ArticleThe American journal of clinical nutrition2026
Adherence to the EAT-Lancet Planetary Health Diet during pregnancy and associations with preterm birth and infant size: a prospective analysis from the New Hampshire Birth Cohort.
Article in The American journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe Planetary Health Diet (PHD), proposed by the EAT-Lancet Commission, seeks to optimize health while preserving the environment. Its benefits for chronic disease prevention are established, but its impacts on birth outcomes are unclear.
objectivesTo assess the association between PHD adherence during pregnancy and newborn outcomes.
methodsThis prospective study included 1431 mother-infant dyads from the New Hampshire Birth Cohort Study. Diet during pregnancy was assessed once at 24-28 wk gestation via a food-frequency questionnaire to calculate the Planetary Health Diet Index (PHDI). Gestational age, birth weight, length, and head circumference were abstracted from medical records. Dietary patterns were identified through self-organizing maps using PHDI components. Associations between PHD and birth outcomes were modeled using multivariable regressions.
resultsHighest PHDI tertile participants were older, had lower prepregnancy BMI, were more often nonsmokers, and had higher neighborhood socioeconomic status. In adjusted regression models, 10-unit increase in PHDI was associated with higher birth weight [β = 24.4 g, 95% confidence interval (CI): 1.21, 43.6], longer gestation (β = 0.10 wk; 95% CI: 0.03, 0.17) and reduced odds of being preterm [odds ratio (OR) = 0.86; 95% CI: 0.74, 0.98]. Three distinct dietary patterns were identified: plant-based, saturated fat-rich, and animal/added sugar-rich. Compared with the plant-based profile, the saturated fat-rich profile was associated with shorter gestation and higher odds of low birth weight (OR = 2.54; 95% CI: 1.23, 5.44). The animal/added sugar-rich profile correlated with lower birth weight (β = -82.4 g; 95% CI: -149.2, -15.6) and shorter length (β = -0.46 cm; 95% CI: -0.84, -0.08). Both nonplant-based profiles increased the odds of preterm birth (OR = 1.92 and OR = 1.66, respectively).
conclusionsOriginally proposed for chronic disease prevention and planetary sustainability, higher adherence to the PHD during pregnancy may also benefit birth outcomes, particularly lower odds of preterm birth.
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