# Associations of economic vulnerability and food insecurity with the Planetary Health Diet in children: PASE study (Brazil)

## TL;DR

This study found that children from economically vulnerable households in Brazil tend to follow a diet closer to the Planetary Health Diet, but this may be due to financial constraints rather than intentional choices.

## Contribution

The study reveals that economic vulnerability and food insecurity may lead to diets that appear more sustainable but are driven by hardship, not conscious sustainability.

## Key findings

- Children from economically vulnerable households showed higher relative alignment with the Planetary Health Diet Index.
- Poverty was linked to reduced consumption of animal-based foods and increased intake of affordable staples like legumes.
- Adherence to the PHD in vulnerable households likely reflects financial constraints rather than active sustainability choices.

## Abstract

This study investigated the associations of economic vulnerability and food insecurity (FI) with the Planetary Health Diet (PHD).

This cross-sectional study included 378 children aged 8 to 9 years from Viçosa, Minas Gerais, Brazil. Food consumption was assessed using 24-h dietary recalls, and adherence to the PHD was measured using the Planetary Health Diet Index (PHDI). Child and family sociodemographic characteristics were assessed using a semi-structured questionnaire. Food insecurity was evaluated using the Brazilian Food Insecurity Scale. Data were analyzed using adjusted linear regression models.

The mean PHDI score was low (37.5), indicating limited overall alignment with the PHD recommendations. Higher relative alignment with the PHDI scoring criteria was observed among children from more economically vulnerable households, including those living in poverty (≤US$5.50 per capita/day), with moderate or severe food insecurity, receiving government assistance, and in households with a higher number of residents. Moreover, poverty was associated with reduced consumption of animal-based foods, whole cereals, fruits, red and orange vegetables, and increased intake of affordable staples such as legumes and vegetable oils.

While children in economically vulnerable households appeared to follow dietary patterns more relatively aligned with the PHD, it seems to be incidental, and likely reflects financial constraints due to economic hardship rather than active sustainability choices. Policymakers should interpret such adherence cautiously and prioritize equitable access to diverse, nutritious foods that align with both health and environmental goals. Further studies are needed to clarify how socioeconomic disparities shape relative adherence to the PHD.