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Adherence to the EAT-Lancet reference diet and risk of type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, and their co-occurrence

Zhang, Shunming LU ; Zeng, Xu-Fen ; Borné, Yan LU ; Huo, Zhenyu ; Yan, Yan ; Gu, Yeqing ; Wu, Hongmei ; Luo, Xiaoqin ; Zhang, Rui and Stubbendorff, Anna LU orcid , et al. (2025) In Food & Function 16(17). p.6773-6785
Abstract


Background and aims: The EAT-Lancet Commission proposed a healthy dietary pattern to prevent diet-related diseases while promoting planetary sustainability, but little is known regarding its associations with type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD), both of which are highly prevalent and frequently co-exist. We aimed to assess association of this diet with risk of T2D, MASLD, and their co-occurrence.
Methods: This study included 170 811 UK Biobank participants (prospective design) and 212 Chinese biopsy-proven MASLD patients (cross-sectional design). Adherence to the EAT-Lancet reference diet was quantified using three different diet indices. Cox and logistic models were... (More)


Background and aims: The EAT-Lancet Commission proposed a healthy dietary pattern to prevent diet-related diseases while promoting planetary sustainability, but little is known regarding its associations with type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD), both of which are highly prevalent and frequently co-exist. We aimed to assess association of this diet with risk of T2D, MASLD, and their co-occurrence.
Methods: This study included 170 811 UK Biobank participants (prospective design) and 212 Chinese biopsy-proven MASLD patients (cross-sectional design). Adherence to the EAT-Lancet reference diet was quantified using three different diet indices. Cox and logistic models were applied to estimate the corresponding effect size.
Results: During follow-up in the UK Biobank, we identified 4240 T2D cases, 1164 MASLD cases, and 215 co-incidents of the two diseases. The multivariable hazard ratios (95% confidence intervals) per standard deviation (SD) increase in the Planetary Health Diet Index were 0.85 (0.82, 0.87) for T2D, 0.80 (0.75, 0.85) for MASLD, and 0.84 (0.74, 0.97) for the co-occurrence of the two conditions. The associations were attenuated after additional adjustment for body mass index. In addition, 96 (45.3%) patients with biopsy-proven MASLD had prevalent T2D; adjusted odds ratios (95% confidence intervals) per SD of T2D were 0.72 (0.51, 1.00) for the Planetary Health Diet Index. Similar association patterns were observed in the other two indices.
Conclusions: Greater adherence to the EAT-Lancet reference diet was not only associated with lower risks of incident T2D, MASLD, and the co-occurrence of the two conditions in the general adult population but was also associated with lower prevalence of T2D among biopsy-proven MASLD patients.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
Humans, Diabetes Mellitus, Type 2/epidemiology, Male, Female, Middle Aged, Cross-Sectional Studies, Aged, Adult, Prospective Studies, Fatty Liver/epidemiology, United Kingdom/epidemiology, Risk Factors, Diet, Healthy
in
Food & Function
volume
16
issue
17
pages
6773 - 6785
publisher
Royal Society of Chemistry
external identifiers
  • scopus:105014118115
  • pmid:40793982
ISSN
2042-6496
DOI
10.1039/d4fo05852f
language
English
LU publication?
yes
id
f565b249-0836-45af-bb1e-56bea9f38ce5
date added to LUP
2025-08-31 09:50:56
date last changed
2025-09-02 03:25:34
@article{f565b249-0836-45af-bb1e-56bea9f38ce5,
  abstract     = {{<p><br>
 Background and aims: The EAT-Lancet Commission proposed a healthy dietary pattern to prevent diet-related diseases while promoting planetary sustainability, but little is known regarding its associations with type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD), both of which are highly prevalent and frequently co-exist. We aimed to assess association of this diet with risk of T2D, MASLD, and their co-occurrence. <br>
 Methods: This study included 170 811 UK Biobank participants (prospective design) and 212 Chinese biopsy-proven MASLD patients (cross-sectional design). Adherence to the EAT-Lancet reference diet was quantified using three different diet indices. Cox and logistic models were applied to estimate the corresponding effect size.<br>
 Results: During follow-up in the UK Biobank, we identified 4240 T2D cases, 1164 MASLD cases, and 215 co-incidents of the two diseases. The multivariable hazard ratios (95% confidence intervals) per standard deviation (SD) increase in the Planetary Health Diet Index were 0.85 (0.82, 0.87) for T2D, 0.80 (0.75, 0.85) for MASLD, and 0.84 (0.74, 0.97) for the co-occurrence of the two conditions. The associations were attenuated after additional adjustment for body mass index. In addition, 96 (45.3%) patients with biopsy-proven MASLD had prevalent T2D; adjusted odds ratios (95% confidence intervals) per SD of T2D were 0.72 (0.51, 1.00) for the Planetary Health Diet Index. Similar association patterns were observed in the other two indices. <br>
 Conclusions: Greater adherence to the EAT-Lancet reference diet was not only associated with lower risks of incident T2D, MASLD, and the co-occurrence of the two conditions in the general adult population but was also associated with lower prevalence of T2D among biopsy-proven MASLD patients.<br>
 </p>}},
  author       = {{Zhang, Shunming and Zeng, Xu-Fen and Borné, Yan and Huo, Zhenyu and Yan, Yan and Gu, Yeqing and Wu, Hongmei and Luo, Xiaoqin and Zhang, Rui and Stubbendorff, Anna and Sonestedt, Emily and Qi, Lu and Huang, Tao and Zheng, Ming-Hua and Niu, Kaijun and Ma, Le}},
  issn         = {{2042-6496}},
  keywords     = {{Humans; Diabetes Mellitus, Type 2/epidemiology; Male; Female; Middle Aged; Cross-Sectional Studies; Aged; Adult; Prospective Studies; Fatty Liver/epidemiology; United Kingdom/epidemiology; Risk Factors; Diet, Healthy}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{17}},
  pages        = {{6773--6785}},
  publisher    = {{Royal Society of Chemistry}},
  series       = {{Food & Function}},
  title        = {{Adherence to the EAT-Lancet reference diet and risk of type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, and their co-occurrence}},
  url          = {{http://dx.doi.org/10.1039/d4fo05852f}},
  doi          = {{10.1039/d4fo05852f}},
  volume       = {{16}},
  year         = {{2025}},
}