The EAT-Lancet Commission's Dietary Composition May Not Prevent Noncommunicable Disease Mortality

Abstract

The recently published EAT-Lancet Commission report on dietary impacts on the environment suggested that their proposed diet could prevent more than 10 million annual premature mortalities from noncommunicable diseases globally. The report did not meet standards for transparency and replicability, nor did it fully account for statistical uncertainty. Our attempt to replicate the mortality calculations for the United States revealed flaws in the assumptions and methods used to estimate the avoided mortalities. After correcting some calculation errors and fully accounting for uncertainty in the avoided mortalities, the mortality reduction effect of the EAT-Lancet proposed diet in the USA is no greater than the impact of energy consumption changes that would prevent under-weight, over-weight, and obesity alone. As our findings call into question the global conclusions of the EAT-Lancet report, futher independent validation is needed before it can be used to inform dietary guidelines.

The affordability of a healthy and sustainable diet: An Australian case study.

“…23,28,30,45 The EAT-Lancet Commission report stated that a global shift in dietary behaviours to align with the PHD could prevent around 19-23% of deaths per year (around 11 million deaths prevented) by way of improved human health, 3 however under subsequent further analysis it appears that these prevented deaths may be purely the result of the changes in energy consumption associated with the PHD. 46 Affordability as a factor affecting food choices For the PHD to be widely adopted, it needs to be acceptable to consumers. While there are several factors that affect consumer food choices, such as accessibility, availability, health concerns and food preferences, 2,47 this review considered purely the role of affordability as a key factor that may in uence the uptake of the PHD, while acknowledging there are many other factors that also in uence food choices.…”

The public health rationale for promoting plant protein as an important part of a sustainable and healthy diet

“…In response to the EAT‐Lancet report, Zagmutt et al . (2020) replicated calculations and found that a dietary change based on merely balancing energy intake would have a very similar effect on mortality rate reduction. Furthermore, public health strategies to facilitate the necessary transition are still a fledgling topic with little evidence of what approaches might be most effective.…”

“…However, the nutritional implications of such a transition have recently sparked a polarised public health debate (Zagmutt et al . 2020; Blackstone & Conrad 2020). In response to the EAT‐Lancet report, Zagmutt et al .…”

The Proof is Not in the EATing

“…A recent publication in The Journal of Nutrition revealed that the change in caloric content of the PH diet could explain 63–94 per cent of the calculated mortalities prevented in the United States, after addressing methodological issues (Zagmutt et al ., ). This means that if underweight, overweight and obesity were to be eliminated from the US population, then the PH diet would not significantly give any additional effect in prevention of premature mortalities from NCDs.…”

“…Unfortunately, the methodology applied in determining the diet is neither sufficiently described, nor in alignment with scientific standards normally required for peer‐reviewed publications of this nature. These are the findings of an independent review of EAT‐Lancet undertaken by EpiX Analytics funded by MatPrat (Zagmutt et al ., 2019a, 2019b, ). The authors of EAT‐Lancet do not describe the methodology used for selecting literature to quantify specific intake levels of different foods; neither how this literature was used to arrive at the specific intake levels, nor an assessment of mortality prevention potential.…”