Adherence to the EAT-Lancet diet in midlife and development in weight or waist circumference after five years in a Danish cohort

Purpose

The EAT-Lancet reference diet has been proposed as a healthy dietary pattern to reduce food-related climate impacts, but little is known regarding associations with bodyweight development. This study investigated adherence to the EAT-Lancet diet in midlife and development in weight and waist circumference (WC) after five years.

Design

The Danish Diet, Cancer and Health cohort recruited participants in 1993–1997. At baseline, data on diet, lifestyle, and anthropometry were collected. Participants self-reported weight and WC five years later. In total, 44,194 participants were included in analyses of weight (43,678 for WC). Baseline adherence to the EAT-Lancet diet was scored 0–14 points. Multiple linear regression was used to estimate associations between the EAT-Lancet diet and development in weight and WC after five years. Poisson regression was used to estimate risk ratios (RR) of obesity (≥30 kg/m²) or elevated WC.

Results

Adherence to the EAT-Lancet diet was not associated with follow-up weight, adjusting for baseline weight and confounders (11–14 vs 0–7 points β: -0.08, 95% CI: -0.27, 0.11 kg), but was associated with lower follow-up WC adjusting for baseline WC and confounders (β: -0.38, 95% CI: -0.69, -0.07 cm), and was associated with lower risk of obesity and elevated WC (RR 0.89, 95% CI: 0.82, 0.98, and 0.95, 95% CI: 0.93, 0.96, respectively).

Conclusion

Adherence to the EAT-Lancet diet in midlife was associated with lower WC but not weight after five years follow up, taking baseline into account. Our findings suggest that greater adherence to the EAT-Lancet diet does not contribute to development of obesity.