Prospective association of the EAT-Lancet reference diet with body weight changes and incidence of overweight and obesity in a French cohort
Florine Berthy, Hafsa Toujgani, Pauline Duquenne, Léopold Fezeu, Denis Lairon, Philippe Pointereau, Mathilde Touvier, Serge Hercberg, Pilar Galán, Benjamin Allès, Julia Baudry, Emmanuelle Kesse‐Guyot
Abstract
Background Obesity has emerged as a significant public health issue globally. In response to the dual health and environmental challenges posed by dietary patterns, the EAT-Lancet Commission recommended a planetary health diet that promotes well-being. The present study aimed to investigate the association of the EAT-Lancet reference diet with body weight changes, incidences of overweight (Body Mass Index (BMI)≥25 kg/m 2 ) and obesity (BMI≥30 kg/m 2 ), in a large French cohort. Methods The study analyzed data from 51,711 adults who participated in the French NutriNet-Santé cohort between 2009 and 2023. Exposure was measured by the level of adherence to the EAT-Lancet reference diet, evaluated through the EAT-Lancet Diet Index (ELD-I), categorized into sex-specific quintiles (Qs) and as a continuous variable. The relationship between ELD-I and changes in body weight (BW) was examined using multivariable linear mixed models. For the incidences of overweight and obesity, multivariable Cox proportional hazards models were employed. Findings During follow-up (median=8·7y), 4,250 and 1,604 persons became overweight and obese, respectively. We observed an inverse association between the level of ELD-I and gain in BW (in kg) (β Q5 ×time=-0.18;95% CI:-0.20, -0.16; p<0·0001). Higher level of ELD-I was associated with lower risks of reaching overweight (HR Q5 compared with Q1 : 0·60; 95% CI:0·54, 0·66; p -trend <0·0001) and obesity status (HR Q5 compared with Q1 :0·54; 95% CI:0·45, 0·63; p -trend <0·0001) during follow-up. Conclusions This comprehensive prospective observational study revealed that a stronger adherence to the EAT-Lancet reference diet is associated with a lower body weight and reduced risks of overweight and obesity. Promoting a sustainable plant-based diet seems to be an effective strategy for addressing the global public health challenge of obesity. Trial registration Https://clinicaltrials.gov/study/NCT03335644