University of São Paulo Planetary Health Diet Index (PHDI)

University of São Paulo

Overview

In 2019, shortly after the release of the EAT-Lancet Commission report, we developed the Planetary Health Diet Index (PHDI), a 16-component index designed to capture adherence to the EAT-Lancet reference diet. The PHDI has been validated and is now being used in research across more than 60 countries.

In Brazil, the PHDI was applied to the nationally representative Household Budget Survey (POF), revealing low adherence among the population. Additionally, the PHDI score was inversely associated with the consumption of ultra-processed foods, highlighting its potential as a tool to monitor and promote healthier and more sustainable dietary patterns.

Alignment with the EAT-Lancet Commission

By using the PHDI to assess adherence to the EAT-Lancet recommendations, we identify dietary gaps and priority areas for action to promote healthy and sustainable diets in Brazil.

The PHDI has been applied in over 60 countries and inspired the development of other dietary indices. Our findings informed public health discussions and I was invited to present at universities and scientific events. Additionally, I authored a white paper addressing the implementation of the Planetary Health Diet in Brazil,strengthening the dialogue between science, policy, and practice.

Key actors

Public health and nutrition researchers
Healthcare professionals
Health sciences students
Civil society organizations and the general public

Lessons Learned

Adherence to the EAT-Lancet diet in Brazil is low, mainly due to high red meat consumption and the growing replacement of traditional foods by UPF.
Changing this scenario requires multisectoral action and alignment with public policies on food, nutrition, and public health.

Next steps

Continue applying the PHDI in Brazilian cohort studies (ELSA-Brasil, NutriNet-Brasil) and national surveys (upcoming POFs, ERICA, and ENANI).
Strengthen partnerships with professional associations (ASBRAN, ABRASCO, ABESO) to build capacity among healthcare professionals.
Collaborate with the Ministry of Health to align PHDI recommendations with the Brazilian Dietary Guidelines (GAPB).
Expand dissemination and knowledge translation activities to inform policy and practice.

For more information contact: Leandro Cacau at lcacau@usp.br

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