EAT-Lancet Reference Diet and Nutritional Adequacy in Children: Examining the Planetary Health Diet Index for Children (PHDI-C)

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Concerns exist regarding its ability to fulfill children’s specific micronutrient requirements. The PHDI-C, an adapted version of the Planetary Health Diet Index (PHDI), was developed to better reflect the nutritional needs of growing children. However, its association with micronutrient adequacy in pediatric populations has not been fully examined. Our study investigates whether the PHDI-C is associated with micronutrient adequacy in children and compares its performance to the original PHDI. Methods: This cross-sectional study compared the association of the PHDI and PHDI-C with nutritional adequacy in children aged 4–5 years from the SENDO cohort. Dietary, lifestyle, and socio-demographic data were collected via parent-administered questionnaires. Scores for both indices were calculated, and participants were categorized into tertiles. Micronutrient adequacy was assessed using the Estimated Average Requirement (EAR) cut-off points, and multivariate analyses examined the relationship between both indices and the risk of inadequate micronutrient intake. Results: After adjusting for potential confounders, higher PHDI-C scores were associated with fewer unmet EARs (p < 0.001). Children in the highest tertile had significantly lower odds (0.37-fold; 95% CI: 0.20–0.69; p = 0.002) of having ≥ 3 inadequate micronutrient intakes compared to the lowest tertile. For the original PHDI, the odds reduction was 0.58-fold (95% CI: 0.31–1.07; p = 0.071). Conclusion: The PHDI-C is linked to better nutritional adequacy than the original PHDI. Further research is needed to validate the PHDI-C in terms of environmental sustainability. EAT-Lancet diet Planetary Health Diet Index Micronutrient adequacy PHDI-C SENDO Cohort Figures Figure 1 Figure 2 Introduction The human diet has undergone significant transformations in recent decades due to technological advancements, globalization, and shifts in agricultural practices. However, the current food system threatens human and planetary health, contributing to poor dietary habits and environmental depletion [ 1 , 2 ]. In response, the EAT-Lancet Commission introduced the “Planetary Health Diet” in 2019—a reference diet designed to improve health while promoting environmental sustainability. Its innovation and strength lie in the development of scientific targets, grounded on the best available evidence, relating to dietary patterns, health outcomes, and ecological sustainability [ 3 ]. The reference diet is intended for individuals aged two years and older and emphasizes a large proportion of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils. It includes a low to moderate amount of seafood, eggs, and poultry while minimizing red meat, processed meat, added sugars, refined grains, and starchy vegetables [ 3 ]. Indices have been developed to measure adherence to the EAT-Lancet diet [ 4 , 5 ] and its effects on health [ 5 – 11 ]. However, when it comes to nutrient adequacy, a key aspect of diet quality, evidence remains scarce [ 12 , 13 ]. Concerns exist regarding the diet’s low intake of animal-source foods and the bioavailability of certain plant-based nutrients, which may make it difficult to meet micronutrient needs, especially in those subgroups of the population with different dietary requirements [ 14 – 17 ]. Notably, in young children, no study has directly assessed the relationship between the EAT-Lancet diet and micronutrient adequacy. Building on this context, Venegas et al. adapted the Planetary Health Diet Index (PHDI) developed by Cacau et al.[ 18 ], creating the Planetary Health Diet Index for Children and Adolescents (PHDI-C) [ 19 ], to better reflect children’s nutritional needs. Both indices use energy-adjusted cut-off values, allowing to account for age-specific energy and nutrient requirements. Additionally, these indices apply continuous scoring scales rather than dichotomous categorizations, thus enhancing their discriminant abilities [ 20 ]. Modifications in the PHDI-C include a) changes to food group thresholds to better accommodate children’s nutritional needs (mainly dairy products, eggs and white meats); b) inclusion of refined cereals and a whole cereals-to-total cereals ratio to balance micronutrient bioavailability and account for phytate levels; and c) the separation of palm oil from other vegetable oils to better align with EAT-Lancet dietary recommendations. This study evaluates the validity of PHDI-C in measuring nutritional adequacy and to compares its performance with the original PHDI in young children. Material and Methods Study Population The SENDO Project is a dynamic, prospective cohort study of Spanish children, initiated 2015 ( https://www.proyectosendo.es/ ). Its main objective is to evaluate the impact of lifestyle and diet on their health. Participants are recruited through their pediatrician or via the SENDO team at schools. Eligibility criteria include being 4 or 5 years old and residing in Spain. The only exclusion criterion is the inability to access an internet-connected device required to complete online questionnaires. Parents complete baseline and annual self-reported questionnaires. The baseline questionnaire collects data on medical history, anthropometric measures, diet, lifestyle, and sociodemographic variables. This cross-sectional study used baseline data from 1328 children recruited between January 2015 and June 2024. We excluded 165 and 125 participants with extreme energy ( P99) or micronutrient intakes ( ≥ + 3 or ≤-3 standard deviations (SD)), respectively, and 93 additional children due to incomplete baseline questionnaires. The final sample comprised 945 participants. Ethical approval The SENDO project complies with the ethical principles of the Declaration of Helsinki for medical research involving human subjects. The study received approval from the Ethics Committee for Clinical Research of Navarra (P. 2016/122). Informed consent was obtained from all participants’ parents during recruitment. Dietary Assessment Information on usual dietary intake was gathered using a validated 147-item semi-quantitative food-frequency questionnaire (FFQ) [21], completed by the participants’ parents. EAT-Lancet Scores: PHDI and PHDI-C We calculated adherence to the EAT-Lancet diet using the PHDI, based on the article by Cacau et al., and the PHDI-C, as proposed by Venegas et al. The scoring criteria for both indices are shown in Table 1 and have been described in previous studies [18,19]. For the PHDI, the score is categorized into 16 items, grouped into 4 main components: adequacy, optimum, ratio, and moderation. The adequacy component includes foods recommended in high quantities, with no negative scoring associated with higher consumption. The optimum component consists of foods with specific intake ranges, where exceeding the thresholds results in diminishing positive scoring. The ratio component accounts for the variety of vegetable intake. The moderation component includes foods that should be limited or avoided entirely, where no consumption receives maximum score. The total score ranges from 0 to 150 points. Key modifications made to the PHDI in developing the PHDI-C include: a higher threshold for dairy intake to ensure sufficient Calcium (Ca) and vitamin D intake; grouping eggs, poultry, and fish together to better reflect children's protein needs; adjusting whole cereal intake to balance nutrient bioavailability and fiber intake; whole grains were replaced by "Grains" in the adequacy component, but a whole cereals-to-total cereals ratio (75%) was introduced to account for whole grain consumption ; separating palm oil from other unsaturated vegetable oils to better reflect its health impacts. For the main analysis, we divided participants into tertiles based on their PHDI and PHDI-C scores. Dietary intake was evaluated across 15 food categories, including vegetables, fruits, legumes, grains, potatoes, nuts, dairy products, eggs, fish and seafood, meat, fast-food, pastries and sweets, sugar-sweetened beverages, olive oil, and other vegetable oils. Covariates Parents provided sociodemographic information about the participants. Physical activity data was collected through a questionnaire covering 14 types of activities. Participants reported the average time spent on each activity over the previous year. Screen time was measured by calculating the average daily hours spent using screens, with separate assessments for weekdays and weekends. Parental attitudes and knowledge of nutritional recommendations were evaluated [22,23]. Outcome assessment The intake of 20 micronutrients was evaluated, including vitamins A, C, D, E, B1, B2, B3, B6, B12, folic acid, Ca, iodine (I), iron (Fe), phosphorus (P), magnesium (Mg), selenium (Se), zinc (Zn), chromium (Cr), potassium (K), and sodium (Na). A team of dietitians determined the nutrient content of each food item by calculating the product of intake frequency, the edible portion, and the nutrient composition of the specified portion size. To estimate total intakes, we utilized data from updated Spanish food composition tables [24] and online databases [25,26], summing the contributions of all food items recorded in the FFQ. Micronutrient intake was classified as inadequate if it fell below the estimated average requirement (EAR) or, if the EAR was unavailable, below the adequate intake (AI), as defined by the Institute of Medicine [27]. Statistical Analysis Participants were grouped into tertiles based on PHDI and PHDI-C scores, with the highest tertile representing the highest adherence. For descriptive purposes, categorical variables were summarized as numbers and percentages, while continuous variables were presented as means and standard deviations (SD). Linear trend tests across tertiles were conducted by assigning the median value of each tertile and treating this as a continuous variable in regression models. We also assessed the energy-adjusted intake of micronutrients in each tertile and the energy-adjusted increase in micronutrient intake for every 10-point increase in both scores. Energy-adjusted intakes of micronutrients were obtained through regression models. To evaluate the relationship between both scores and the risk of ≥3 inadequate intakes, we used the EAR cut-point method and fitted generalized estimating equations to account for intra-cluster correlation among siblings. Multivariate models were progressively adjusted for: 1) sex, age (continuous), and total energy intake (continuous); 2) breastfeeding duration (none, 12 months), parental knowledge of nutritional recommendations for children (low, medium and high) and parental attitudes towards child’s dietary habits (unhealthy, average and healthy); 3) physical activity (continuous) and screen time (continuous). The first tertile was always used as the category of reference. The analysis consisted of calculating: 1) the difference and 95% Confidence Interval (CI) in the number of inadequate intakes of micronutrients across values of the PHDI and PHDI-C and 2) the Odds ratios (ORs) and 95% CIs for the inadequate intake of ≥3 micronutrients. Multivariable-adjusted proportions of children with ≥3 inadequate micronutrient intakes were also estimated for each tertile of both scores. All statistical analyses were performed using Stata version 15.0 (Stata Corp., College Station, TX, USA). Two-tailed p-values were used, with statistical significance set at p<0.05. Results This study included 945 participants (49.1% girls) with an average age of 4.98 (SD: 0.83). Overall adherence to the EAT-Lancet diet was moderate, as measured by the PHDI, with a median score of 64 (IQR: 58.90-70.10) on a potential range of 0 to 150. Higher PHDI scores were observed in children who had longer breastfeed periods, were more physically active, spent less time in front of screens and who have parents with healthier attitudes towards their child’s dietary habits and greater knowledge of nutritional recommendations for their children (Table 2). Regarding dietary composition (Table 3), higher PHDI scores were associated with higher total energy intake (TEI). Both scores were associated with a higher proportion of carbohydrates, a lower proportion of protein, and to healthier fat profiles. As adherence increased, cholesterol and saturated fat intake decreased, while monounsaturated and polyunsaturated fat intake increased, with greater intakes of linoleic acid, arachidonic acid, linolenic acid, EPA and DHA. Regarding food groups, children with higher scores in both indices consumed more vegetables, fruits, legumes, cereal grains, potatoes, and nuts, and fewer dairy products, pastries and sweets, sugar-sweetened beverages, and meat. Children with higher PHDI-C scores also consumed more eggs. We calculated the energy-adjusted mean intake for each micronutrient by tertiles (Table 4) and the energy-adjusted increase in micronutrient intake for each 10-point increase of each score (Table S2). Participants with higher PHDI and PHDI-C scores had higher intakes of vitamins A, C, E, B1, B3, and B6, as well as folic acid, Fe, Mg, Zn, Cr, and K. However, higher adherence to the EAT-Lancet diet was associated with lower intakes of vitamins B2 and B12, Ca, and I. Regarding Se, improved intake was only observed with higher PHDI-C scores. We calculated the prevalence of inadequacy for each micronutrient according to tertiles (Table S1). Participants in the highest tertile of both scores had a lower prevalence of inadequacy of vitamins A and E, folic acid, and K. However, they had a higher prevalence of inadequate intakes of I and Ca (only in PHDI-C). The splines in Figure 1 illustrate the relationship between both scores and the number of micronutrients with inadequate intake (solid line) with 95% CI (dashed line). After adjusting for potential confounders, we observed that the number of inadequate micronutrient intakes decreased as the PHDI-C score improved, displaying an inverse linear association ( p < 0.001). However, this pattern was not observed for the PHDI, where the initial reduction in the number of inadequate intakes plateaued at scores above 70. Table 5 presents the OR and 95% CI for unmet EARs for ≥3 micronutrients across PHDI and PHDI-C tertiles. We found a significant linear trend in the odds of having ≥3 micronutrient inadequacies across tertiles of both scores. In the fully adjusted model, children in T3 of PHDI had 0.58-fold lower odds (95%CI 0.31–1.07) of having ≥3 micronutrient inadequacies, and the linear trend was only marginally significant (p=0.071) . Regarding the PHDI-C, children in T3 of the fully adjusted model had 0.31-fold lower odds (95%CI 0.16–0.59) of having ≥3 inadequate micronutrient intakes ( p for trend < 0.001). We also calculated the marginal effect of both scores on the risk of having an inadequate intake of ≥3 micronutrients, this is, the multivariate-adjusted proportion of children with inadequate intake of ≥3 micronutrient in each tertile of both indices (Figure 2). The adjusted proportions of children with ≥3 micronutrient inadequacies of the PHDI-C were 18.4% (95% CI: 14.8–22.0%), 12.9% (95% CI; 9.8–15.9%), 10.8% (95% CI: 7.9–13.6%), in T1, T2 and T3 respectively. Regarding the PHDI, the adjusted proportions were 16.3% (95% CI: 13.2–19.5), 12.8% (95% CI; 9.8–15-7%), 12.1% (95% CI: 8.7–15.5%), in T1, T2 and T3 respectively. These results suggest that better adherence to the PHDI-C shows a stronger association with improved nutrient adequacy than adherence to the PHDI. Discussion The present cross-sectional study explored whether the PHDI-C, an adaptation of the PHDI for children and adolescents, is associated with nutrient adequacy and compared its performance with the original version of the PHDI. The PHDI-C introduces changes to the PHDI, modifying certain intake values of the different food groups, therefore indirectly testing whether slight adjustments to the EAT-Lancet recommendations in children might better accommodate growing children’s nutritional needs. To the best of our knowledge, this is the first study assessing micronutrient adequacy of the EAT-Lancet diet in young children in a real-world setting. Moreover, no previous study has directly compared the PHDI-C with the PHDI in terms of nutrient adequacy, to assess if the proposed changes are in fact a better fit for children’s dietary needs. Our results indicate that higher PHDI-C scores were associated with fewer unmet EARs than the original PHDI score and that both indices were positively associated with higher intakes of nutrients predominantly derived from plant-source foods, some of which are considered nutrients of public health concern, such as fiber, K, Fe [28]. This is consistent with previous studies in adult population [13,29]. Conversely, both indices were negatively associated with nutrients primarily obtained from animal- source foods, including vitamins B2 and B12, Ca, and I, which are commonly lacking in diets worldwide [16,30]. These results align with those obtained in the original validation study of the PHDI conducted in adults [18]. In terms of inadequate intakes, higher scores in both indices were associated with fewer inadequacies of vitamins E, K and A (measured as retinol equivalents). However, higher scores were associated with higher inadequacy of I in both indices, and of Ca in the PHDI-C. Notably, a study conducted in Norway that assessed the environmental and nutritional consequences of shifting 2-year-old children's diets towards a theoretical EAT-Lancet scenario diet found that this transition improved micronutrient adequacy, except for Se, Ca and I [31] . Similarly, a study by Lassen et al. using Danish food composition data showed that the EAT-Lancet diet would be deficient in vitamins A and D, Ca, I and Se for the population aged 6–65 years [32]. Contrasting with these previous studies, research conducted in European adolescents found that Ca and I intake increased with higher PHDI scores [12]. It is likely that the higher thresholds for animal-based food intake, such as dairy, eggs, and white meats, are responsible for the observed improved association between nutrient adequacy and the PHDI-C. Several children in our cohort had I inadequacy, and animal-source products—such as eggs, dairy and fish—are good sources of it [33,34]. Conversely, regarding Ca, it is unexpected that the PHDI-C, which raises the threshold for dairy consumption, does not correlate with improved its adequacy, despite dairy products being a good dietary source of Ca. This discrepancy may be due to changes in the scoring of whole grains versus refined grains, as the latter contain less Ca [35]. Strengths and limitations We acknowledge that our study has both strengths and limitations. To the best of our knowledge, this is the first study to analyze the relationship between adherence to the EAT-Lancet diet and nutrient adequacy in young children, using two novel dietary indices. It provides initial insights into the performance of the PHDI-C, which introduces modifications to the EAT-Lancet diet to better accommodate the nutritional needs of children, addressing the limitations pointed out in previous studies [14,19,36]. Another strength is the use of Generalized Estimating Equation models, which account for the potential correlation between siblings—a common challenge in pediatric studies. Despite these contributions, some limitations exist. First, our study population showed moderate adherence to the EAT-Lancet diet, aligning with findings from other studies [12,19,36]. Even among participants with the highest adherence, animal-derived product consumption remained well above the dietary targets set by the EAT-Lancet diet [3], though lower than levels reported in population-based studies in Spain [37]. Thus, our study may not fully capture the impact of strict adherence to the EAT-Lancet dietary pattern. It is possible that higher adherence could enhance nutrient adequacy, while severely restricted intakes of animal-source foods could also exacerbate potential nutrient shortfalls. Future research in populations with higher adherence to the EAT-Lancet diet could provide further insights into this balance. Second, another limitation relates to self-reported dietary data, which may introduce measurement errors. FFQs tend to overestimate food intake, potentially leading to an underestimation of micronutrient inadequacies. However, the FFQ used in this study has been previously validated [21], and we excluded participants with extreme energy and micronutrient intakes to minimize bias. Moreover, the high level of parental education of our participants likely improves the validity of self-reported dietary data and reduces potential confounding factors related to socioeconomic disparities. Third, we assessed the probability of micronutrient adequacy rather than actual micronutrient deficiencies, which would require biomarker analysis for a more precise evaluation. Fourth, absolute intakes of micronutrients may have been underestimated because we did not consider the intake of fortified foods or supplements. Finally, as this is an observational study, we cannot completely rule out residual confounding from unmeasured factors. However, the comprehensive questionnaire used allowed us to adjust for multiple potential confounders, strengthening the reliability of our findings. Conclusion This study provides novel insights into the relationship between adherence to the EAT-Lancet diet and micronutrient adequacy in young children, comparing the performance of the PHDI and its child-adapted version, the PHDI-C. Our findings suggest that higher adherence is associated with improved micronutrient adequacy, with a slightly stronger association with nutritional adequacy for the PHDI-C as compared to the original PHDI. Future research should further investigate the impact of the EAT-Lancet diet in populations with high adherence and assess the PHDI-C's validity in measuring the environmental sustainability of diets in children and adolescents in relation to the EAT-Lancet targets. Abbreviations AI, Adequate Intake BMI, Body Mass Index CI, Confidence Interval DHA, Docosahexaenoic Acid EAR, Estimated Average Requirement EPA, Eicosapentaenoic Acid FFQ, Food-Frequency Questionnaire PHDI, Planetary Healthy Diet Index PHDI-C, Planetary Healthy Diet Index adapted to children and adolescents OR, Odds Ratio SD, Standard Deviation SENDO, Seguimiento del Niño para un Desarrollo Óptimo T1, tertile 1 T2, tertile 2 T3, tertile 3 TEI, Total Energy Intake Ca, Calcium I, Iodine, Fe, Iron P, Phosphorous M, Magnesium Se, Selenium Zn, Zinc Cr, Chromium K, Potassium Na, Sodium Declarations Funding: The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. Competing interests: The authors have no relevant financial or non-financial interests to disclose . Authors' contributions NMC, MAMG, IZ, EF: Conceptualization, Methodology and Software. EF: Data curation, writing of the original draft. NMC, IZ: Supervision. All authors critically reviewed the manuscript. Ethics approval and consent to participate The SENDO project adheres to the rules of the Declaration of Helsinki on the ethical principles for medical research in human beings. This study was approved by the Ethics Committee for Clinical Research of Navarra (P. 2016/122). An informed consent was obtained during the recruitment from all participants’ parents. Consent to participate Written informed consent was obtained from the parents. Availability of data and material: The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. References Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. The Lancet. 2019;393:791–846. Food and Agricultural Organisation of the United Nations (FAO). Sustainable Healthy Diets—Guiding Principles. 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Environmental and nutritional assessment of young children’s diets in Norway: comparing the current diet with national dietary guidelines and the EAT-Lancet reference diet. Eur J Nutr. 2023;62:3383–96. Lassen AD, Christensen LM, Trolle E. Development of a Danish Adapted Healthy Plant-Based Diet Based on the EAT-Lancet Reference Diet. Nutrients. 2020;12:738. Myers M, Ruxton CHS. Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen’s Eggs. Nutrients. 2023;15:2657. National Institutes of Health Office of Dietary Supplements. Iodine. Fact Sheet for Health Professionals. 2023. European Comission. Nutritional value of whole grains. 2021. Venegas Hargous C, Orellana L, Corvalan C, Strugnell C, Allender S, Bell C. Chilean children’s adherence to sustainable healthy diets and its associations with sociodemographic and anthropometric factors: a cross-sectional study. Eur J Nutr. 2024;63:2459–75. Agencia Española de Consumo SA y N. Estudio ENALIA 2012-2014: Encuesta Nacional de consumo de Alimentos en población Infantil y Adolescente. Madrid; 2017. Tables Table 1 is available in the Supplementary Files section. Table 2. Characteristics of participants and their families in the SENDO project by tertiles of the PHDI. Numbers are mean (sd) or N (%) T1 T2 T3 p for trend Range of PHDI score 29.27-60.86 60.87-68.26 68.27-100.78 n 315 315 315 Sex (female), % 141 (44.8) 165 (52.4) 158 (50.2) 0.181 Age (years) 4.99 (0.86) 5.04 (0.86) 4.90 (0.75) 0.171 Race (white), % 299 (94.9) 300 (95.2) 303 (96.2) 0.443 Birthweight (g) 3267 (602.5) 3188 (515.4) 3260 (482.9) 0.922 Z-score of the BMI 0.04 (1.19) 0.05 (1.12) 0.01 (1.14) 0.655 Moderate-vigorous physical activity (h/day) 1.08 (0.78) 1.04 (0.74) 1.27 (0.81) 0.002 Screen time (h/day) 1.22 (0.91) 1.05 (0.83) 1.02 (1.06) 0.007 Gestational age (weeks), % 0.989 40 147 (47.1) 141 (44.8) 144 (46.0) Birthweight (g), % 0.541 4000 26 (8.3) 12 (3.8) 13 (4.2) Breastfeeding duration (months), % <0.001 No breastfeeding 66 (21.0) 48 (15.2) 36 (11.4) 12 81 (26.0) 83 (26.3) 144 (45.7) Weight Status (%) 0.368 Low weight 48 (15.2) 51 (16.2) 50 (15.9) Normal weight 222 (70.5) 229 (72.7) 230 (73.0) Overweight/obesity 45 (14.3) 35 (11.1) 35 (11.1) Maternal age (years) 39.79 (4.66) 40.21 (4.03) 39.76 (4.05) 0.918 Parents higher education % Both 156 (49.5) 181 (57.5) 177 (56.2) 0.093 At least one 259 (82.2) 270 (85.7) 279 (88.6) 0.024 Parental healthy attitudes towards child’s dietary habits, % <0.001 Low (70%) 161 (51.1) 199 (63.2) 239 (75.9) Parental knowledge about the child’s nutritional recommendations, % 0.001 Low (70%) 28 (8.9) 45 (14.3) 55 (17.5) Number of children, % 0.153 1 48 (15.2) 40 (12.7) 48 (15.2) 2 168 (53.3) 157 (49.8) 186 (59.0) 3-4 84 (26.7) 96 (30.5) 74 (23.5) 5 or more 15 (4.8) 22 (7.0) 7 (2.2) Child’s position among siblings, % 0.615 The oldest/singletons 107 (34.0) 121 (38.4) 116 (36.8) 2 nd /3, 2 nd or 3 rd /4 42 (13.3) 54 (17.1) 36 (11.4) The youngest or beyond the 4 th 166 (52.7) 140 (44.4) 163 (51.7) Table 3. Dietary composition according to tertiles of PHDI and PHDI-C. Mean (sd) PHDI PHDI-C T1 T3 T1 T3 n 315 315 315 315 Macronutrients TEI (kcal) 1958 (499.7) 2038 (433.1)* 2039 (495.4) 2002 (441.4) Carbohydrate intake (% of TEI) 42.91 (5.48) 44.24 (5.30)* 42.53 (5.53) 44.62 (5.16)* Protein intake (% of TEI) 17.61 (2.19) 16.46 (1.95)* 17.30 (2.51) 16.87 (1.94)* Fat intake (% of TEI) 39.48 (5.75) 39.30 (5.06) 40.17 (5.74) 38.51 (5.01)* Cholesterol, mg/d 289.29 (86.44) 253.44 (63.65)* 285.77 (85.31) 259.16 (66.44)* SFA intake (% of TEI) 11.66 (2.26) 10.39 (2.03)* 11.82 (2.33) 10.25 (2.00)* MUFA intake (% of TEI) 14.75 (3.87) 15.90 (3.17)* 15.08 (4.00) 15.42 (3.12) PUFA intake (% of TEI) 4.54 (1.22) 4.89 (1.16)* 4.45 (1.17) 4.82 (1.11)* Linoleic cid (18:2n-6), g/d 8.19 (3.20) 9.14 (3.17)* 8.28 (3.00) 8.83 (2.98)* Arachidonic acid (20:4n-6), g/d 0.11 (0.03) 0.10 (0.03)* 0.12 (0.04) 0.10 (0.03)* Linolenic acid (18:3n-3), g/d 0.63 (0.19) 0.77 (0.25)* 0.64 (0.19) 0.75 (0.24)* EPA (20:5n-3), mg/d 85.11 (48.95) 93.54 (43.06)* 88.40 (48.29) 91.34 (46.89) DHA (22:6n-3), mg/d 155.5 (114.3) 179.8 (98.49)* 161.4 (114.2) 176.50 (108.1) Fibre intake (g/d) 17.67 (5.26) 25.14 (6.67)* 18.03 (5.22) 24.62 (6.78)* Food groups Vegetables 168.6 (108.6) 282.2 (121.7)* 174.9 (109.5) 283.0 (124.5)* Fruits 313.7 (197.3) 499.4 (252.5)* 323.9 (202.6) 455.3 (232.6)* Legumes 26.78 (15.25) 39.05 (23.31)* 27.12 (13.74) 39.66 (22.28)* Cereal grains 80.64 (36.63) 103.2 (56.21)* 77.01 (42.26) 106.2 (52.97)* Potatoes 23.67 (21.20) 34.82 (22.31)* 25.36 (25.50) 33.41 (19.46)* Nuts 1.05 (1.00) 2.14 (1.42)* 1.14 (0.96) 2.12 (1.41)* Dairy products 543.4 (251.0) 384.9 (221.5)* 608.3 (274.5) 398.0 (184.6)* Eggs 20.21 (13.00) 20.24 (7.92) 18.73 (12.81) 21.45 (7.79)* Fish and Seafood 32.93 (17.82) 36.38 (15.34)* 33.78 (17.3) 35.53 (15.79) Meat 138.5 (44.37) 120.0 (45.41)* 134.7 (43.58) 120.56 (43.78)* Fastfood 59.10 (31.37) 58.51 (29.27) 58.54 (27.71) 56.13 (28.02) Pastries and sweets 87.11 (63.23) 65.64 (44.80)* 95.39 (70.21) 62.47 (39.79)* Sugar-sweetened beverages 44.89 (74.80) 31.25 (51.89)* 54.41 (92.00) 30.58 (43.48)* Olive oil 15.99 (14.13) 20.87 (12.07)* 18.26 (15.86) 19.31 (10.81) Other vegetable oils 2.73 (4.03) 2.48 (3.48) 2.49 (3.77) 2.56 (3.89) TEI: Total Energy Intake; SFA, saturated fatty acids; MUFA, monounsaturated fatty acids; PUFA, polyunsaturated fatty acids; T1, tertile 1; T3, tertile 3 *p for trend < 0.05 Table 4. Energy-adjusted intake of micronutrients by tertiles of PHDI and PHDI-C. Mean (sd) EAR for children 4-8 years old PHDI PHDI-C T1 T3 T1 T3 n 315 315 315 315 Micronutrients Vitamin A (equiv Retinol) (µg/d) 275 982.4 (24.81) 1159.1 (24.74)* 952.21 (24.51) 1181.60 (24.51)* Vitamin C (mg/d) 22 113.4 (3.23) 176.9 (3.22)* 114.16 (3.31) 169.05 (3.31)* Vitamin D (µg/d) 10 2.99 (0.10) 3.17 (0.10) 2.98 (0.10) 3.24 (0.10) Vitamin E (mg/d) 6 7.55 (0.15) 9.49 (0.15)* 7.69 (0.15) 9.19 (0.15)* Vitamin B1 (mg/d) 0.5 1.36 (0.01) 1.50 (0.01)* 1.34 (0.01) 1.52 (0.01)* Vitamin B2 (mg/d) 0.5 2.05 (0.03) 1.98 (0.03) 2.08 (0.03) 2.00 (0.03)* Vitamina B3 (mg/d) 6.0 34.78 (0.43) 36.49 (0.43)* 33.94 (0.42) 36.94 (0.42)* Vitamin B6 (mg/d) 0.5 2.16 (0.02) 2.49 (0.02)* 2.11 (0.02) 2.50 (0.02)* Folic Acid (µg/d) 160 270.4 (4.08) 335.3 (4.07)* 267.84 (4.03) 336.9 (4.03)* Vitamin B12 (µg/d) 1.0 4.80 (0.07) 4.41 (0.07)* 4.66 (0.07) 4.51 (0.07)* Ca (mg/d) 800 1198 (13.72) 1096 (13.69)* 1236 (13.57) 1118 (13.57)* I (µg/d) 65 112.5 (1.24) 102.8 (1.24)* 113.9 (1.24) 105.0 (1.24)* Fe (mg/d) 4.1 12.99 (0.11) 15.00 (0.11)* 12.70 (0.11) 15.05 (0.11)* P (mg/d) 405 1661 (35.92) 1739 (35.82)* 1706 (35.81) 1781 (35.81) Mg (mg/d) 110 282.0 (2.42) 322.7 (2.42)* 281.0 (2.41) 322.6 (2.41)* Se (µg/d) 23 71.24 (0.73) 70.92 (0.73) 68.55 (0.72) 73.20 (0.72)* Zn (mg/d) 4 9.38 (0.11) 9.79 (0.11)* 9.32 (0.11) 9.72 (0.11) Cr (µg/d) 15 (AI) 62.47 (1.11) 69.21 (1.11)* 64.21 (1.11) 69.16 (1.11)* K (mg/d) 2300 (AI) 3199 (33.59) 3664 (33.50)* 3208 (33.76) 3639 (33.75)* Na (mg/d) 1000 (AI) 2925 (48.05) 2919 (47.92) 2904 (47.91) 2882 (47.90) EAR, Estimated Average Requirement; AI, Adequate Intake, *p for trend < 0.05 Table 5. OR and 95%CI for inadequate intake of 3 or more micronutrients associated with tertiles of PHDI and PHDI-C. Mean (sd) OR (95% CI) PHDI T1 T2 T3 pft % of participants with ≥3 inadequate intakes of micronutrients 21.90 10.16 9.84 Crude 1.00 (ref) 0.41 (0.26-0.63) 0.39 (0.25-0.62) <0.001 Multivariate adjusted model 1 1.00 (ref) 0.59 (0.35-1.00) 0.49 (0.27-0.89) 0.016 Multivariate adjusted model 2 1.00 (ref) 0.62 (0.36-1.07) 0.55 (0.29-1.03) 0.050 Multivariate adjusted model 3 1.00 (ref) 0.63 (0.36-1.10) 0.58 (0.31-1.07) 0.071 PHDI-C T1 T2 T3 pft % of participants with ≥3 inadequate intakes of micronutrients 19.68 12.38 9.84 <0.001 Crude 1.00 (ref) 0.58 (0.38-0.89) 0.45 (0.28-0.71) <0.001 Multivariate adjusted model 1 1.00 (ref) 0.47 (0.27-0.81) 0.34 (0.19-0.59) <0.001 Multivariate adjusted model 2 1.00 (ref) 0.48 (0.27-0.85) 0.36 (0.19-0.67) 0.001 Multivariate adjusted model 3 1.00 (ref) 0.50 (0.28-0.88) 0.37 (0.20-0.69) 0.002 Model 1: adjusted for sex (male vs. female), age (continuous), and energy intake (continuous); Model 2: additionally adjusted for breastfeeding duration (none, 12 months), parental knowledge about the child’s nutritional recommendations (low, medium, and high score) for children, and parental attitudes towards child’s dietary habits (low, medium, and high score); Model 3: additionally adjusted for moderate–vigorous physical activity (continuous) and screen time (continuous). Additional Declarations No competing interests reported. Supplementary Files Table1.docx SUPPLEMENTARYMATERIAL.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6270397","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":444510319,"identity":"a7ec5b1a-cf32-4dc6-9f59-066633cf4cc7","order_by":0,"name":"Elise Fabios","email":"","orcid":"","institution":"University of Navarra","correspondingAuthor":false,"prefix":"","firstName":"Elise","middleName":"","lastName":"Fabios","suffix":""},{"id":444510320,"identity":"a8a36f59-0d17-4133-9479-15cd503ca732","order_by":1,"name":"Itziar Zazpe","email":"","orcid":"","institution":"University of Navarra","correspondingAuthor":false,"prefix":"","firstName":"Itziar","middleName":"","lastName":"Zazpe","suffix":""},{"id":444510321,"identity":"0a9142ed-2540-4b8c-94a4-b43dc5b04943","order_by":2,"name":"Susana Santiago","email":"","orcid":"","institution":"University of Navarra","correspondingAuthor":false,"prefix":"","firstName":"Susana","middleName":"","lastName":"Santiago","suffix":""},{"id":444510322,"identity":"ee04dc80-75cb-4b17-a6ba-abce85cb27f8","order_by":3,"name":"Silvia García","email":"","orcid":"","institution":"University of the Balearic Islands-IUNICS","correspondingAuthor":false,"prefix":"","firstName":"Silvia","middleName":"","lastName":"García","suffix":""},{"id":444510323,"identity":"5fd5a2b3-f7f3-4540-aa6d-38f401c5c284","order_by":4,"name":"Miguel Ángel Martínez-González","email":"","orcid":"","institution":"University of Navarra","correspondingAuthor":false,"prefix":"","firstName":"Miguel","middleName":"Ángel","lastName":"Martínez-González","suffix":""},{"id":444510324,"identity":"67944050-5fc0-45aa-85e5-2a3e0984555c","order_by":5,"name":"Nerea Martín-Calvo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3UlEQVRIiWNgGAWjYNACAyBmB+IPROs4ANLCzMDAOIN4LQwQLcw8xKg2Fzv87POHgjvy/M08ho9t2+7IGxxgPozXgZaz04xnHDB4ZjjjMI+xcW7bM8MNB9jSJPBpMbidYAz0y+EEhsNsadK5bYcZZzbwmOF1mMHt9M9gLfIgLZZth+1nNvB/xuswg9s5EFsMDjMfk2ZsO5zYz8DDQMBhOcUMZwwOG248zHzYsOfc4eR+ZjYzAlrSNzNU/DksL3e8sfHBj7LDtm3szY+Jj1IIYCZR/SgYBaNgFIwCTAAAMqFJpER0iSUAAAAASUVORK5CYII=","orcid":"","institution":"University of Navarra","correspondingAuthor":true,"prefix":"","firstName":"Nerea","middleName":"","lastName":"Martín-Calvo","suffix":""}],"badges":[],"createdAt":"2025-03-20 14:08:39","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6270397/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6270397/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":81700287,"identity":"2c31ec82-e824-4b32-b847-09cdc190b354","added_by":"auto","created_at":"2025-04-30 13:04:48","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":374197,"visible":true,"origin":"","legend":"\u003cp\u003eThe splines above show the change (95% CI) in the number of micronutrient inadequacy associated with The PHDI and the PHDI-C. The histograms below show the frequency of participants by PHDI/PHDI-c\u003c/p\u003e\n\u003cp\u003eAdjusted for sex, age, energy intake, breastfeeding duration, parental knowledge about nutritional recommendations for children, parental attitudes towards child’s dietary habits, physical activity and screen time.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-6270397/v1/23feb64454235b615f5dc26e.png"},{"id":81700174,"identity":"9b29e99c-07e8-41cd-b15c-1557ef27e8d3","added_by":"auto","created_at":"2025-04-30 13:04:36","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":174382,"visible":true,"origin":"","legend":"\u003cp\u003eAdjusted proportions of children with ≥ 3 inadequate micronutrient intake (95% CI) in each tertile of the PHDI and PHDI-C Scores.\u003c/p\u003e\n\u003cp\u003eAdjusted for sex, age, energy intake, breastfeeding duration, parental knowledge about nutritional recommendations for children, parental attitudes towards child’s dietary habits, physical activity and screen time.\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-6270397/v1/d51d9536992aef789e7a9956.png"},{"id":82504004,"identity":"7b3d8ac0-cd5c-4832-b020-3b1a33e5a6cf","added_by":"auto","created_at":"2025-05-12 09:17:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1660501,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6270397/v1/acf7859e-7bfc-4bf9-8ed3-02e530280911.pdf"},{"id":81700241,"identity":"acd38af1-c41c-4297-bb83-1c137bcf4d2e","added_by":"auto","created_at":"2025-04-30 13:04:44","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":433476,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.docx","url":"https://assets-eu.researchsquare.com/files/rs-6270397/v1/9a15349c65d6a931dfca5498.docx"},{"id":81699746,"identity":"cfe3c568-d167-4b07-9066-13c6c2e30a10","added_by":"auto","created_at":"2025-04-30 13:03:54","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":114944,"visible":true,"origin":"","legend":"","description":"","filename":"SUPPLEMENTARYMATERIAL.docx","url":"https://assets-eu.researchsquare.com/files/rs-6270397/v1/059580f3cc07c765d98a941d.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"EAT-Lancet Reference Diet and Nutritional Adequacy in Children: Examining the Planetary Health Diet Index for Children (PHDI-C)","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe human diet has undergone significant transformations in recent decades due to technological advancements, globalization, and shifts in agricultural practices. However, the current food system threatens human and planetary health, contributing to poor dietary habits and environmental depletion [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In response, the EAT-Lancet Commission introduced the \u0026ldquo;Planetary Health Diet\u0026rdquo; in 2019\u0026mdash;a reference diet designed to improve health while promoting environmental sustainability. Its innovation and strength lie in the development of scientific targets, grounded on the best available evidence, relating to dietary patterns, health outcomes, and ecological sustainability [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The reference diet is intended for individuals aged two years and older and emphasizes a large proportion of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils. It includes a low to moderate amount of seafood, eggs, and poultry while minimizing red meat, processed meat, added sugars, refined grains, and starchy vegetables [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIndices have been developed to measure adherence to the EAT-Lancet diet [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] and its effects on health [\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9 CR10\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. However, when it comes to nutrient adequacy, a key aspect of diet quality, evidence remains scarce [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Concerns exist regarding the diet\u0026rsquo;s low intake of animal-source foods and the bioavailability of certain plant-based nutrients, which may make it difficult to meet micronutrient needs, especially in those subgroups of the population with different dietary requirements [\u003cspan additionalcitationids=\"CR15 CR16\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Notably, in young children, no study has directly assessed the relationship between the EAT-Lancet diet and micronutrient adequacy.\u003c/p\u003e \u003cp\u003eBuilding on this context, Venegas et al. adapted the Planetary Health Diet Index (PHDI) developed by Cacau et al.[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], creating the Planetary Health Diet Index for Children and Adolescents (PHDI-C) [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], to better reflect children\u0026rsquo;s nutritional needs. Both indices use energy-adjusted cut-off values, allowing to account for age-specific energy and nutrient requirements. Additionally, these indices apply continuous scoring scales rather than dichotomous categorizations, thus enhancing their discriminant abilities [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Modifications in the PHDI-C include a) changes to food group thresholds to better accommodate children\u0026rsquo;s nutritional needs (mainly dairy products, eggs and white meats); b) inclusion of refined cereals and a whole cereals-to-total cereals ratio to balance micronutrient bioavailability and account for phytate levels; and c) the separation of palm oil from other vegetable oils to better align with EAT-Lancet dietary recommendations.\u003c/p\u003e \u003cp\u003eThis study evaluates the validity of PHDI-C in measuring nutritional adequacy and to compares its performance with the original PHDI in young children.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Population\u003c/h2\u003e \u003cp\u003eThe SENDO Project is a dynamic, prospective cohort study of Spanish children, initiated 2015 (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.proyectosendo.es/\u003c/span\u003e\u003cspan address=\"https://www.proyectosendo.es/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e). Its main objective is to evaluate the impact of lifestyle and diet on their health. Participants are recruited through their pediatrician or via the SENDO team at schools. Eligibility criteria include being 4 or 5 years old and residing in Spain. The only exclusion criterion is the inability to access an internet-connected device required to complete online questionnaires. Parents complete baseline and annual self-reported questionnaires. The baseline questionnaire collects data on medical history, anthropometric measures, diet, lifestyle, and sociodemographic variables.\u003c/p\u003e \u003cp\u003eThis cross-sectional study used baseline data from 1328 children recruited between January 2015 and June 2024. We excluded 165 and 125 participants with extreme energy (\u0026lt;\u0026thinsp;P1 or \u0026gt;\u0026thinsp;P99) or micronutrient intakes (\u0026thinsp;\u0026ge;\u0026thinsp;+\u0026thinsp;3 or \u0026le;-3 standard deviations (SD)), respectively, and 93 additional children due to incomplete baseline questionnaires. The final sample comprised 945 participants.\u003c/p\u003e \u003c/div\u003e\u003cp\u003e\u003cem\u003eEthical approval\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe SENDO project complies with the ethical principles of the Declaration of Helsinki for medical research involving human subjects. The study received approval from the Ethics Committee for Clinical Research of Navarra (P. 2016/122). Informed consent was obtained from all participants\u0026rsquo; parents during recruitment.\u003c/p\u003e\n\n\u003cp\u003e\u003cem\u003eDietary Assessment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eInformation on usual dietary intake was gathered using a validated 147-item semi-quantitative food-frequency questionnaire (FFQ) [21], completed by the participants\u0026rsquo; parents.\u003c/p\u003e\n\n\u003cp\u003e\u003cem\u003eEAT-Lancet\u003c/em\u003e\u003cem\u003e Scores: PHDI and PHDI-C\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe calculated adherence to the EAT-Lancet diet using the PHDI, based on the article by Cacau et al., and the PHDI-C, as proposed by Venegas et al. The scoring criteria for both indices are shown in Table 1 and have been described in previous studies [18,19].\u003c/p\u003e\n\n\u003cp\u003eFor the PHDI, the score is categorized into 16 items, grouped into 4 main components: adequacy, optimum, ratio, and moderation. The adequacy component includes foods recommended in high quantities, with no negative scoring associated with higher consumption. The optimum component consists of foods with specific intake ranges, where exceeding the thresholds results in diminishing positive scoring. The ratio component accounts for the variety of vegetable intake. The moderation component includes foods that should be limited or avoided entirely, where no consumption receives maximum score. The total score ranges from 0 to 150 points.\u003c/p\u003e\n\n\u003cp\u003eKey modifications made to the PHDI in developing the PHDI-C include: a higher threshold for dairy intake to ensure sufficient Calcium (Ca) and vitamin D intake; grouping eggs, poultry, and fish together to better reflect children\u0026apos;s protein needs; adjusting whole cereal intake to balance nutrient bioavailability and fiber intake; whole grains were replaced by \u0026quot;Grains\u0026quot; in the adequacy component, but a whole cereals-to-total cereals ratio (75%) was introduced to account for whole grain consumption\u003cstrong\u003e; \u003c/strong\u003eseparating palm oil from other unsaturated vegetable oils to better reflect its health impacts. \u003c/p\u003e\n\n\u003cp\u003eFor the main analysis, we divided participants into tertiles based on their PHDI and PHDI-C scores.\u003c/p\u003e\n\n\u003cp\u003eDietary intake was evaluated across 15 food categories, including vegetables, fruits, legumes, grains, potatoes, nuts, dairy products, eggs, fish and seafood, meat, fast-food, pastries and sweets, sugar-sweetened beverages, olive oil, and other vegetable oils.\u003c/p\u003e\n\n\u003cp\u003e\u003cem\u003eCovariates\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParents provided sociodemographic information about the participants. Physical activity data was collected through a questionnaire covering 14 types of activities. Participants reported the average time spent on each activity over the previous year. Screen time was measured by calculating the average daily hours spent using screens, with separate assessments for weekdays and weekends. Parental attitudes and knowledge of nutritional recommendations were evaluated [22,23].\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOutcome assessment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe intake of 20 micronutrients was evaluated, including vitamins A, C, D, E, B1, B2, B3, B6, B12, folic acid, Ca, iodine (I), iron (Fe), phosphorus (P), magnesium (Mg), selenium (Se), zinc (Zn), chromium (Cr), potassium (K), and sodium (Na). A team of dietitians determined the nutrient content of each food item by calculating the product of intake frequency, the edible portion, and the nutrient composition of the specified portion size. To estimate total intakes, we utilized data from updated Spanish food composition tables [24] and online databases [25,26], summing the contributions of all food items recorded in the FFQ.\u003c/p\u003e\n\u003cp\u003eMicronutrient intake was classified as inadequate if it fell below the estimated average requirement (EAR) or, if the EAR was unavailable, below the adequate intake (AI), as defined by the Institute of Medicine [27].\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStatistical Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were grouped into tertiles based on PHDI and PHDI-C scores, with the highest tertile representing the highest adherence. For descriptive purposes, categorical variables were summarized as numbers and percentages, while continuous variables were presented as means and standard deviations (SD). Linear trend tests across tertiles were conducted by assigning the median value of each tertile and treating this as a continuous variable in regression models.\u003c/p\u003e\n\u003cp\u003eWe also assessed the energy-adjusted intake of micronutrients in each tertile and the energy-adjusted increase in micronutrient intake for every 10-point increase in both scores. Energy-adjusted intakes of micronutrients were obtained through regression models.\u003cem\u003e \u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTo evaluate the relationship between both scores and the risk of \u0026ge;3 inadequate intakes, we used the EAR cut-point method and fitted generalized estimating equations to account for intra-cluster correlation among siblings. Multivariate models were progressively adjusted for: 1) sex, age (continuous), and total energy intake (continuous); 2) breastfeeding duration (none, \u0026lt; 6, 6\u0026ndash;12, and \u0026gt; 12 months), parental knowledge of nutritional recommendations for children (low, medium and high) and parental attitudes towards child\u0026rsquo;s dietary habits (unhealthy, average and healthy); 3) physical activity (continuous) and screen time (continuous). The first tertile was always used as the category of reference. The analysis consisted of calculating: 1) the difference and 95% Confidence Interval (CI) in the number of inadequate intakes of micronutrients across values of the PHDI and PHDI-C and 2) the Odds ratios (ORs) and 95% CIs for the inadequate intake of \u0026ge;3 micronutrients. Multivariable-adjusted proportions of children with \u0026ge;3 inadequate micronutrient intakes were also estimated for each tertile of both scores.\u003c/p\u003e\n\u003cp\u003eAll statistical analyses were performed using Stata version 15.0 (Stata Corp., College Station, TX, USA). Two-tailed p-values were used, with statistical significance set at p\u0026lt;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThis study included 945 participants (49.1% girls) with an average age of 4.98 (SD: 0.83). Overall adherence to the EAT-Lancet diet was moderate, as measured by the PHDI, with a median score of 64 (IQR: 58.90-70.10) on a potential range of 0 to 150.\u0026nbsp;Higher PHDI scores were observed in children who had longer breastfeed periods, were more physically active, spent less time in front of screens and who have parents with healthier attitudes towards their child\u0026rsquo;s dietary habits and greater knowledge of nutritional recommendations for their children (Table 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRegarding dietary composition (Table 3), higher PHDI scores were associated with higher total energy intake (TEI). Both scores were associated with a higher proportion of carbohydrates, a lower proportion of protein, and to healthier fat profiles. As adherence increased, cholesterol and saturated fat intake decreased, while monounsaturated and polyunsaturated fat intake increased, with greater intakes of linoleic acid, arachidonic acid, linolenic acid, EPA and DHA.\u003c/p\u003e\n\u003cp\u003eRegarding food groups, children with higher scores in both indices consumed more vegetables, fruits, legumes, cereal grains, potatoes, and nuts, and fewer dairy products, pastries and sweets, sugar-sweetened beverages, and meat. Children with higher PHDI-C scores also consumed more eggs.\u003c/p\u003e\n\u003cp\u003eWe calculated the energy-adjusted mean intake for each micronutrient by tertiles (Table 4) and the energy-adjusted increase in micronutrient intake for each 10-point increase of each score\u0026nbsp;(Table S2). Participants with higher PHDI and PHDI-C scores had higher intakes of vitamins A, C, E, B1, B3, and B6, as well as folic acid, Fe, Mg, Zn, Cr, and K. However, higher adherence to the EAT-Lancet diet was associated with lower intakes of vitamins B2 and B12, Ca, and I. Regarding Se, improved intake was only observed with higher PHDI-C scores.\u003c/p\u003e\n\u003cp\u003eWe calculated the prevalence of inadequacy for each micronutrient according to tertiles (Table S1). Participants in the highest tertile of both scores had a lower prevalence of inadequacy of vitamins A and E, folic acid, and K. However, they had a higher prevalence of inadequate intakes of I and Ca (only in PHDI-C).\u003c/p\u003e\n\u003cp\u003eThe splines in Figure 1 illustrate the relationship between both scores and the number of micronutrients with inadequate intake (solid line) with 95% CI (dashed line). After adjusting for potential confounders, we observed that the number of inadequate micronutrient intakes decreased as the PHDI-C score improved, displaying an inverse linear association (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; 0.001). However, this pattern was not observed for the PHDI, where the initial reduction in the number of inadequate intakes plateaued at scores above 70.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 5 presents the OR and 95% CI for unmet EARs for \u0026ge;3 micronutrients across PHDI and PHDI-C tertiles. We found a significant linear trend in the odds of having\u0026nbsp;\u0026ge;3 micronutrient inadequacies across tertiles of both scores. In the fully adjusted model, children in T3 of PHDI had 0.58-fold lower odds (95%CI 0.31\u0026ndash;1.07) of having \u0026ge;3 micronutrient inadequacies, and the linear trend was only marginally significant (p=0.071)\u003cstrong\u003e.\u003c/strong\u003e Regarding the PHDI-C, children in T3 of the fully adjusted model had 0.31-fold lower odds (95%CI 0.16\u0026ndash;0.59) of having \u0026ge;3 inadequate micronutrient intakes (\u003cem\u003ep\u0026nbsp;\u003c/em\u003efor trend \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003eWe also calculated the marginal effect of both scores on the risk of having an inadequate intake of \u0026ge;3 micronutrients, this is, the multivariate-adjusted proportion of children with inadequate intake of \u0026ge;3 micronutrient in each tertile of both indices (Figure 2). The adjusted proportions of children with \u0026ge;3 micronutrient inadequacies of the PHDI-C were 18.4% (95% CI: 14.8\u0026ndash;22.0%), 12.9% (95% CI; 9.8\u0026ndash;15.9%), 10.8% (95% CI: 7.9\u0026ndash;13.6%), in T1, T2 and T3 respectively. Regarding the PHDI, the adjusted proportions were 16.3% (95% CI: 13.2\u0026ndash;19.5), 12.8% (95% CI; 9.8\u0026ndash;15-7%), 12.1% (95% CI: 8.7\u0026ndash;15.5%), in T1, T2 and T3 respectively. These results suggest that better adherence to the PHDI-C shows a stronger association with improved nutrient adequacy than adherence to the PHDI.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present cross-sectional study explored whether the PHDI-C, an adaptation of the PHDI for children and adolescents, is associated with nutrient adequacy and compared its performance with the original version of the PHDI. The PHDI-C introduces changes to the PHDI, modifying certain intake values of the different food groups, therefore indirectly testing whether slight adjustments to the EAT-Lancet recommendations in children might better accommodate growing children\u0026rsquo;s nutritional needs. To the best of our knowledge, this is the first study assessing micronutrient adequacy of the EAT-Lancet diet in young children in a real-world setting. Moreover, no previous study has directly compared the PHDI-C with the PHDI in terms of nutrient adequacy, to assess if the proposed changes are in fact a better fit for children\u0026rsquo;s dietary needs.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur results indicate that higher PHDI-C scores were associated with fewer unmet EARs than the original PHDI score and that both indices were positively associated with higher intakes of nutrients predominantly derived from plant-source foods, some of which are considered nutrients of public health concern, such as fiber, K, Fe [28]. This is consistent with previous studies in adult population [13,29].\u0026nbsp;Conversely, both indices were negatively associated with nutrients primarily obtained from animal- source foods, including vitamins B2 and B12, Ca, and I, which are commonly lacking in diets worldwide [16,30]. These results align with those obtained in the original validation study of the PHDI conducted in adults [18].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In terms of inadequate intakes, higher scores in both indices were associated with fewer inadequacies of vitamins E, K and A (measured as retinol equivalents). However, higher scores were associated with higher inadequacy of I in both indices, and of Ca in the PHDI-C. Notably, a study conducted in Norway that assessed the environmental and nutritional consequences of shifting 2-year-old children\u0026apos;s diets towards a theoretical EAT-Lancet scenario diet found that this transition improved micronutrient adequacy, except for Se, Ca and I [31] . Similarly, a study by Lassen et al. using Danish food composition data showed that the EAT-Lancet diet would be deficient in vitamins A and D, Ca, I and Se for the population aged 6\u0026ndash;65 years [32]. Contrasting with these previous studies, research conducted in European adolescents found that Ca and I intake increased with higher PHDI scores [12].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;It is likely that the higher thresholds for animal-based food intake, such as dairy, eggs, and white meats, are responsible for the observed improved association between nutrient adequacy and the PHDI-C. Several children in our cohort had I inadequacy, and animal-source products\u0026mdash;such as eggs, dairy and fish\u0026mdash;are good sources of it [33,34]. Conversely, regarding Ca, it is unexpected that the PHDI-C, which raises the threshold for dairy consumption, does not correlate with improved its adequacy, despite dairy products being a good dietary source of Ca. This discrepancy may be due to changes in the scoring of whole grains versus refined grains, as the latter contain less Ca [35].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths and limitations\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe acknowledge that our study has both strengths and limitations. To the best of our knowledge, this is the first study to analyze the relationship between adherence to the EAT-Lancet diet and nutrient adequacy in young children, using two novel dietary indices. It provides initial insights into the performance of the PHDI-C, which introduces modifications to the EAT-Lancet diet to better accommodate the nutritional needs of children, addressing the limitations pointed out in previous studies [14,19,36]. Another strength is the use of Generalized Estimating Equation models, which account for the potential correlation between siblings\u0026mdash;a common challenge in pediatric studies.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Despite these contributions, some limitations exist. First, our study population showed moderate adherence to the EAT-Lancet diet, aligning with findings from other studies [12,19,36]. Even among participants with the highest adherence, animal-derived product consumption remained well above the dietary targets set by the EAT-Lancet diet [3], though lower than levels reported in population-based studies in Spain [37]. Thus, our study may not fully capture the impact of strict adherence to the EAT-Lancet dietary pattern. It is possible that higher adherence could enhance nutrient adequacy, while severely restricted intakes of animal-source foods could also exacerbate potential nutrient shortfalls. Future research in populations with higher adherence to the EAT-Lancet diet could provide further insights into this balance.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Second, another limitation relates to self-reported dietary data, which may introduce measurement errors. FFQs tend to overestimate food intake, potentially leading to an underestimation of micronutrient inadequacies. However, the FFQ used in this study has been previously validated [21], and we excluded participants with extreme energy and micronutrient intakes to minimize bias. Moreover, the high level of parental education of our participants likely improves the validity of self-reported dietary data and reduces potential confounding factors related to socioeconomic disparities. Third, we assessed the probability of micronutrient adequacy rather than actual micronutrient deficiencies, which would require biomarker analysis for a more precise evaluation. Fourth, absolute intakes of micronutrients may have been underestimated because we did not consider the intake of fortified foods or supplements. Finally, as this is an observational study, we cannot completely rule out residual confounding from unmeasured factors. However, the comprehensive questionnaire used allowed us to adjust for multiple potential confounders, strengthening the reliability of our findings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study provides novel insights into the relationship between adherence to the EAT-Lancet diet and micronutrient adequacy in young children, comparing the performance of the PHDI and its child-adapted version, the PHDI-C. Our findings suggest that higher adherence is associated with improved micronutrient adequacy, with a slightly stronger association with nutritional adequacy for the PHDI-C as compared to the original PHDI. Future research should further investigate the impact of the EAT-Lancet diet in populations with high adherence and assess the PHDI-C\u0026apos;s validity in measuring the environmental sustainability of diets in children and adolescents in relation to the EAT-Lancet targets.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAI, Adequate Intake\u003c/p\u003e\n\u003cp\u003eBMI, Body Mass Index\u003c/p\u003e\n\u003cp\u003eCI, Confidence Interval\u003c/p\u003e\n\u003cp\u003eDHA, Docosahexaenoic Acid\u003c/p\u003e\n\u003cp\u003eEAR, Estimated Average Requirement\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEPA, Eicosapentaenoic Acid\u003c/p\u003e\n\u003cp\u003eFFQ, Food-Frequency Questionnaire \u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePHDI, Planetary Healthy Diet Index\u003c/p\u003e\n\u003cp\u003ePHDI-C, Planetary Healthy Diet Index adapted to children and adolescents\u003c/p\u003e\n\u003cp\u003eOR, Odds Ratio\u003c/p\u003e\n\u003cp\u003eSD, Standard Deviation\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSENDO, Seguimiento del Ni\u0026ntilde;o para un Desarrollo \u0026Oacute;ptimo\u003c/p\u003e\n\u003cp\u003eT1, tertile 1\u003c/p\u003e\n\u003cp\u003eT2, tertile 2\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eT3, tertile 3\u003c/p\u003e\n\u003cp\u003eTEI, Total Energy Intake\u003c/p\u003e\n\u003cp\u003eCa, Calcium\u003c/p\u003e\n\u003cp\u003eI, Iodine,\u003c/p\u003e\n\u003cp\u003eFe, Iron\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eP, Phosphorous\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eM, Magnesium\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSe, Selenium\u003c/p\u003e\n\u003cp\u003eZn, Zinc\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCr, Chromium\u003c/p\u003e\n\u003cp\u003eK, Potassium\u003c/p\u003e\n\u003cp\u003eNa, Sodium\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose\u003cem\u003e.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNMC, MAMG, IZ, EF: Conceptualization, Methodology and Software. EF: Data curation, writing of the original draft. NMC, IZ: Supervision. All authors critically reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe SENDO project adheres to the rules of the Declaration of Helsinki on the ethical principles for medical research in human beings. This study was approved by the Ethics Committee for Clinical Research of Navarra (P. 2016/122). An informed consent was obtained during the recruitment from all participants\u0026rsquo; parents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the parents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSwinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. The Lancet. 2019;393:791\u0026ndash;846. \u003c/li\u003e\n\u003cli\u003eFood and Agricultural Organisation of the United Nations (FAO). Sustainable Healthy Diets\u0026mdash;Guiding Principles. World Health Organization F and AO of the UN, editor. Rome: Food and Agriculture Organization of the United Nations; 2019. \u003c/li\u003e\n\u003cli\u003eWillett W, Rockstr\u0026ouml;m J, Loken B, Springmann M, Lang T, Vermeulen S, et al. Food in the Anthropocene: the EAT\u0026ndash;Lancet Commission on healthy diets from sustainable food systems. The Lancet. Lancet Publishing Group; 2019. p. 447\u0026ndash;92. \u003c/li\u003e\n\u003cli\u003ede Oliveira Neta RS, Lima SCVC, do Nascimento LL, de Souza CVS, de Oliveira Lyra C, Marchioni DML, et al. Indices for measurement of sustainable diets: A scoping review. PLoS One. 2023;18. \u003c/li\u003e\n\u003cli\u003eStubbendorff A, Stern D, Ericson U, Sonestedt E, Hallstr\u0026ouml;m E, Born\u0026eacute; Y, et al. A systematic evaluation of seven different scores representing the EAT\u0026ndash;Lancet reference diet and mortality, stroke, and greenhouse gas emissions in three cohorts. 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Association between planetary health diet and cardiovascular disease: a prospective study from the UK Biobank. Eur J Prev Cardiol. 2024; \u003c/li\u003e\n\u003cli\u003eGuzm\u0026aacute;n-Castellanos KB, Zazpe I, Santiago S, Bes-Rastrollo M, Mart\u0026iacute;nez-Gonz\u0026aacute;lez M\u0026Aacute;. Planetary Health Diet and Cardiovascular Disease Risk in the Seguimiento Universidad de Navarra (SUN) Cohort. Nutrients . 2025;17. \u003c/li\u003e\n\u003cli\u003eCai H, Talsma EF, Chang Z, Wen X, Fan S, van\u0026rsquo;t Veer P, et al. Health outcomes, environmental impacts, and diet costs of adherence to the EAT-Lancet Diet in China in 1997\u0026ndash;2015: a health and nutrition survey. Lancet Planet Health. 2024;8:e1030\u0026ndash;42. \u003c/li\u003e\n\u003cli\u003eCacau LT, Hanley-Cook GT, Huybrechts I, De Henauw S, Kersting M, Gonzalez-Gross M, et al. Relative validity of the Planetary Health Diet Index by comparison with usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet among European adolescents: the HELENA study. Eur J Nutr. 2023;62:2527\u0026ndash;39. \u003c/li\u003e\n\u003cli\u003eFrank SM, Jaacks LM, Adair LS, Avery CL, Meyer K, Rose D, et al. Adherence to the Planetary Health Diet Index and correlation with nutrients of public health concern: an analysis of NHANES 2003\u0026ndash;2018. American Journal of Clinical Nutrition. 2024;119:384\u0026ndash;92. \u003c/li\u003e\n\u003cli\u003eBeal T, Ortenzi F, Fanzo J. Estimated micronutrient shortfalls of the EAT\u0026ndash;Lancet planetary health diet. Lancet Planet Health. Elsevier B.V.; 2023. p. e233\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eBeal T, Gardner CD, Herrero M, Iannotti LL, Merbold L, Nordhagen S, et al. Friend or Foe? The Role of Animal-Source Foods in Healthy and Environmentally Sustainable Diets. Journal of Nutrition. Elsevier B.V.; 2023. p. 409\u0026ndash;25. \u003c/li\u003e\n\u003cli\u003eBeal T, Ortenzi F. Priority Micronutrient Density in Foods. Front Nutr. 2022;9. \u003c/li\u003e\n\u003cli\u003eConti MV, Vincenti A, Beretta A, Calcaterra V, Taranto S, Diotti M, et al. Planetary Health Diet for Childhood Obesity Prevention: Integrating Nutritional Health with Environmental Stewardship. Nutrients. 2024;16:4316. \u003c/li\u003e\n\u003cli\u003eCacau 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;13:1698. \u003c/li\u003e\n\u003cli\u003eVenegas Hargous C, Orellana L, Strugnell C, Corvalan C, Allender S, Bell C. Adapting the Planetary Health Diet Index for children and adolescents. International Journal of Behavioral Nutrition and Physical Activity. 2023;20. \u003c/li\u003e\n\u003cli\u003eBurggraf C, Teuber R, Brosig S, Meier T. Review of a priori dietary quality indices in relation to their construction criteria. Nutr Rev. 2018;76:747\u0026ndash;64. \u003c/li\u003e\n\u003cli\u003eZazpe I, Santiago S, de la O V, Romanos-Nanclares A, Rico-Camp\u0026agrave; A, \u0026Aacute;lvarez-zallo N, et al. Validity and reproducibility of a semi-quantitative food frequency questionnaire in Spanish preschoolers \u0026mdash; The SENDO project. Nutr Hosp. 2020; \u003c/li\u003e\n\u003cli\u003eSantiago S, Ben\u0026iacute;tez-Borja A, Mart\u0026iacute;n-Calvo N, Romanos-Nanclares A, Moreno-Galarraga L, Zazpe I. Association between parental attitudes towards their offspring\u0026rsquo;s diet and children\u0026rsquo;s actual dietary habits \u0026mdash; The SENDO project. Nutr Hosp. 2021; \u003c/li\u003e\n\u003cli\u003eRomanos-Nanclares A, Zazpe I, Santiago S, Mar\u0026iacute;n L, Rico-Camp\u0026agrave; A, Mart\u0026iacute;n-Calvo N. Influence of Parental Healthy-Eating Attitudes and Nutritional Knowledge on Nutritional Adequacy and Diet Quality among Preschoolers: The SENDO Project. Nutrients. 2018;10:1875. \u003c/li\u003e\n\u003cli\u003eMoreiras Tuni Olga, Carbajal Angel. Tablas de composici\u0026oacute;n de alimentos. 2019. \u003c/li\u003e\n\u003cli\u003eSpanish Agency for Consumer Affairs FS and Nutrition. The Spanish Food Composition Database. . \u003c/li\u003e\n\u003cli\u003eU.S. Departament Of Agriculture. Food Data [Internet]. . \u003c/li\u003e\n\u003cli\u003eNational Institutes of Health USD of H and HServices. Nutrient Recommendations and Databases . https://ods.od.nih.gov/HealthInformation/nutrientrecommendations.aspx. \u003c/li\u003e\n\u003cli\u003eUSDA. Dietary Guidelines for Americans. Food Sources of Select Nutrients. \u003c/li\u003e\n\u003cli\u003eMontejano Vallejo R, Schulz C-A, van de Locht K, Oluwagbemigun K, Alexy U, N\u0026ouml;thlings U. Associations of Adherence to a Dietary Index Based on the EAT\u0026ndash;Lancet Reference Diet with Nutritional, Anthropometric, and Ecological Sustainability Parameters: Results from the German DONALD Cohort Study. J Nutr. 2022;152:1763\u0026ndash;72. \u003c/li\u003e\n\u003cli\u003ePassarelli S, Free CM, Shepon A, Beal T, Batis C, Golden CD. Global estimation of dietary micronutrient inadequacies: a modelling analysis. Lancet Glob Health. 2024;12:e1590\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eWright EC, van Oort B, Bj\u0026oslash;ntegaard MM, Carlsen MH, Andersen LF. Environmental and nutritional assessment of young children\u0026rsquo;s diets in Norway: comparing the current diet with national dietary guidelines and the EAT-Lancet reference diet. Eur J Nutr. 2023;62:3383\u0026ndash;96. \u003c/li\u003e\n\u003cli\u003eLassen AD, Christensen LM, Trolle E. Development of a Danish Adapted Healthy Plant-Based Diet Based on the EAT-Lancet Reference Diet. Nutrients. 2020;12:738. \u003c/li\u003e\n\u003cli\u003eMyers M, Ruxton CHS. Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen\u0026rsquo;s Eggs. Nutrients. 2023;15:2657. \u003c/li\u003e\n\u003cli\u003eNational Institutes of Health Office of Dietary Supplements. Iodine. Fact Sheet for Health Professionals. 2023. \u003c/li\u003e\n\u003cli\u003eEuropean Comission. Nutritional value of whole grains. 2021. \u003c/li\u003e\n\u003cli\u003eVenegas Hargous C, Orellana L, Corvalan C, Strugnell C, Allender S, Bell C. Chilean children\u0026rsquo;s adherence to sustainable healthy diets and its associations with sociodemographic and anthropometric factors: a cross-sectional study. Eur J Nutr. 2024;63:2459\u0026ndash;75. \u003c/li\u003e\n\u003cli\u003eAgencia Espa\u0026ntilde;ola de Consumo SA y N. Estudio ENALIA 2012-2014: Encuesta Nacional de consumo de Alimentos en poblaci\u0026oacute;n Infantil y Adolescente. Madrid; 2017. \u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1 is available in the Supplementary Files section.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eCharacteristics of participants and their families in the SENDO project by tertiles of the PHDI. Numbers are mean (sd) or N (%)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT3\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;p for trend\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRange of PHDI score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e29.27-60.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e60.87-68.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e68.27-100.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex (female), %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e141 (44.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e165 (52.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e158 (50.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.181\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e4.99 (0.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e5.04 (0.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e4.90 (0.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.171\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRace (white), %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e299 (94.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e300 (95.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e303 (96.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.443\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirthweight (g)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3267 (602.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e3188 (515.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e3260 (482.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.922\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eZ-score of the BMI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.04 (1.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e0.05 (1.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e0.01 (1.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.655\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModerate-vigorous physical activity (h/day)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.08 (0.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e1.04 (0.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.27 (0.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScreen time (h/day)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.22 (0.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e1.05 (0.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e1.02 (1.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGestational age (weeks), %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.989\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026lt;38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e44 (14.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e45 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e41 (13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e38 to 40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e121 (38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e129 (41.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e128 (40.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026gt;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e147 (47.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e141 (44.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e144 (46.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBirthweight (g), %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.541\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026lt;2500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e33 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e28 (8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e20 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e2500-3000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e57 (18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e76 (24.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e70 (22.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e3000-3500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e115 (36.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e133 (42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e132 (42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e3500-4000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e81 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e66 (21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e78 (24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026gt;4000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e26 (8.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e12 (3.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e13 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBreastfeeding duration (months), %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eNo breastfeeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e66 (21.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e48 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e36 (11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026lt;6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e95 (30.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e93 (29.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e64 (20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e6 to 12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e75 (23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e91 (28.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e71 (22.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u0026gt;12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e81 (26.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e83 (26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e144 (45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeight Status (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.368\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eLow weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e48 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e51 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e50 (15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eNormal weight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e222 (70.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e229 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e230 (73.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eOverweight/obesity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e45 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e35 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e35 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaternal age (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 104px;\"\u003e\n \u003cp\u003e39.79 (4.66)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 113px;\"\u003e\n \u003cp\u003e40.21 (4.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 94px;\"\u003e\n \u003cp\u003e39.76 (4.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.918\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParents higher education %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eBoth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e156 (49.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e181 (57.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e177 (56.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eAt least one\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e259 (82.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e270 (85.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e279 (88.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParental healthy attitudes towards child\u0026rsquo;s dietary habits, %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eLow (\u0026lt;40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e21 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e17 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e7 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eModerate (40-70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e133 (42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e99 (31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e69 (21.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eHigh (\u0026gt;70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e161 (51.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e199 (63.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e239 (75.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParental knowledge about the child\u0026rsquo;s nutritional recommendations, %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eLow (\u0026lt;40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e84 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e59 (18.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e62 (19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eModerate (40-70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e203 (64.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e211 (67.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e198 (62.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eHigh (\u0026gt;70%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e28 (8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e45 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e55 (17.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of children, %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.153\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e48 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e40 (12.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e48 (15.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e168 (53.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e157 (49.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e186 (59.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e3-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e84 (26.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e96 (30.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e74 (23.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e5 or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e15 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e22 (7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e7 (2.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChild\u0026rsquo;s position among siblings, %\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.615\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eThe oldest/singletons\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e107 (34.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e121 (38.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e116 (36.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003e2\u003csup\u003end\u003c/sup\u003e/3, 2\u003csup\u003end\u003c/sup\u003e or 3\u003csup\u003erd\u003c/sup\u003e/4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e42 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e54 (17.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e36 (11.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 227px;\"\u003e\n \u003cp\u003eThe youngest or beyond the 4\u003csup\u003eth\u003c/sup\u003e \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e166 (52.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e140 (44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e163 (51.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eDietary composition according to tertiles of PHDI and PHDI-C. Mean (sd)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"689\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 236px;\"\u003e\n \u003cp\u003ePHDI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 245px;\"\u003e\n \u003cp\u003ePHDI-C\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003eT1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003eT3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eT1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003eT3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMacronutrients\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eTEI (kcal)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e1958 (499.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e2038 (433.1)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e2039 (495.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e2002 (441.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eCarbohydrate intake (% of TEI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e42.91 (5.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e44.24 (5.30)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e42.53 (5.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e44.62 (5.16)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eProtein intake (% of TEI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e17.61 (2.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e16.46 (1.95)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e17.30 (2.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e16.87 (1.94)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eFat intake (% of TEI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e39.48 (5.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e39.30 (5.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e40.17 (5.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e38.51 (5.01)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eCholesterol, mg/d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e289.29 (86.44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e253.44 (63.65)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e285.77 (85.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e259.16 (66.44)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eSFA intake (% of TEI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e11.66 (2.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e10.39 (2.03)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e11.82 (2.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e10.25 (2.00)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eMUFA intake (% of TEI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e14.75 (3.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e15.90 (3.17)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e15.08 (4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e15.42 (3.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003ePUFA intake (% of TEI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e4.54 (1.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e4.89 (1.16)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e4.45 (1.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e4.82 (1.11)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eLinoleic cid (18:2n-6), g/d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e8.19 (3.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e9.14 (3.17)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e8.28 (3.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e8.83 (2.98)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eArachidonic acid (20:4n-6), g/d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e0.11 (0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e0.10 (0.03)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e0.12 (0.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e0.10 (0.03)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eLinolenic acid (18:3n-3), g/d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e0.63 (0.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e0.77 (0.25)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e0.64 (0.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e0.75 (0.24)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eEPA (20:5n-3), mg/d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e85.11 (48.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e93.54 (43.06)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e88.40 (48.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e91.34 (46.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eDHA (22:6n-3), mg/d\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e155.5 (114.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e179.8 (98.49)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e161.4 (114.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e176.50 (108.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eFibre intake (g/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e17.67 (5.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e25.14 (6.67)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e18.03 (5.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e24.62 (6.78)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFood groups\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eVegetables\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e168.6 (108.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e282.2 (121.7)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e174.9 (109.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e283.0 (124.5)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eFruits\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e313.7 (197.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e499.4 (252.5)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e323.9 (202.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e455.3 (232.6)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eLegumes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e26.78 (15.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e39.05 (23.31)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e27.12 (13.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e39.66 (22.28)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eCereal grains\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e80.64 (36.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e103.2 (56.21)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e77.01 (42.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e106.2 (52.97)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003ePotatoes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e23.67 (21.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e34.82 (22.31)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e25.36 (25.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e33.41 (19.46)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eNuts\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e1.05 (1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e2.14 (1.42)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e1.14 (0.96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e2.12 (1.41)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eDairy products\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e543.4 (251.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e384.9 (221.5)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e608.3 (274.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e398.0 (184.6)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eEggs\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e20.21 (13.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e20.24 (7.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e18.73 (12.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e21.45 (7.79)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eFish and Seafood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e32.93 (17.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e36.38 (15.34)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e33.78 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e35.53 (15.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003eMeat\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e138.5 (44.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e120.0 (45.41)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e134.7 (43.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e120.56 (43.78)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eFastfood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e59.10 (31.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e58.51 (29.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e58.54 (27.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e56.13 (28.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 208px;\"\u003e\n \u003cp\u003ePastries and sweets\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e87.11 (63.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e65.64 (44.80)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e95.39 (70.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e62.47 (39.79)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eSugar-sweetened beverages\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e44.89 (74.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e31.25 (51.89)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e54.41 (92.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e30.58 (43.48)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eOlive oil\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e15.99 (14.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e20.87 (12.07)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e18.26 (15.86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e19.31 (10.81)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eOther vegetable oils\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e2.73 (4.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 113px;\"\u003e\n \u003cp\u003e2.48 (3.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e2.49 (3.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 121px;\"\u003e\n \u003cp\u003e2.56 (3.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;TEI: Total Energy Intake; SFA, saturated fatty acids; MUFA, monounsaturated fatty acids; PUFA, polyunsaturated fatty acids; T1, tertile 1; T3, tertile 3\u003c/p\u003e\n\u003cp\u003e*p for trend \u0026lt; 0.05\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eEnergy-adjusted intake of micronutrients by tertiles of PHDI and PHDI-C. Mean (sd)\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"699\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEAR for children 4-8 years old\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 208px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePHDI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 255px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePHDI-C\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 155px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003eT1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003eT3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003eT1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003eT3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 155px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 155px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMicronutrients\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamin A (equiv Retinol) (\u0026micro;g/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e982.4 (24.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1159.1 (24.74)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e952.21 (24.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e1181.60 (24.51)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamin C (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e113.4 (3.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e176.9 (3.22)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e114.16 (3.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e169.05 (3.31)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamin D (\u0026micro;g/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2.99 (0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3.17 (0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e2.98 (0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3.24 (0.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamin E (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e7.55 (0.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e9.49 (0.15)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e7.69 (0.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e9.19 (0.15)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamin B1 (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.36 (0.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.50 (0.01)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e1.34 (0.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e1.52 (0.01)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamin B2 (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2.05 (0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.98 (0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e2.08 (0.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2.00 (0.03)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamina B3 (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e34.78 (0.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e36.49 (0.43)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e33.94 (0.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e36.94 (0.42)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamin B6 (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2.16 (0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2.49 (0.02)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e2.11 (0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2.50 (0.02)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eFolic Acid (\u0026micro;g/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e270.4 (4.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e335.3 (4.07)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e267.84 (4.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e336.9 (4.03)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eVitamin B12 (\u0026micro;g/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e1.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e4.80 (0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e4.41 (0.07)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e4.66 (0.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e4.51 (0.07)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eCa (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e800\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1198 (13.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1096 (13.69)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e1236 (13.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e1118 (13.57)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eI (\u0026micro;g/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e112.5 (1.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e102.8 (1.24)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e113.9 (1.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e105.0 (1.24)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eFe (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e12.99 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e15.00 (0.11)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e12.70 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e15.05 (0.11)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eP (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e405\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1661 (35.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1739 (35.82)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e1706 (35.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e1781 (35.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eMg (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e110\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e282.0 (2.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e322.7 (2.42)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e281.0 (2.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e322.6 (2.41)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eSe (\u0026micro;g/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e71.24 (0.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e70.92 (0.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e68.55 (0.72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e73.20 (0.72)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eZn (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e9.38 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e9.79 (0.11)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e9.32 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e9.72 (0.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eCr (\u0026micro;g/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e15 (AI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e62.47 (1.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e69.21 (1.11)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e64.21 (1.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e69.16 (1.11)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eK (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e2300 (AI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3199 (33.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e3664 (33.50)*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e3208 (33.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3639 (33.75)*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 155px;\"\u003e\n \u003cp\u003eNa (mg/d)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e1000 (AI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2925 (48.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e2919 (47.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e2904 (47.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2882 (47.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;EAR, Estimated Average Requirement; AI, Adequate Intake,\u003c/p\u003e\n\u003cp\u003e*p for trend \u0026lt; 0.05\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5.\u0026nbsp;\u003c/strong\u003eOR and 95%CI for inadequate intake of 3 or more micronutrients associated with tertiles of PHDI and PHDI-C. Mean (sd)\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"604\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePHDI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003epft\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003e% of participants with \u0026ge;3 inadequate intakes of micronutrients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e21.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e10.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e9.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003eCrude\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00 (ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.41 (0.26-0.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.39 (0.25-0.62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003eMultivariate adjusted model 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00 (ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.59 (0.35-1.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.49 (0.27-0.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003eMultivariate adjusted model 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00 (ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.62 (0.36-1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.55 (0.29-1.03)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003eMultivariate adjusted model 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00 (ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.63 (0.36-1.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.58 (0.31-1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePHDI-C\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003epft\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003e% of participants with \u0026ge;3 inadequate intakes of micronutrients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e19.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e12.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e9.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003eCrude\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00 (ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.58 (0.38-0.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.45 (0.28-0.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003eMultivariate adjusted model 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00 (ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.47 (0.27-0.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.34 (0.19-0.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003eMultivariate adjusted model 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00 (ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.48 (0.27-0.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.36 (0.19-0.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 226px;\"\u003e\n \u003cp\u003eMultivariate adjusted model 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e1.00 (ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.50 (0.28-0.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 104px;\"\u003e\n \u003cp\u003e0.37 (0.20-0.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eModel 1: adjusted for sex (male vs. female), age (continuous), and energy intake (continuous);\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eModel 2: additionally adjusted for breastfeeding duration (none, \u0026lt;6, 6\u0026ndash;12, and \u0026gt;12 months), parental knowledge about the child\u0026rsquo;s nutritional recommendations (low, medium, and high score) for children, and parental attitudes towards child\u0026rsquo;s dietary habits (low, medium, and high score);\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eModel 3: additionally adjusted for moderate\u0026ndash;vigorous physical activity (continuous) and screen time (continuous).\u003cstrong\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"EAT-Lancet diet, Planetary Health Diet Index, Micronutrient adequacy, PHDI-C, SENDO Cohort","lastPublishedDoi":"10.21203/rs.3.rs-6270397/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6270397/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose:\u003c/h2\u003e \u003cp\u003eThe EAT-Lancet Commission introduced a global reference diet in 2019 for individuals aged two years and older. Concerns exist regarding its ability to fulfill children\u0026rsquo;s specific micronutrient requirements. The PHDI-C, an adapted version of the Planetary Health Diet Index (PHDI), was developed to better reflect the nutritional needs of growing children. However, its association with micronutrient adequacy in pediatric populations has not been fully examined. Our study investigates whether the PHDI-C is associated with micronutrient adequacy in children and compares its performance to the original PHDI.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eThis cross-sectional study compared the association of the PHDI and PHDI-C with nutritional adequacy in children aged 4\u0026ndash;5 years from the SENDO cohort. Dietary, lifestyle, and socio-demographic data were collected via parent-administered questionnaires. Scores for both indices were calculated, and participants were categorized into tertiles. Micronutrient adequacy was assessed using the Estimated Average Requirement (EAR) cut-off points, and multivariate analyses examined the relationship between both indices and the risk of inadequate micronutrient intake.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eAfter adjusting for potential confounders, higher PHDI-C scores were associated with fewer unmet EARs \u003cem\u003e(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/em\u003e Children in the highest tertile had significantly lower odds (0.37-fold; 95% CI: 0.20\u0026ndash;0.69; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002) of having\u0026thinsp;\u0026ge;\u0026thinsp;3 inadequate micronutrient intakes compared to the lowest tertile. For the original PHDI, the odds reduction was 0.58-fold (95% CI: 0.31\u0026ndash;1.07; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.071).\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eThe PHDI-C is linked to better nutritional adequacy than the original PHDI. Further research is needed to validate the PHDI-C in terms of environmental sustainability.\u003c/p\u003e","manuscriptTitle":"EAT-Lancet Reference Diet and Nutritional Adequacy in Children: Examining the Planetary Health Diet Index for Children (PHDI-C)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-30 12:20:13","doi":"10.21203/rs.3.rs-6270397/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"08b65ac0-4300-44f1-9843-2e29f874cced","owner":[],"postedDate":"April 30th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-12T09:09:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-30 12:20:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6270397","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6270397","identity":"rs-6270397","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}