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-h 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 was fitted to models that included DASH, EAT and MDS as dependent variables to assess associations between healthy sustainable diet indicators and dietary cost and eating OH. Adjusted models were controlled for BMI, sex and total energy intake (kJ) 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 (IRR): 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 is warranted in Albania.

中文翻译：

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坚持健康和可持续的饮食不以成本区分，而是以阿尔巴尼亚年轻人的食物来源区分

营养食品的高成本和外出就餐 (OH) 可能是健康和可持续饮食的障碍。我们检查了对停止高血压的饮食方法 (DASH)、EAT– 的依从性柳叶刀参考饮食 (EAT) 和地中海饮食评分 (MDS) 以及与饮食成本和饮食 OH 的关联。我们评估了来自阿尔巴尼亚地拉那的 289 名年轻人（18-24 岁）的单次多次 24 小时饮食召回的横断面数据。膳食成本（以阿尔巴尼亚列克 (ALL) 计）通过将食品消费数据与当地快餐连锁店、超市、餐馆和食品供应商的零售价格相匹配来估算。泊松回归拟合模型，包括 DASH、EAT 和 MDS 作为因变量，以评估健康可持续饮食指标与饮食成本和饮食 OH 之间的关联。使用残差法控制调整后的模型的 BMI、性别和总能量摄入 (kJ)。我们的研究结果表明，阿尔巴尼亚年轻男女对健康和可持续饮食模式的依从性相对较差。此外，磷> 0·05)。尽管如此，吃 OH 与较低的 DASH 依从性有关（IRR：0·79；磷= 0·003) 和 MDS (IRR: 0·69;磷< 0·001)。总之，对健康和可持续饮食模式的坚持很差，而且不以成本区分，而是以食物来源（即 OH 或在家）来区分。阿尔巴尼亚有必要进一步研究这些发现对公共和环境健康的潜在影响。