(P23-007-25) Association Between the Adherence to the Planetary Health Diet Index (PHDI) and Anemia Among Adult Population of Peru: Evidence From the National Dietary Survey 2017–2018

Objectives: To estimate the association between the adherence to the Planetary Health Diet Index (PHDI) and anemia in the Peruvian adult population

Methods: Cross-sectional analysis of Peruvian adults participants of the National Survey of Food and Nutritional Surveillance by Life Stages (2017-2018). We analysed 24-hour dietary recall data to estimate the adherence to the PHDI categorized into tertiles. Hemoglobin concentration was determined by capillary blood using HemoCue Hb201ᐩ, and anemia was diagnosed following the 2001 WHO cut-offs for adults adjusted by altitude (m.a.s.l). Percentage of iron adequacy intake to the estimated average requirement (EAR) was calculated by sex and age, assuming a 10% of dietary iron bioavailability. Multivariable Poisson survey weighted regression was used to evaluate the association between PHDI score and anemia.

Results: Data from 890 participants was analyzed (mean age 37.8 years, 58% females). PDHI score was 69.2 (SE: 0.52) points. Anemia prevalence was 16.1% (95%CI: 13.4 - 18.8) higher in females (24.8%) than males (4.1%). The mean iron intake (mg/day) by PHDI tertiles (T1, T2, and T3) were 11.5; 11.6; and 13.1 mg/dl, respectively, with significant differences between T2-T3 (p= 0.034). The percentage of iron contribution by PHDI tertiles were 96.8 [88.9-104.8] in the T1; 97.8 [89.6-106.0] in the T2; and 108.8 [97.6-120.1] in the T3. We found a statistically significant interaction between PHDI tertiles and sex (p=0.023), showing a significative less prevalence of anemia in males PHDI T3 (0.01 95%CI  -0.01; 0.02) than the T1 (0.07 95%CI 0.02;0.11), with no statistically significant difference by tertiles in women. In addition, a lower  prevalence of anemia was associated with having a higher education level than lower education, and residing in rural areas vs urban areas.

Conclusions: In Peruvian adults, a greater adherence to PHDI was associated with lower prevalence of anemia in men, but not women. Further analysis of micronutrient adequacy and PHDI would provide insights for specific recommendations, particularly for vulnerable groups like women across different residential areas.

Funding Sources: This research was supported by the National Program for Scientific Research and Advanced Studies.