Planetary Health Diet and Cardiovascular Disease Risk in the Seguimiento Universidad de Navarra (SUN) Cohort

Background/Objectives: Noncommunicable diseases, particularly cardiovascular disease (CVD), represent a significant global public health challenge, with unhealthy diets as a major risk factor. This study investigates the association between adherence to the Planetary Health Diet proposed by the EAT-Lancet Commission and CVD risk. Methods: Utilizing data from the Seguimiento Universidad de Navarra (SUN) cohort, which included 18,656 participants (mean age 38 years; 61% women), we assessed dietary intake using a validated food frequency questionnaire and the Planetary Health Diet Index to evaluate adherence (range 0-42). CVD was defined as new-onset stroke, myocardial infarction, or CVD death. Results: After a median follow-up time of 11.5 years, 220 cases of CVD were identified. Higher adherence to the Planetary Health Diet revealed no statistically significant reduction in CVD risk associated with the diet. Cox proportional hazard models indicated a trend towards lower CVD risk in the highest adherence quartile, but this did not reach significance (HR 0.77, 95% CI 0.51-1.18, p-trend = 0.127). Sensitivity analyses corroborated these results. Discrepancies in previous studies highlight the complexity of dietary assessments and underscore the need for standardized scoring systems. Conclusions: In a large Spanish cohort, adherence to the Planetary Health Diet showed no significant reduction in CVD risk. Further research is needed to reach a consensus on the operational definition of the Planetary Health Diet and to clarify the relationship between diet and CVD risk.