Global adherence to a healthy and sustainable diet and potential reduction in premature death

Summary

The Planetary Health Diet (PHD), also known as the EAT-Lancet reference diet, was developed to optimize global dietary quality while keeping the environmental impacts of food production within sustainable planetary boundaries. We calculated current national and global adherence to the PHD using the Planetary Health Dietary Index (PHDI). In addition, we used data on diet and mortality from three large US cohorts (n = 206,404 men and women, 54,536 deaths) to estimate the total and cause-specific mortality among adults 20 y of age and older that could be prevented by shifting from current diets to the reference PHD. The PHDI varied substantially across countries, although adherence was universally far from optimal (mean PHDI = 85 out of 140). By improving the global PHDI to 120, approximately