n = 25,262). The SDI-US consisted of four subindices and was calculated using a 24-hour dietary recall, food expenditures, environmental impacts of foods, and food practices. A higher score indicates a more sustainable dietary pattern. Obesity was defined as BMI ≥ 30 kg/m² . Logistic regression models were used to estimate odds ratios (OR) with 95% CI. Between 2007 and 2018, obesity prevalence in US adults was 38.2% (95% CI 37.0%-39.3%), and mean SDI-US score was 13.2 (range: 4.3-20.0). In a multivariable-adjusted model, a higher SDI-US score was associated with lower odds of obesity (Q5 vs. Q1, OR 0.68, 95% CI 0.58-0.79, p < 0.001). When stratified by sex (p interaction = 0.04), a stronger inverse association was observed in women (OR 0.64, 95% CI 0.53-0.77, p < 0.0001) than in men (OR 0.74, 95% CI 0.60-0.91, p = 0.01). More sustainable dietary patterns were inversely associated with obesity among US adults, supporting the potential of sustainable diets in preventing obesity.