Toward a healthy and sustainable diet in Mexico: where are we and how can we move forward?

Background: Dietary recommendations worldwide have focused on promoting healthy diets to prevent diseases. In 2019, the EAT-Lancet Commission presented global scientific targets for healthy diets and sustainable food production and proposed a healthy reference diet (EAT-HRD) that can be adapted to the culture, geography, and demography of the population and individuals in any country. Objectives: We aimed to describe the daily energy intake from food groups and subgroups in Mexican adults relative to the EAT-HRD and propose an adaptation of the EAT-HRD to the Mexican context. Methods: We analyzed data from the Mexican National Health and Nutrition Surveys in 2012 and 2016. Diet information was obtained using the 5-step multiple-pass 24-h dietary recall method. We estimated the mean energy intake from food groups and subgroups and compared these figures with the midpoint of the EAT-HRD and with the Mexican Dietary Guidelines (MDGs). We also proposed an adaptation of the EAT-HRD to the Mexican context based on the mean energy intake and the comparison between the MIX1s and the EAT-HRD. Results: Mexican adults consume higher than the EAT-HRD for grains (mostly refined), dairy, added sugars, and animal-based proteins (particularly red meat, poultry, eggs, and processed meats); and lower than the EAT-HRD for vegetables, fruits, legumes, nuts, tubers and starchy vegetables, fish, and added fats. Based on these findings, we propose a healthy and sustainable reference diet adapted for the Mexican population. Conclusions: Mexican adults have a diet that is far from being healthy and is not sustainable. The adaptation of the EAT-HRD to the Mexican context is a timely input for current government efforts to move to a sustainable and healthy food system. including the update of the current MDGs.