17 January 2019 - Zoe Harcombe - The EAT Lancet diet is nutritionally deficient

A report was published in The Lancet on 17th January 2019. The report was commissioned by The Lancet. The report was written by 37 people from 16 different countries and was 3 years in the making (Ref 1).

The “healthy reference diet”

The researchers summarised “The healthy reference diet” as follows (Table 1). This has been called The EAT diet in media reports today:

Replicating the “Healthy reference diet”

Using a front-end tool, which I have had developed to run off the USDA (United States Department of Agriculture) all-food database, I entered the foods as closely to Table 1 in the Lancet as possible. I used the table notes to select foods as accurately as possible (e.g. the 40g of unsaturated oils were specified as 8g each of olive, soybean, rapeseed, sunflower and peanut oils.) I used the calorie intake column in the table to ensure that I had got as closely as possible to the line item in the Lancet table (some lines are within 1 calorie!)

My food list (in the order of the Lancet table) was as follows:

The tool then aggregates macro and micronutrients found in all these amounts of all these different foods. This is shown below:

Macronutrients

The “Healthy reference (EAT) diet (based on 2,500 calories, so for an adult male) has the following macronutrient composition:

Micronutrients

The EAT diet is based on an adult male. An adult female would likely consume four fifths of the above diet and thus four fifths of the above vitamins and minerals. Notwithstanding this, the above diet is deficient in the following nutrients:

Vitamin B12 – the US RDA is 2.4mcg, the EAT diet is slightly deficient in providing 2.27mcg. I would not mention this nutrient but for the comment in Table 1 that animal items can be replaced with plant protein options and these will not provide any B12. (There is an amusing error on p16 of the 51 page report. It says “The only exception is vitamin B12 that is low in animal-based diets.” I think they mean plant-based diets!)

Retinol (the form in which the body needs vitamin A – we cannot rely on carotene to be converted). The EAT diet provides just 17% of retinol recommended.

Vitamin D – the EAT diet provides just 5% of vitamin D recommendation and some of that provided will have come from plants and not be D3, which is the body’s preferred form.

Vitamin K – the USDA is not ideal when it comes to vitamin K. It does not distinguish between K1 (primarily found in leafy green vegetables) and K2 (primarily found in fermented foods and some foods of animal origin). 72% of the vitamin K in the EAT diet came from the broccoli (K1). As is the case with all nutrients, the animal form (K2) is better absorbed by the body.

Sodium – the EAT diet provides just 22% of the sodium recommendation. Sodium is so often demonised that people forget that it is a vital nutrient.

Potassium – the EAT diet provides just 67% of potassium recommended.

Calcium – more seriously, the EAT diet provides just 55% of calcium recommended.

Iron – the EAT diet provides 88% of iron recommended. Again, the body better absorbs heme iron, which comes from meat, poultry, seafood and fish. The US recommendations state: “The RDAs for vegetarians are 1.8 times higher than for people who eat meat. This is because heme iron from meat is more bioavailable than nonheme iron from plant-based foods, and meat, poultry, and seafood increase the absorption of nonheme iron” (Ref 2).

I have analysed separately the 7g beef, 7g pork, 29g chicken and 28g of fish, to find the maximum amount of heme iron (some of the iron in these foods is non-heme) and it amounts to 1.1mg – just 6% of the iron intake recommended. Given that the rest of the iron is non-heme, the deficiency is far greater than the number 88% suggests, as the requirement is 1.8 times higher.

Omega-3 – essential fatty acids. Unfortunately, the tool doesn’t aggregate to the fatty acid level, but this diet is highly likely deficient in omega-3 and highly likely (given the 350 calories of nutritionally poor, highly unsaturated, vegetable oils) has an unhealthy omega-6 to omega-3 ratio. Fish is the best source of omega-3 and the 28g of fish in the EAT diet provides 284mg of omega-3 fatty acids vs. an RDA of 1.6g for adult males (Ref 3).

There are numerous other issues with this plant-biased advice. Not least – what will all these plants be grown in when there is no top soil left because we have replaced soil-rejuvenating ruminants with soil-raping plants? (Ref 4)

However, the focus of this post was to highlight that the EAT diet is nutritionally deficient and that has been done.