Association between the EAT-Lancet Diet, Incidence of Cardiovascular Events, and All-cause Mortality: Results from a Swiss Cohort

Background: An unhealthy diet is a major contributor to several noncommunicable diseases, including cardiovascular diseases (CVD), the leading cause of death worldwide. Additionally, our food system has significant impacts on the environment. The EAT-Lancet Commission has recommended a healthy diet that preserves global environmental resources.

Objective: This prospective study evaluated the associations between adherence to the EAT-Lancet diet and the incidence of cardiovascular events and all-cause mortality in a Swiss cohort.

Methods: We analyzed data from the CoLaus|PsyCoLaus cohort study (n = 3,866). Dietary intake was assessed using a semiquantitative food frequency questionnaire. The EAT-Lancet adherence score was calculated based on the recommended intake and reference intervals of 12 food components, ranging from 0 to 39 points. Participants were categorized into low-, medium-, and high-adherence groups according to score tertiles. We used Cox Proportional Hazards regressions to assess the association between diet adherence, incident cardiovascular events and all-cause mortality.

Results: During a mean follow-up of 7.9 years (SD, ±2.0), 294 individuals (7.6%) from our initial sample experienced a first cardiovascular event, and 264 (6.8%) died. Compared with the low-adherence group, the adjusted hazard ratios for all-cause mortality were 0.88 (95% CI: 0.66-1.17) and 0.70 (95% CI: 0.49-0.98) for the medium- and high-adherence groups, respectively (p for trend = 0.04). We observed no association between adherence groups and cardiovascular events.

Conclusions: In a Swiss cohort, high adherence to the EAT-Lancet diet was associated with a potential 30% lower risk of overall mortality. However, no association was found between the EAT-Lancet diet and cardiovascular events.