Li Zhaoyu, Ye Kaisy Xinhong, Yang Mengxue, Lee Tih-Shih, Suckling John, Feng Lei, Wang Zhenglian, Chen Chen
School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
Food Res Int. 2025 Nov;219:116977. doi: 10.1016/j.foodres.2025.116977. Epub 2025 Jun 30.
The planetary health diet (PHD) proposed by the EAT-Lancet Commission, advocates for reduced meat and dairy intake while emphasizing the consumption of whole grains, fruits, vegetables, nuts, and legumes. Existing studies have shown that the PHD can lower mortality rates and slow cognitive decline in various populations. However, its specific effects on cognitive impairment among elderly individuals in China remain unclear, primarily due to regional socioeconomic and cultural differences. This study utilizes data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to create the animal diet index (ADI) and the planetary health diet index (PHDI). We employed multivariable Cox proportional hazards regression models to assess the associations between these dietary indices and the risk of cognitive impairment in elderly participants. The research also examines the impact of grain intake and its relationship with environmental indicators, including greenhouse gas emissions, water footprint, and land use. Our results reveal that a higher PHDI is significantly correlated with a lower risk of cognitive impairment (HR = 0.539), while a higher ADI is associated with an increased risk (HR = 1.379). Furthermore, increased grain intake is associated with reduced cognitive impairment (HR = 0.729). Notably, the PHDI is linked to greater environmental burdens, contrasting with the ADI's association with lower grain-related environmental impacts. Stratified analyses indicate the PHD is protective across most regions, while the risks associated with animal-based diets are consistent. These findings suggest that while adherence to the PHD and increased grain intake may enhance cognitive health, they may also reflect trade-offs with environmental sustainability across China. Consequently, this study informs dietary strategies that aim to balance health and environmental concerns, emphasizing the need for context-specific approaches to dietary transitions.
由EAT-柳叶刀委员会提出的行星健康饮食（PHD）提倡减少肉类和奶制品的摄入量，同时强调全谷物、水果、蔬菜、坚果和豆类的消费。现有研究表明，行星健康饮食可以降低不同人群的死亡率并减缓认知衰退。然而，其对中国老年人认知障碍的具体影响仍不明确，主要是由于地区社会经济和文化差异。本研究利用中国健康与养老追踪调查（CLHLS）的数据创建动物饮食指数（ADI）和行星健康饮食指数（PHDI）。我们采用多变量Cox比例风险回归模型来评估这些饮食指数与老年参与者认知障碍风险之间的关联。该研究还考察了谷物摄入量的影响及其与环境指标的关系，包括温室气体排放、水足迹和土地利用。我们的结果显示，较高的行星健康饮食指数与较低的认知障碍风险显著相关（风险比=0.539），而较高的动物饮食指数则与风险增加相关（风险比=1.379）。此外，谷物摄入量增加与认知障碍减少相关（风险比=0.729）。值得注意的是，行星健康饮食指数与更大的环境负担相关，这与动物饮食指数与较低的谷物相关环境影响的关联形成对比。分层分析表明，行星健康饮食在大多数地区具有保护作用，而与动物性饮食相关的风险则是一致的。这些发现表明，虽然坚持行星健康饮食和增加谷物摄入量可能会增强认知健康，但它们也可能反映了中国各地在健康与环境可持续性之间的权衡。因此，本研究为旨在平衡健康和环境问题的饮食策略提供了信息，强调了针对饮食转变采取因地制宜方法的必要性。
