Association between Planetary Health Diet and fatal/non-fatal major disease events in UK Biobank

Abstract Background The Planetary Health Diet (PHD) has been associated with lower risk of cardiovascular disease (CVD) and all-cause mortality. However, evidence on its relationship with other major conditions including metabolic diseases and cancer remains limited. This study aimed to investigate the association between adherence to the PHD and the incident events and mortality of metabolic diseases, cancer, and CVD in the UK Biobank cohort. Methods Adherence to the PHD was assessed using 24-hour dietary assessments and scored on a 0-130 scale. PHD scores were categorized into quintiles. Incident cases of metabolic diseases (hypertension and kidney disease), CVD, and four diet-related cancer were identified from hospital and primary care records, while cause-specific mortality data for the same conditions were obtained from death certificates. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for sociodemographic variables, lifestyle, and health-related confounders. Results A total of 167,231 participants were followed up for a median of 11 years. Compared to those in the lowest quintile of adherence, participants in the highest quintile had a significantly lower risk of developing hypertension (HR: 0.83; 95% CI: 0.75-0.91), kidney disease (HR: 0.67; 95% CI: 0.56-0.80), CVD (HR: 0.87; 95% CI: 0.82-0.92), colorectal cancer (HR: 0.79; 95% CI: 0.67-0.93), and cancer (HR: 0.94; 95% CI: 0.90-0.99). Higher adherence was also associated with a reduced mortality risk of cancer (HR:0.76; 95% CI: 0.69-0.84), CVD (HR: 0.89; 95% CI: 0.77-0.99), and all-cause (HR: 0.78; 95% CI: 0.72-0.84), adjusted for confounders. Conclusions Greater adherence to the Planetary Health Diet was associated with a lower risk of metabolic conditions, colorectal cancer, and cardiovascular disease, as well as lower mortality. These associations were independent of key confounders, including adiposity. Key messages • Greater adherence to the Planetary Health Diet is linked to lower risk of major chronic diseases and mortality, independent of major confounding factors including adiposity. • Our findings support the Planetary Health Diet as a protective dietary pattern for human health.