Planetary Health Diet Study Highlights Nutrient Tradeoffs

A Swedish population study evaluating adherence to the EAT-Lancet Commission’s Planetary Health Diet finds higher nutrient density and generally adequate micronutrient status, but flags increased anemia risk among women, with outcomes sensitive to dietary scoring methods and energy adjustment. The findings are relevant for Mexico, where regulators, food producers, healthcare providers and pharmaceutical companies are aligning nutrition policy, obesity management and sustainability goals amid high obesity prevalence and expanding GLP-1 adoption. The evidence informs policy design, fortification strategy and investment decisions across the food, health and ESG sectors.

A large Swedish study evaluating adherence to the EAT-Lancet Commission’s Planetary Health Diet finds that higher adherence is associated with greater nutrient density and generally adequate micronutrient status, but raises concerns about anemia risk in women. The findings indicate that methodological choices influence conclusions about nutrient sufficiency. Researchers say the results support the diet’s viability in high-income settings while underscoring the need for sex-specific monitoring and careful policy design.

“Changing what we eat is essential to building a future in which both people and planet can thrive,” the EAT-Lancet Commission stated in outlining the rationale behind the Planetary Health Diet, a science-based reference model intended to promote human health while reducing pressure on environmental systems. The new evidence provides a detailed assessment of how that model performs when translated into measurable nutrient outcomes.

The Planetary Health Diet is structured around plant-forward consumption patterns. Whole grains, fruits, vegetables, legumes and nuts form the dietary base, with limited quantities of red meat, dairy and added sugars. The framework was developed primarily on health criteria, though its name reflects evidence suggesting that adoption would reduce environmental impacts associated with current dietary patterns. In countries such as Sweden, where baseline consumption includes relatively high intakes of animal products and processed foods, researchers sought to test whether shifting toward this reference model compromises micronutrient adequacy.

Nutrient Density and the “Energy Trap”

The study analyzed dietary data alongside plasma biomarkers to compare reported intake with biological indicators of nutrient status. Participants with higher adherence to the Planetary Health Diet tended to consume fewer calories overall. However, once researchers adjusted for total energy intake, diets aligned with the model showed significantly higher nutrient density.

After energy adjustment, higher adherence was positively associated with intake of vitamin A, vitamin E, thiamine, vitamin B6, folate, vitamin C, calcium, magnesium, potassium, iron and zinc. Researchers attributed these improvements to greater reliance on plant-based foods rich in micronutrients. The findings suggest that, calorie for calorie, the diet provides a broad spectrum of essential nutrients.

At the same time, the study highlights what researchers describe as an “energy trap.” Some scoring systems used to measure adherence reward lower overall food intake. When absolute daily nutrient totals are evaluated without adjusting for energy, certain nutrients may appear insufficient simply because total caloric intake declines. The researchers applied seven different adherence scores and found that results often shifted depending on which scoring framework was used. In several cases, associations that initially appeared negative became positive once energy intake was factored in. The authors conclude that scientific conclusions about sustainable diets can be shaped significantly by methodological choices.

Biomarkers Reveal Mixed Signals

A central feature of the study was its comparison of self-reported dietary intake with blood biomarkers. For folate, both measures aligned. Higher adherence to the Planetary Health Diet was associated with a significantly lower risk of folate deficiency. This result is particularly relevant for women of reproductive age, who require approximately 400 micrograms of folate per day, compared with a general adult recommendation of about 330 micrograms.

Vitamin D presented a more complex pattern. Reported intake of vitamin D declined at higher adherence levels, reflecting reduced consumption of animal-based foods. However, plasma biomarkers told a different story. Among women, there was no significant increase in vitamin D deficiency risk. Among men, deficiency risk was lower at higher adherence levels in certain scoring models. Researchers note that Sweden’s dairy fortification policies likely mitigate potential shortfalls, highlighting the importance of national context.

For selenium and zinc, most scoring methods showed no meaningful difference in deficiency risk between high- and low-adherence groups. These findings indicate that, in this setting, reduced animal-product consumption did not translate into widespread micronutrient deficiencies when diets were otherwise balanced.

Gender-Specific Outcomes and Anemia Risk

The researchers stratified their analysis by sex to account for different physiological requirements and energy needs. On average, men consumed approximately 2,635 kilocalories per day, compared with about 2,031 kilocalories for women, influencing total micronutrient intake.

Among women, higher adherence was associated with a slightly increased risk of anemia. The authors attribute this primarily to reduced intake of animal-sourced iron. While plant-based iron contributes to total intake, it has lower bioavailability than heme iron found in meat. The finding does not negate the broader nutrient benefits observed but signals the need for targeted monitoring, particularly for women of reproductive age.

Men showed no comparable anemia signal and, in some models, demonstrated lower vitamin D deficiency risk with higher adherence. The sex-specific differences reinforce the importance of tailoring dietary guidance to demographic characteristics rather than applying uniform assumptions across populations.

Policy, Prevention and Market Context

The study’s findings intersect with broader health and policy debates. The World Health Organization has increasingly framed diet as central to both chronic disease prevention and long-term health system resilience. The agency recently issued guidance encouraging governments to strengthen school food policies and has endorsed GLP-1–based therapies as part of comprehensive obesity management strategies.

Parallel research underscores the systemic implications of metabolic health. A large international study found that obesity significantly increases the risk of hospitalization and death from a wide range of infectious diseases, positioning excess weight as a factor in acute care outcomes as well as chronic disease. Together, these data reinforce the relevance of preventive dietary models that address both metabolic and micronutrient dimensions.

Fiscal and regulatory measures are also under review. Researchers at the Potsdam Institute for Climate Impact Research have concluded that removing reduced value-added tax rates on meat in the European Union could lower food-related greenhouse gas emissions by roughly 5% annually, framing dietary change as both a public health and environmental intervention. Meanwhile, pharmaceutical expansion in GLP-1 therapies reflects growing demand for clinical approaches to metabolic management.

Against this backdrop, the Swedish evidence suggests that the Planetary Health Diet can support adequate micronutrient status in high-income countries characterized by high baseline meat consumption. While the observed anemia risk among women warrants attention, the overall nutrient density profile and biomarker results indicate that the diet does not inherently compromise micronutrient adequacy when energy intake and local fortification practices are considered.

The researchers emphasize that outcomes are context-specific and shaped by food systems, fortification policies and baseline dietary habits. They conclude that sustainable diet frameworks should be evaluated with transparent methodology and demographic sensitivity.