Adherence to the EAT-Lancet reference diet and risk of type 2 diabetes: results from the NutriNet-Santé cohort study
In 2019, the EAT-Lancet Commission introduced a planetary, healthy, and reference diet aimed at alleviating the global health and environmental challenges posed by existing dietary habits. This study investigates the relationship between the EAT-Lancet reference diet and the risk of type 2 diabetes (T2D).
We conducted an observational and prospective web-based study using data from 88,964 adults involved in the French NutriNet-Santé cohort from 2009 to 22 (with 78.8% being female; the mean (SD) baseline age of participants was 43.8 (14.5) years). Dietary intakes were evaluated through at least three repeated 24-hour dietary records (mean = 6.3 (2.8)). The endpoint was the occurrence of incident T2D. The primary exposure was the EAT-Lancet diet index (ELD-I), modeled as a continuous variable and categorised into sex-specific quintiles (Qs). Hazard ratios (HRs) and confidence intervals (CIs) were calculated using Cox proportional hazards models, adjusted for potential confounders. The potential mediating effect of body mass index (BMI) in this relationship was also examined.
During the follow-up period (median = 8.79 years), 812 cases of incident T2D were reported. The ELD-I scores ranged from −192 to 429 points, with a median (interquartile range [IQR]) of 42.8 (29.1) points. Each 25.7-point increase in the ELD-I score (1SD) corresponded to an 11% reduction in T2D risk (HR1SD: 0.89; 95% CI: 0.82–0.96; P = .003). The association was mediated by BMI up to 61%.
This large cohort study indicates that greater adherence to the EAT-Lancet reference diet correlates with a reduced risk of developing T2D beyond the influence of BMI. These findings reinforce previous research, highlighting the value of the EAT-Lancet reference diet as a healthy and sustainable dietary option.
- Adherence to the EAT-Lancet reference diet and risk of type 2 diabetes: results from the NutriNet-Santé cohort study Get access Arrow : Florine Berthy, Benjamin Allès, Léopold K Fezeu, Denis Lairon, Philippe Pointereau, Mathilde Touvier, Serge Hercberg, Pilar Galan, Julia Baudry, Emmanuelle Kesse-Guyot
- International Journal of Epidemiology, Volume 54, Issue 3, June 2025, dyaf011, https://doi.org/10.1093/ije/dyaf011
By Emmanuelle Kesse-Guyot
