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Planetary health diet index and risk of irritable bowel syndrome : a prospective cohort study

Xu, Xinyu ; Dong, Yang ; Hu, Jingxi ; He, Zitong ; Borné, Yan LU ; Sonestedt, Emily LU orcid ; Huang, Tao and Zhang, Shunming LU (2026) In European Journal of Nutrition 65(5).
Abstract

BACKGROUND: The EAT-Lancet Commission introduced the planetary health diet to promote human health while reducing environmental impact. However, no study has yet examined how adherence to this diet is associated with risk of irritable bowel syndrome (IBS).

OBJECTIVE: This study aimed to investigate the association between the planetary health diet index (PHDI) and the risk of developing IBS.

METHODS: This prospective cohort study included 177,754 participants (mean age: 55.6 ± 7.93 years, 44.8% males) free of IBS at baseline from the UK Biobank who completed at least one 24-h dietary assessment in 2009-2012. Adherence to the PHDI was quantified using a diet score ranging from 0 to 140 points. Incident IBS was identified... (More)

BACKGROUND: The EAT-Lancet Commission introduced the planetary health diet to promote human health while reducing environmental impact. However, no study has yet examined how adherence to this diet is associated with risk of irritable bowel syndrome (IBS).

OBJECTIVE: This study aimed to investigate the association between the planetary health diet index (PHDI) and the risk of developing IBS.

METHODS: This prospective cohort study included 177,754 participants (mean age: 55.6 ± 7.93 years, 44.8% males) free of IBS at baseline from the UK Biobank who completed at least one 24-h dietary assessment in 2009-2012. Adherence to the PHDI was quantified using a diet score ranging from 0 to 140 points. Incident IBS was identified through electronic health records. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the PHDI and IBS risk.

RESULTS: During a median follow-up of 10.5 years, 2684 IBS cases were documented. In the fully adjusted model, participants in the highest PHDI quartile had a significantly lower risk of incident IBS compared with those in the lowest quartile (HR = 0.73; 95% CI: 0.66, 0.82; P for trend < 0.0001); the corresponding HR (95% CI) per 10-point increase was 0.92 (0.89, 0.95). Sensitivity and subgroup analyses yielded generally consistent results. In addition, such inverse association was more pronounced among participants aged < 60 years and females than their counterparts (P for interaction < 0.05).

CONCLUSIONS: Higher adherence to the PHDI was associated with a lower risk of incident IBS, providing further evidence that adherence to the planetary health diet may benefit gastrointestinal health.

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Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Irritable Bowel Syndrome/epidemiology, Female, Prospective Studies, Middle Aged, Male, Diet, Healthy/statistics & numerical data, Proportional Hazards Models, United Kingdom/epidemiology, Risk Factors, Adult, Aged
in
European Journal of Nutrition
volume
65
issue
5
article number
199
publisher
Springer
external identifiers
  • pmid:42400868
  • scopus:105043753819
ISSN
1436-6215
DOI
10.1007/s00394-026-04055-y
language
English
LU publication?
yes
additional info
© 2026. Springer-Verlag GmbH Germany, part of Springer Nature.
id
d89a1870-4559-4992-9a69-31937f58e334
date added to LUP
2026-07-21 13:36:19
date last changed
2026-09-16 07:52:22
@article{d89a1870-4559-4992-9a69-31937f58e334,
  abstract     = {{<p>BACKGROUND: The EAT-Lancet Commission introduced the planetary health diet to promote human health while reducing environmental impact. However, no study has yet examined how adherence to this diet is associated with risk of irritable bowel syndrome (IBS).</p><p>OBJECTIVE: This study aimed to investigate the association between the planetary health diet index (PHDI) and the risk of developing IBS.</p><p>METHODS: This prospective cohort study included 177,754 participants (mean age: 55.6 ± 7.93 years, 44.8% males) free of IBS at baseline from the UK Biobank who completed at least one 24-h dietary assessment in 2009-2012. Adherence to the PHDI was quantified using a diet score ranging from 0 to 140 points. Incident IBS was identified through electronic health records. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between the PHDI and IBS risk.</p><p>RESULTS: During a median follow-up of 10.5 years, 2684 IBS cases were documented. In the fully adjusted model, participants in the highest PHDI quartile had a significantly lower risk of incident IBS compared with those in the lowest quartile (HR = 0.73; 95% CI: 0.66, 0.82; P for trend &lt; 0.0001); the corresponding HR (95% CI) per 10-point increase was 0.92 (0.89, 0.95). Sensitivity and subgroup analyses yielded generally consistent results. In addition, such inverse association was more pronounced among participants aged &lt; 60 years and females than their counterparts (P for interaction &lt; 0.05).</p><p>CONCLUSIONS: Higher adherence to the PHDI was associated with a lower risk of incident IBS, providing further evidence that adherence to the planetary health diet may benefit gastrointestinal health.</p>}},
  author       = {{Xu, Xinyu and Dong, Yang and Hu, Jingxi and He, Zitong and Borné, Yan and Sonestedt, Emily and Huang, Tao and Zhang, Shunming}},
  issn         = {{1436-6215}},
  keywords     = {{Humans; Irritable Bowel Syndrome/epidemiology; Female; Prospective Studies; Middle Aged; Male; Diet, Healthy/statistics & numerical data; Proportional Hazards Models; United Kingdom/epidemiology; Risk Factors; Adult; Aged}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{5}},
  publisher    = {{Springer}},
  series       = {{European Journal of Nutrition}},
  title        = {{Planetary health diet index and risk of irritable bowel syndrome : a prospective cohort study}},
  url          = {{http://dx.doi.org/10.1007/s00394-026-04055-y}},
  doi          = {{10.1007/s00394-026-04055-y}},
  volume       = {{65}},
  year         = {{2026}},
}