Planet-friendly diet helps prevent CVD

Diets that are friendly for the planet are also good for human health, according to a study.

“In this study we examined the association between adherence to a planetary-healthy diet and 20-year incidence of cardiovascular disease (CVD),” the researchers said.

“We found that adherence to a planetary-healthy diet, the EAT-Lancet Reference Diet (EAT-LD), was strongly associated with lower 20-year CVD incidence,” they added.

At 20 years, CVD incidence reached 3,600 cases per 10,000 individuals (95 percent confidence interval [CI], 3,506‒3,695). The median values were 17 out of 42 points for EAT-Lancet Index and 27 out of 55 for the MedDietScore. [Eur J Clin Nutr 2025;79:536-543]

The two diet scales showed an inverse relationship with 20-year CVD incidence (EAT-Lancet Index: hazard ratio [HR], 0.83, 95 percent CI, 0.77‒0.90; MedDietScore: HR, 0.90, 95 percent CI, 0.84‒0.93).

“Our findings highlight that diets that are good for planetary health are also healthy for humans,” the researchers said. “Promoting diets that are culturally acceptable, economically viable, easily accessible, planet-friendly, and sustainable should be a key strategy for enhancing both public and planetary health.”

Mechanism

Previous studies have examined the mechanisms by which healthy, plant-based diets such as Mediterranean diet or EAT-LD reduce CVD risk. [Curr Nutr Rep 2015;4:313-322; Nutr Bull 2016;41:323-338; Curr Atheroscler Rep 2019;21:1-8; Front Cardiovasc Med 2021;8:756810; Trends Cardiovasc Med 2018;28:437-441]

In essence, plant-based diets rich in fruits, vegetables, whole grains, healthy fats, nuts and legumes, as well as coffee and tea, translate to the “consumption of low energy-density foods, high dietary fibre, beneficial fat ratios, antioxidants, micronutrients, and vitamins.”

This dietary pattern can improve CVD risk factors, including better lipid profiles, blood pressure, glycaemic control, body weight control, vascular health, inflammation and gut microbial profiles, and lower CVD risk.

Several studies have also examined the effect of EAT-LD on CVD risk, and the current findings are consistent with these studies. [Am J Clin Nutr 2022;116:980-991; J Am Heart Assoc 2023;12:e026318; Stroke 2022;53:154-163; Lancet 2019;394:213-214; Am J Clin Nutr 2023;117:903-909]

“It should be noted that different scores have been used to compute the adherence to the EAT-LD, as is also the case for the MTD,” according to the researchers. “Concerning the MTD, MedDietScore along with two other scores has the greatest amount of evidence, while for the EAT-LD no comparison has been performed between the different indexes used.” [BMJ Open 2018;8:e019033]

Notably, the EAT-LD has been shown to be inadequate for some micronutrients, particularly those found in higher amounts in animal-based foods (eg, iron, zinc, calcium, vitamin B12). [Lancet Planet Health 2023;7:e233-e237; Am J Clin Nutr 2023;117:1174-1185; Am J Clin Nutr 2024;119:384-392]

Method

The current prospective cohort study had its baseline phase in 2002 and three consecutive follow-ups in 2006, 2012, and 2022. Researchers calculated the EAT-Lancet Index and the MedDietScore scales based on previously published guidelines to assess the adherence to these dietary patterns.

The cohort included 1,988 Greek adults initially free of CVD at baseline. The development of a cardiovascular event was examined throughout the 20-year period.