Adherence to EAT-Lancet diet, biological aging, and life expectancy in the UK Biobank: a cohort study

Abstract

Background: The EAT-Lancet diet was proposed to nurture human health and support environmental sustainability. However, the interactions between EAT-Lancet diet, biological aging, and life expectancy have not been explored.

Objectives: We aimed to investigate the associations of adherence to EAT-Lancet diet pattern with biological aging and life expectancy, as well as the potential modifying effect of genetic susceptibility.

Methods: Data from the UK Biobank cohort study were analyzed. The EAT-Lancet diet index was calculated using 24-h dietary recall data to assess adherence to the EAT-Lancet diet. Polygenic risk scores (PRSs) were constructed to evaluate genetic risk of biological aging. Multivariable linear regression and flexible parametric survival models were used to investigate the association of EAT-Lancet diet index with biological aging acceleration and with residual life expectancy, respectively. Mediation analysis was used to identify potential mediators.

Results: Among 141,562 included participants (56.02 ± 7.94 y; 45.12% male), those with higher adherence to the EAT-Lancet diet were significantly associated with a slower pace of biological aging [for Stubbendorff EAT-Lancet diet index: KDM-BA acceleration: -1.37 y, 95% confidence interval (CI): -1.51, -1.24; PhenoAge acceleration: -0.93 y, 95% CI: -1.00, -0.86; comparing extreme quartiles, both P < 0.001]. At age 45, participants with the highest adherence to the EAT-Lancet diet also gained 1.13 y of life expectancy than those with the lowest adherence. Similar patterns were observed when we used the Knuppel EAT-Lancet diet index. Adiposity indices, particularly waist-to-height ratio, mediated 29.31%-35.40% of this association. No significant interaction was found between EAT-Lancet diet and genetic risks. The protective effects remained robust in a series of sensitivity analyses and across different subgroups.

Conclusions: Adherence to the EAT-Lancet diet is linked to delayed biological aging and increased life expectancy, regardless of genetic predisposition. This suggests that promoting this sustainable dietary pattern could serve as a practical nutritional strategy for enhancing healthy longevity.

Keywords: EAT-Lancet diet; biological aging; genetic risk; life expectancy; prevention.