Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
Linyi University, Linyi, Shandong, China.
Clin Nutr. 2024 Dec;43(12):167-179. doi: 10.1016/j.clnu.2024.10.021. Epub 2024 Oct 19.
BACKGROUND & AIMS: In 2019, the EAT-Lancet Commission promoted a plant-based diet, emphasizing its potential to enhance human health and environmental sustainability. Nevertheless, a thorough evaluation of health benefits associated with EAT-Lancet diet requires robust statistical backing. This synthesis seeks to compile evidence related to the effects of the EAT-Lancet diet on major cardiovascular disease (CVD) and mortality.
A systematic review and meta-analysis were conducted utilizing data from MEDLINE, EMBASE, PubMed, Web of Science, and medRxiv, covering the period from January 2019 to October 8, 2024. We included all cohort and case-control studies that investigated the association between the emerging EAT-Lancet diet and outcomes such as diabetes, CVD, all-cause mortality, and cancer. Summary effect size estimates are presented as hazard ratios (HRs) and were analyzed using random-effects models. Study heterogeneity was assessed with the Q statistic and I statistic. Subgroup analyses were performed to identify potential sources of variability, while publication bias was evaluated using Begg's and Egger's tests. Additionally, sensitivity analyses were conducted to assess the robustness of the results.
We identified 28 publications that included a total of over 2.21 million participants. Adhering to the EAT-Lancet dietary patterns was negatively associated with diabetes, CVD (mortality), all-cause mortality, and cancer (mortality), with HRs of 0.78 (95 % CI: 0.65-0.92), 0.84 (95 % CI: 0.81-0.87), 0.83 (95 % CI: 0.78-0.89), and 0.86 (95 % CI: 0.80-0.92), respectively. Significant heterogeneity was observed for diabetes (I = 94.0 %), all-cause mortality (I = 85.5 %), and cancer incidence (I = 79.3 %). Importantly, no evidence of publication bias was found for any of the clinical outcomes analyzed. Sensitivity analyses confirmed the robustness of the results across various dietary scoring systems for CVD mortality, all-cause mortality, and cancer.
Following the EAT-Lancet diet was significantly associated with reduced odds of diabetes, CVD, cancer and mortality. These findings are clinically important, highlighting the beneficial effects of the recent EAT-Lancet diet on various health outcomes.
2019 年，EAT-Lancet 委员会提倡以植物为基础的饮食，强调其对人类健康和环境可持续性的潜在益处。然而，要全面评估 EAT-Lancet 饮食与健康益处之间的关联，需要强有力的统计支持。本综述旨在汇总与 EAT-Lancet 饮食对主要心血管疾病（CVD）和死亡率影响相关的证据。
系统检索了 MEDLINE、EMBASE、PubMed、Web of Science 和 medRxiv 数据库，检索时间为 2019 年 1 月至 2024 年 10 月 8 日，纳入了所有队列和病例对照研究，以评估新兴的 EAT-Lancet 饮食与糖尿病、CVD、全因死亡率和癌症等结局之间的关联。使用随机效应模型呈现汇总效应大小估计值，即危险比（HR）。使用 Q 统计量和 I 统计量评估研究异质性。进行亚组分析以确定潜在的变异性来源，使用 Begg 和 Egger 检验评估发表偏倚。此外，还进行了敏感性分析以评估结果的稳健性。
我们确定了 28 篇包含超过 221 万参与者的研究。遵循 EAT-Lancet 饮食模式与糖尿病、CVD（死亡率）、全因死亡率和癌症（死亡率）呈负相关，HR 分别为 0.78（95%CI：0.65-0.92）、0.84（95%CI：0.81-0.87）、0.83（95%CI：0.78-0.89）和 0.86（95%CI：0.80-0.92）。糖尿病（I²=94.0%）、全因死亡率（I²=85.5%）和癌症发生率（I²=79.3%）存在显著的异质性。对于分析的所有临床结局，均未发现发表偏倚的证据。敏感性分析证实了 CVD 死亡率、全因死亡率和癌症不同饮食评分系统结果的稳健性。
遵循 EAT-Lancet 饮食与糖尿病、CVD、癌症和死亡率降低显著相关。这些发现具有重要的临床意义，突显了最近的 EAT-Lancet 饮食对各种健康结局的有益影响。
