Adherence to Healthy and Sustainable Diets Is Not Differentiated by Cost, But Rather Source of Foods among Young Adults in Albania release_vanmr2j6nzay3dkzqrtvlmzwoe

Abstract

High cost of nutritious foods and eating out of home (OH) might be barriers to healthy and sustainable diets. We examined adherence to Dietary Approaches to Stop Hypertension (DASH), EAT-Lancet reference diet (EAT), and Mediterranean diet score (MDS) and the associations with dietary cost and eating OH. We evaluated cross-sectional data from single multiple-pass 24-hour diet recalls from 289 young adults (18-24 years) in Tirana, Albania. Dietary cost [in Albanian Lek (ALL)] was estimated by matching food consumption data with retail prices from local fast-food chains, supermarkets, restaurants, and food vendors. Poisson regression were fit to models that included DASH, EAT, and MDS as dependent variables to assess associations between healthy sustainable diet indicators and dietary cost and OH eating. Adjusted models controlled for BMI, sex, and total energy intake (kcal) using the residual method. Our findings indicate relatively poor adherence to healthy and sustainable dietary patterns among young men and women in Albania. Furthermore, better adherence to DASH, EAT, or MDS was not associated with dietary cost (per 100 ALL; range incidence rate ratios (IRRs): 0.97-1.00; all (un-)adjusted P>0.05). Nonetheless, eating OH was related to lower adherence to DASH (IRR: 0.79; P=0.003) and MDS (IRR: 0.69; P<0.001). In conclusion, adherence to health and sustainable dietary patterns was poor and not differentiated by cost, but rather source of foods (i.e. OH or at home). Further research on the potential public and environmental health effects of these findings are warranted in Albania.
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