Eur J Nutr. 2026 Aug 6;65(6):232. doi: 10.1007/s00394-026-04078-5.
ABSTRACT
PURPOSE: We aimed to develop a culturally specific Chinese Planetary Health Diet Score (CPHDS) and to evaluate its associations with environmental footprints and all-cause mortality.
METHODS: We constructed a 14-component CPHDS (range 0-140) based on the 2019 EAT-Lancet Commission recommendations, the latest Chinese Dietary Guidelines, and existing dietary scoring frameworks, while incorporating adaptations specific to Chinese dietary practices and nutritional characteristics. Using data from the China Health and Nutrition Survey (1991-2015), we included 19,660 adults without cardiovascular disease or cancer at baseline. Dietary intake was repeatedly assessed using three consecutive 24-hour dietary recalls, and mortality data were collected through household surveys. Linear mixed-effects models and time-varying Cox proportional hazards models were used to evaluate the associations of the CPHDS with diet-related environmental impacts and all-cause mortality, respectively.
RESULTS: The mean CPHDS was 50.3 (SD 11.3) points. A higher CPHDS was associated with reduced greenhouse gas emissions [β : - 0.039 (- 0.042, - 0.037) kg CO equivalent], water use [- 0.106 (- 0.109, - 0.103) m3], and land use [- 0.173 (- 0.177, - 0.169) m2]. Over a median follow-up of 9.1 (interquartile range, IQR: 4.1, 18.0) years, 1654 deaths were recorded. Compared with participants in the lowest quartile, those in the highest CPHDS quartile showed a 14% lower risk of all-cause mortality (HR = 0.86; 95% CI 0.75, 0.99; P for trend = 0.044). Each 10% increment in CPHDS was associated with a 7% lower mortality risk (HR = 0.93; 95% CI 0.88, 0.98).
CONCLUSIONS: Greater adherence to the Chinese Planetary Health Diet was associated with reduced diet-related environmental burdens and a lower risk of all-cause mortality in Chinese adults, supporting the potential relevance of a culturally adapted planetary health diet framework for promoting both environmental sustainability and population health for China.
PMID:42560398 | DOI:10.1007/s00394-026-04078-5