Planetary Health Diet Index and risk of total and cause-specific mortality in three prospective cohorts
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Planetary Health Diet Index and risk of total and cause-specific mortality in three prospective cohorts. / Bui, Linh P.; Pham, Tung T.; Wang, Fenglei; Chai, Boyang; Sun, Qi; Hu, Frank B.; Lee, Kyu Ha; Guasch-Ferre, Marta; Willett, Walter C.
In: American Journal of Clinical Nutrition, Vol. 120, No. 1, 2024, p. 80-91.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Planetary Health Diet Index and risk of total and cause-specific mortality in three prospective cohorts
AU - Bui, Linh P.
AU - Pham, Tung T.
AU - Wang, Fenglei
AU - Chai, Boyang
AU - Sun, Qi
AU - Hu, Frank B.
AU - Lee, Kyu Ha
AU - Guasch-Ferre, Marta
AU - Willett, Walter C.
N1 - Publisher Copyright: © 2024 American Society for Nutrition
PY - 2024
Y1 - 2024
N2 - Background: In 2019, the EAT-Lancet Commission proposed a healthy dietary pattern that, along with reductions in food waste and improved agricultural practices, could feed the increasing global population sustainably. We developed a Planetary Health Diet Index (PHDI) to quantify adherence to the EAT-Lancet reference diet. Objectives: We aimed to assess associations between PHDI and total and cause-specific mortality in 3 prospective cohorts of males and females in the United States. Methods: We followed 66,692 females from the Nurses’ Health Study (1986–2019), 92,438 females from the Nurses’ Health Study II (1989–2019), and 47,274 males from the Health Professionals Follow-up Study (1986–2018) who were free of cancer, diabetes, and major cardiovascular diseases at baseline. The PHDI was calculated every 4 y using a semiquantitative food frequency questionnaire. Hazard ratios (HRs) were calculated using multivariable proportional-hazards models. Results: During follow-up, we documented 31,330 deaths among females and 23,206 among males. When comparing the highest with the lowest quintile of PHDI, the pooled multivariable-adjusted HRs were 0.77 [95% confidence interval (CI): 0.75, 0.80] for all-cause mortality (P-trend < 0.0001). The PHDI was associated with lower risk of deaths from cardiovascular diseases (HR: 0.86; 95% CI: 0.81, 0.91), cancer (HR: 0.90; 95% CI: 0.85, 0.95), respiratory diseases (HR: 0.53; 95% CI: 0.48, 0.59), and neurodegenerative diseases (HR: 0.72; 95% CI: 0.67, 0.78). In females, but not males, the PHDI was also significantly associated with a lower risk of deaths from infectious diseases (HR: 0.62; 95% CI: 0.51, 0.76). PHDI scores were also associated inversely with greenhouse gas emissions and other environmental impacts. Conclusions: In 3 large United States-based prospective cohorts of males and females with up to 34 y of follow-up, a higher PHDI was associated with lower risk of total and cause-specific mortality and environment impacts.
AB - Background: In 2019, the EAT-Lancet Commission proposed a healthy dietary pattern that, along with reductions in food waste and improved agricultural practices, could feed the increasing global population sustainably. We developed a Planetary Health Diet Index (PHDI) to quantify adherence to the EAT-Lancet reference diet. Objectives: We aimed to assess associations between PHDI and total and cause-specific mortality in 3 prospective cohorts of males and females in the United States. Methods: We followed 66,692 females from the Nurses’ Health Study (1986–2019), 92,438 females from the Nurses’ Health Study II (1989–2019), and 47,274 males from the Health Professionals Follow-up Study (1986–2018) who were free of cancer, diabetes, and major cardiovascular diseases at baseline. The PHDI was calculated every 4 y using a semiquantitative food frequency questionnaire. Hazard ratios (HRs) were calculated using multivariable proportional-hazards models. Results: During follow-up, we documented 31,330 deaths among females and 23,206 among males. When comparing the highest with the lowest quintile of PHDI, the pooled multivariable-adjusted HRs were 0.77 [95% confidence interval (CI): 0.75, 0.80] for all-cause mortality (P-trend < 0.0001). The PHDI was associated with lower risk of deaths from cardiovascular diseases (HR: 0.86; 95% CI: 0.81, 0.91), cancer (HR: 0.90; 95% CI: 0.85, 0.95), respiratory diseases (HR: 0.53; 95% CI: 0.48, 0.59), and neurodegenerative diseases (HR: 0.72; 95% CI: 0.67, 0.78). In females, but not males, the PHDI was also significantly associated with a lower risk of deaths from infectious diseases (HR: 0.62; 95% CI: 0.51, 0.76). PHDI scores were also associated inversely with greenhouse gas emissions and other environmental impacts. Conclusions: In 3 large United States-based prospective cohorts of males and females with up to 34 y of follow-up, a higher PHDI was associated with lower risk of total and cause-specific mortality and environment impacts.
KW - diet pattern
KW - mortality
KW - planetary health diet
KW - prospective cohort
KW - sustainable diet
U2 - 10.1016/j.ajcnut.2024.03.019
DO - 10.1016/j.ajcnut.2024.03.019
M3 - Journal article
AN - SCOPUS:85196754399
VL - 120
SP - 80
EP - 91
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
SN - 0002-9165
IS - 1
ER -
ID: 396939318