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Peer-reviewedCC BYnpj Science of Food

Aligning patient and planetary health: planetary health diet adherence and inflammatory bowel disease prognosis across Western and Eastern cohorts

  • Lintao Dan1
  • Haiting Shu1
  • Yuhao Sun1
  • Judith Wellens2
  • Yang Chen1
  • Minzi Deng1
  • Jialu Yao3
  • Xixian Ruan1
  • Henit Yanai4
  • Xue Li5
  • Britta Siegmund6
  • Xiaoyan Wang1
2 more authors
  • Fernando Magro7
  • Jie Chen1
7 affiliations
  1. 1Department of Gastroenterology, The Third Xiangya Hospital of Central South University
  2. 2Leuven University Hospital, Department of Gastroenterology and Hepatology
  3. 3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet
  4. 4Division of Gastroenterology, Rabin Medical Center
  5. 5Department of Big Data in Health Science, School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine
  6. 6Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin
  7. 7CINTESIS@RISE Department, Faculdade de Medicina da Universidade do Porto
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Abstract

This study aims to evaluate whether planetary health diet (PHD) could be a potential tool to achieve sustainability in IBD management. We included 1455 IBD participants from the UK Biobank (UKB) and 205 from the ONE-IBD cohort. Dietary intake was captured through validated questionnaires and seven PHD adherence algorithms were evaluated. Environmental impact was estimated using dietary carbon footprints. Outcomes included IBD-related surgery, colorectal cancer, and all-cause mortality in the UKB, while readmission and recurrence in ONE-IBD. Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). During a median 10.5-year follow-up, 191 surgeries, 78 CRC, and 232 deaths occurred. Adherence to PHD were inversely associated with surgery risk (HRper SD 0.67–0.80). All algorithms were linked to lower dietary carbon footprints (r −0.061 to −0.468). A modified-Knuppel algorithm provided similar protection (HRper SD = 0.73, 95% CI 0.60-0.89) and environmental correlation (r = −0.244). In ONE-IBD, the modified algorithm was associated with lower readmission risk (HRper SD = 0.80, 95% CI 0.65–1.00). Proteomics data suggest potential benefits through improved intestinal barrier integrity and reduced fibrosis. To conclude, higher PHD adherence is associated with better IBD outcomes and lower environmental burden, supporting that the PHD may represent a promising and sustainable dietary pattern in IBD management.

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Cite

BibTeXRIS
BibTeX
@article{dan2026aligning,
  title = {{Aligning patient and planetary health: planetary health diet adherence and inflammatory bowel disease prognosis across Western and Eastern cohorts}},
  author = {Lintao Dan and Haiting Shu and Yuhao Sun and Judith Wellens and Yang Chen and Minzi Deng and Jialu Yao and Xixian Ruan and Henit Yanai and Xue Li and Britta Siegmund and Xiaoyan Wang and Fernando Magro and Jie Chen},
  journal = {npj Science of Food},
  year = {2026},
  month = jun,
  doi = {10.1038/s41538-026-00959-5},
  url = {https://doi.org/10.1038/s41538-026-00959-5},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Aligning patient and planetary health: planetary health diet adherence and inflammatory bowel disease prognosis across Western and Eastern cohorts
AU  - Lintao Dan
AU  - Haiting Shu
AU  - Yuhao Sun
AU  - Judith Wellens
AU  - Yang Chen
AU  - Minzi Deng
AU  - Jialu Yao
AU  - Xixian Ruan
AU  - Henit Yanai
AU  - Xue Li
AU  - Britta Siegmund
AU  - Xiaoyan Wang
AU  - Fernando Magro
AU  - Jie Chen
PY  - 2026
DA  - 2026/06/01
JO  - npj Science of Food
DO  - 10.1038/s41538-026-00959-5
UR  - https://doi.org/10.1038/s41538-026-00959-5
AB  - This study aims to evaluate whether planetary health diet (PHD) could be a potential tool to achieve sustainability in IBD management. We included 1455 IBD participants from the UK Biobank (UKB) and 205 from the ONE-IBD cohort. Dietary intake was captured through validated questionnaires and seven PHD adherence algorithms were evaluated. Environmental impact was estimated using dietary carbon footprints. Outcomes included IBD-related surgery, colorectal cancer, and all-cause mortality in the UKB, while readmission and recurrence in ONE-IBD. Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). During a median 10.5-year follow-up, 191 surgeries, 78 CRC, and 232 deaths occurred. Adherence to PHD were inversely associated with surgery risk (HRper SD 0.67–0.80). All algorithms were linked to lower dietary carbon footprints (r −0.061 to −0.468). A modified-Knuppel algorithm provided similar protection (HRper SD = 0.73, 95% CI 0.60-0.89) and environmental correlation (r = −0.244). In ONE-IBD, the modified algorithm was associated with lower readmission risk (HRper SD = 0.80, 95% CI 0.65–1.00). Proteomics data suggest potential benefits through improved intestinal barrier integrity and reduced fibrosis. To conclude, higher PHD adherence is associated with better IBD outcomes and lower environmental burden, supporting that the PHD may represent a promising and sustainable dietary pattern in IBD management.
SN  - 2396-8370
ER  -