Author Identifier (ORCID)
Abstract
Background and objective – In 2019, the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems proposed the EAT-Lancet planetary health diet as a universal reference dietary pattern aimed at promoting human health while minimizing environmental degradation. However, epidemiological evidence regarding the association between adherence to the EAT-Lancet diet and the risk of heart failure (HF), particularly among individuals with cardiovascular-kidney-metabolic syndrome (CKMs) stages 0–3, remains limited. Therefore, this study aimed to examine the associations between adherence to the EAT-Lancet dietary pattern, its individual dietary components, and the risk of HF among individuals at CKMs stages 0–3. Materials and methods – In this prospective study, a total of 120, 849 participants with CKMs stages 0–3 from the UK Biobank cohort were included. Dietary data were collected using an online 24-h dietary recall questionnaire. The EAT-Lancet Diet Index, ranging from 0 to 14, was constructed based on the EAT-Lancet reference diet to evaluate adherence. Cox proportional hazards models and restricted cubic spline functions were used to assess the associations between the EAT-Lancet Diet Index, its dietary components, and HF risk. Results – Over a median follow-up of 14.88 years, 2, 454 participants developed HF. A higher EAT-Lancet Diet Index was significantly associated with a lower risk of HF compared to the lowest index group (hazard ratio [HR]: 0.88; 95% confidence interval [CI]: 0.80, 0.97). This association remained robust across subgroup and multiple sensitivity analyses. Restricted cubic spline analysis revealed a significant inverse linear relationship between the EAT-Lancet Diet Index and HF risk. Among dietary components, reduced intake of red meat (beef, lamb, and pork) (HR: 0.90; 95% CI: 0.83, 0.98) and increased intake of peanuts or other nuts (HR: 0.76; 95% CI: 0.60, 0.95) were significantly associated with lower HF risk. Conclusion – This study demonstrates that greater adherence to the EAT-Lancet diet is significantly associated with a reduced relative hazard of HF among individuals with CKM stages 0–3, particularly through reduced consumption of red meat and increased intake of peanuts or other nuts.
Keywords
cardiovascular diseases, cardiovascular kidney metabolic syndrome, EAT-Lancet diet, heart failure, plant-based diet
Document Type
Journal Article
Date of Publication
5-13-2026
Article Number
1802388
Volume
13
Publication Title
Frontiers in Nutrition
Publisher
Frontiers
School
School of Medical and Health Sciences
Funding Information
This work has been supported by Special Fund Project for Science and Technology Innovation Strategy of Guangdong Province (No. STKJ2023003).
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Recommended Citation
Fu, P., Zheng, H., Wu, K., Lan, Y., Wu, D., Wu, W., Zheng, H., Cai, Z., Wang, Y., Lin, Q., Zhang, B., & Chen, Y. (2026). Adherence to the EAT-Lancet diet and the risk of heart failure in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: A prospective cohort study. Frontiers in Nutrition, 13, 1802388. https://doi.org/10.3389/fnut.2026.1802388