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Author Notes:

Wilhemina Quarpong, 1518 Clifton Rd NE, RRR720, Atlanta, GA 30322, USA. Email: wilhemina.quarpong@emory.edu

Wilhemina Quarpong and Anne M. Williams formulated the research questions for this secondary analysis; Anne M. Williams, Samson Wakoli and Shadrack Oiye were involved in the design of the original study and collection of data; Wilhemina Quarpong conducted the analysis and prepared the first draft of the manuscript. All authors made substantive contributions to the manuscript and approved the final version.

The authors wish to thank Christine P. Stewart for her feedback on this manuscript and the WASH Benefits trial research team. The authors also would like to thank Hanqi Luo for her programming support. Original data collection was supported by a Peter J. Shields and Henry A. Jastro Research Award to AMW from the Graduate Group in Nutritional Biology at the University of California, Davis.

The authors declare no conflicts of interest.



  • diet cost
  • EAT‐Lancet reference diet
  • healthy diet
  • Kenya
  • lactating mothers' diet
  • mothers' body mass index
  • mothers' energy intake

Interpreting alignment to the EAT‐Lancet diet using dietary intakes of lactating mothers in rural Western Kenya


Journal Title:

Maternal and Child Nutrition


Volume 19, Number 3


Type of Work:

Article | Final Publisher PDF


The EAT‐Lancet reference diet intends to be good for planetary and human health. We compared single multiple pass method 24‐h dietary intake of mothers (n = 242) from a cross‐sectional study in Western Kenya to the recommended range of intake of 11 EAT‐Lancet food groups (e.g., 0–100 g/day legumes; maximum score 11), defining alignment two ways: daily intake among food groups where a minimum intake of 0 g was either acceptable or unacceptable. Ordinal logistic regression models assessed associations between alignment and body mass index (BMI). Cost of mothers' diets and hypothetical diets within recommended ranges (lower bounds >0 g) were estimated using food price data from markets within the mothers' locality. Mean energy intake was 1827 (95% confidence interval [CI]: 1731–1924) kcal/day. Relative to the EAT‐Lancet diet, mothers' diets were on average higher for grains; within recommendations for tubers, fish, beef and dairy; closer to lower bounds for chicken, eggs, legumes and nuts; and lower for fruits and vegetables. Mean (95% CI) alignment scores were 8.2 (8.0–8.3) when 0 g intakes were acceptable and 1.7 (1.6–1.9) otherwise. No significant associations were found between alignment and BMI. Mothers' diets and hypothetical diets within recommended ranges averaged 184.6 KES (1.6 USD) and 357.5 KES (3.0 USD)/person/day, respectively. Lactating mothers' diets were not diverse and diverged from the reference diet when an intake of 0 g was considered unacceptable. Lower bound intakes of 0 g for micronutrient‐dense food groups are inappropriate in food‐insecure populations. It would likely cost more than mothers currently spend to tailor their diets to the EAT‐Lancet reference diet.

Copyright information:

© 2023 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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