Citation: Berthy, F., Toujgani, H., Duquenne, P., Fezeu, L. K., Lairon, D., Pointereau, P., Touvier, M., Hercberg, S., Galan, P., Alles, B., Baudry, J., & Kesse-Guyot, E. (2025). Prospective association of the EAT-Lancet reference diet with body weight changes and incidence of overweight and obesity in a French cohort. The American Journal of Clinical Nutrition, 122(3), 450–459. https://doi.org/10.1093/ajcn/nqaa123
Abstract
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/m²], and obesity (BMI 30 kg/m²), 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 years), 4,250 and 1,604 persons became overweight and obese, respectively. We observed an inverse association between the level of ELD-I and gain in BW (in kg) [βQ5 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) Q5 compared with Q1: 0.60; 95% CI: 0.54, 0.66; P-trend < 0.0001] and obesity status (HR Q5 compared with Q1: 0.54; 95% CI: 0.45, 0.63; P-trend < 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.
updated 2025 November
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