Berthy Florine, Toujgani Hafsa, Duquenne Pauline, Fezeu Léopold K, Lairon Denis, Pointereau Philippe, Touvier Mathilde, Hercberg Serge, Galan Pilar, Allès Benjamin, Baudry Julia, Kesse-Guyot Emmanuelle
Université Sorbonne Paris Nord and Université Paris Cité, Inserm, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France.
Aix Marseille Université, CV2N, Inserm, INRAE, Marseille, France.
Am J Clin Nutr. 2025 Aug;122(2):450-459. doi: 10.1016/j.ajcnut.2025.06.013. Epub 2025 Jun 17.
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. OBJECTIVES: This study aimed to investigate the association of the EAT-Lancet reference diet with body weight (BW) changes, incidences of overweight [body mass index (BMI) ≥25 kg/m], and obesity (BMI ≥30 kg/m), 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 BW was examined using multivariable linear mixed models. For the incidences of overweight and obesity, multivariable Cox proportional hazards models were employed. RESULTS: During follow-up (median = 8.7 y), 4250 and 1604 persons became overweight and obese, respectively. We observed an inverse association between the level of ELD-I and gain in BW (in kg) [β × time = -0.18; 95% confidence interval (CI): -0.20, -0.16; P < 0.0001]. Higher level of ELD-I was associated with lower risks of reaching overweight [hazard ratio (HR): 0.60; 95% CI: 0.54, 0.66; <0.0001] and obesity status (HR: 0·54; 95% CI: 0.45, 0.63; p <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 lower BW 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. This trial was registered at clinicaltrials.gov as NCT03335644.
背景：肥胖已成为全球重大的公共卫生问题。为应对饮食模式带来的健康和环境双重挑战，“柳叶刀饮食委员会”推荐了一种促进健康的地球健康饮食。 目的：本研究旨在调查在一个大型法国队列中，“柳叶刀饮食委员会”参考饮食与体重（BW）变化、超重（体重指数[BMI]≥25kg/m²）和肥胖（BMI≥30kg/m²）发生率之间的关联。 方法：该研究分析了2009年至2023年间参与法国NutriNet-Santé队列的51711名成年人的数据。通过“柳叶刀饮食委员会”饮食指数（ELD-I）评估对“柳叶刀饮食委员会”参考饮食的依从水平来衡量暴露情况，将其分为按性别划分的五分位数（Qs），并作为连续变量。使用多变量线性混合模型检查ELD-I与BW变化之间的关系。对于超重和肥胖的发生率，采用多变量Cox比例风险模型。 结果：在随访期间（中位数=8.7年），分别有4250人和1604人超重和肥胖。我们观察到ELD-I水平与BW增加（以千克为单位）之间呈负相关[β×时间=-0.18；95%置信区间（CI）：-0.20，-0.16；P<0.0001]。ELD-I水平越高，随访期间达到超重[风险比（HR）：0.60；95%CI：0.54，0.66；P<0.0001]和肥胖状态（HR：0.54；95%CI：0.45，0.63；P<0.0001）的风险越低。 结论：这项全面的前瞻性观察研究表明，更强地坚持“柳叶刀饮食委员会”参考饮食与较低的BW以及降低超重和肥胖风险相关。推广可持续的植物性饮食似乎是应对肥胖这一全球公共卫生挑战的有效策略。该试验已在clinicaltrials.gov上注册，注册号为NCT03335644。
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