Abstract
BACKGROUND: The EAT-Lancet planetary health diet (PHD) has been designed to benefit both human and planetary health, but questions remain regarding its nutritional adequacy. OBJECTIVES: This study aimed to assess the nutritional adequacy of the PHD by evaluating diets in the United Kingdom (UK) population and comparing the PHD with the Mediterranean diet. METHODS: Dietary data from participants aged ≥15 y from the nationally representative, serial, cross-sectional UK National Diet and Nutrition Survey (2008-2019) who completed 4-d food diaries (n = 9671) were analyzed. Nutritional biomarkers were available in a subset (n = 4622). Alignment with the PHD was assessed based on consumption of 14-food components (PHD score range 0-140). Analyses were age-stratified and adjusted for sociodemographic, behavioral, and anthropometric factors. RESULTS: At the national level, some nutrient intakes were inadequate: for example, ∼50% of the population showed inadequate intakes for iron, zinc, and calcium. The population mean ± standard deviation PHD score was 75.8 ± 13.9 points. Higher alignment with the PHD was associated with a greater likelihood of nutritional adequacy for various nutrients. Positive associations were observed for most vitamins and minerals, with adjusted odds ratios (95% confidence intervals) per 20-point higher PHD score of 2.40 (2.10, 2.76) for iron, 1.26 (1.13, 1.42) for zinc, 1.81 (1.60, 2.04) for calcium, and 3.35 (2.17, 5.16) for vitamin D. No overall association with the PHD was seen for vitamin B12 [0.80 (0.59,1.08)] intake. Either positive or no associations were found between PHD score and nutritional biomarkers. These findings did not differ materially by subgroup or when compared with a Mediterranean-type diet for selected nutrients of concern and their biomarkers. CONCLUSIONS: Nutritional adequacy was either better or unchanged with greater alignment to the PHD, suggesting that the PHD is unlikely to present concerns of nutritional inadequacy at the population level in the UK.