Nair Nilendra K, Bui Linh P, Sawicki Caleigh M, Kandula Namratha R, Kanaya Alka M, Lee Kyu Ha, Stampfer Meir J, Willett Walter C, Bhupathiraju Shilpa N
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Curr Dev Nutr. 2025 May 19;9(6):107468. doi: 10.1016/j.cdnut.2025.107468. eCollection 2025 Jun.
The global food system significantly impacts environmental and human health, contributing to substantial greenhouse gas emissions.
We examined associations between a novel Planetary Health Diet Index (PHDI) that reflects adherence to the EAT-Lancet recommendations and cardiometabolic risk in a cohort of South Asians.
We analyzed data from MASALA study participants with baseline ( = 891) and 5-y follow-up ( = 735) data. The PHDI comprised 15 food components and ranged from 0 to a maximum of 140, with higher scores indicating greater adherence to the PHDI. We used multivariable linear and logistic regression models to examine cross-sectional and prospective (5-y) associations between baseline PHDI and cardiometabolic risk factors, adjusting for demographic, health, and lifestyle factors and baseline values of the outcome (prospective analyses only).
Among MASALA study participants (47% female, mean age 55 y), the mean PHDI score was 88.8 (SD 9.47). Prospectively, higher PHDI was associated with lower percentage difference in fasting glucose (-0.29 ± 0.15 %), glycated hemoglobin (HbA1c) (-0.08 ± 0.04%), higher high-density lipoprotein (0.40 ± 0.17 mmol/L), lower body weight (-0.37 ± 0.12 kg), body mass index (BMI) (-0.08 ± 0.03 kg/m), waist circumference (-0.49 ± 0.17 cm), and systolic blood pressure (-0.65 ± 0.30 mmHg) ( < 0.05 for all). Each 10-unit higher PHDI was associated with a 20% lower likelihood of incident type 2 diabetes (OR [95% CI]: 0.80 [0.54, 0.86]). Cross-sectionally, at baseline, 10 unit higher PHDI was associated with (β ± SE) lower percentage difference in fasting glucose (-0.45 ± 0.22 %) and HbA1c (-0.49 ± 0.22%), lower LDL (-0.015 ± 0.007 mmol/L), CRP (-5.40 ± 2.42 ug/L), higher adiponectin (4.67 ± 2.02 mg/dL), lower body weight (-0.59 ± 0.26 kg), BMI (-0.27 ± 0.11 kg/m), waist circumference (-025 ± 0.29 cm), visceral fat (-1.37 ± 1.32 cm), and pericardial fat (-0.58 ± 0.43 cm) ( < 0.05 for all). Higher PHDI scores were associated with lower odds of obesity (OR [95% CI]: 0.80 [0.71, 0.92]) and overweight (0.77 [0.74, 0.85]).
Greater adherence to a planetary healthy diet was associated with lower cardiometabolic risk factors and risk of incident type 2 diabetes.
全球粮食系统对环境和人类健康有重大影响，导致大量温室气体排放。
我们在一组南亚人群中研究了一种反映对《柳叶刀》饮食建议遵循程度的新型行星健康饮食指数（PHDI）与心血管代谢风险之间的关联。
我们分析了来自MASALA研究参与者的基线（n = 891）和5年随访（n = 735）数据。PHDI包含15种食物成分，范围从0到最高140分，分数越高表明对PHDI的遵循程度越高。我们使用多变量线性和逻辑回归模型来研究基线PHDI与心血管代谢风险因素之间的横断面和前瞻性（5年）关联，并对人口统计学、健康和生活方式因素以及结局的基线值进行了调整（仅前瞻性分析）。
在MASALA研究参与者中（47%为女性，平均年龄55岁），PHDI平均得分为88.8（标准差9.47）。前瞻性地，较高的PHDI与空腹血糖百分比差异降低（-0.29±0.15%）、糖化血红蛋白（HbA1c）降低（-0.08±0.04%）、高密度脂蛋白升高（0.40±0.17 mmol/L）、体重降低（-0.37±0.12 kg）、体重指数（BMI）降低（-0.08±0.03 kg/m²）、腰围降低（-0.49±0.17 cm）和收缩压降低（-0.65±0.30 mmHg）相关（所有P<0.05）。PHDI每升高10分，2型糖尿病发病风险降低20%（比值比[95%置信区间]：0.80[0.54, 0.86]）。横断面分析中，在基线时，PHDI每升高10分与空腹血糖百分比差异降低（-0.45±0.22%）和HbA1c降低（-0.49±0.22%）、低密度脂蛋白降低（-0.015±0.007 mmol/L）、C反应蛋白降低（-5.40±2.42 μg/L）、脂联素升高（4.67±2.02 mg/dL）、体重降低（-0.59±0.26 kg）、BMI降低（-0.27±0.11 kg/m²）、腰围降低（-0.25±0.29 cm）、内脏脂肪降低（-1.37±1.32 cm）和心包脂肪降低（-0.58±0.43 cm）相关（所有P<0.05）。较高的PHDI分数与肥胖（比值比[95%置信区间]：0.80[0.71, 0.92]）和超重（0.77[0.74, 0.85]）的较低几率相关。
更高程度地遵循行星健康饮食与较低的心血管代谢风险因素和2型糖尿病发病风险相关。
