Limited risks of nutrient deficiency and significant modelled health benefits of adherence to a moderate plant-based diet in French adults.

purposeIn Western countries, plant-based diets could lead to long-term health benefits but also carry some risks of nutrient inadequacy. Here, we estimated the nutritional risks and health benefits of adopting plant-forward diets.

methodsBased on the latest French representative survey (INCA3), we identified a subgroup of adults with more plant-based (PB+) diets characterized by both protein and energy intakes from plants > 80th percentile. We compared the prevalence of nutrient inadequacy, excess intake, and risk of overt deficiency in PB+ and in the rest of the population (PB-) and evaluated the hypothetical burden of disease (as disability adjusted life years, DALYs) if the entire population shifted to the PB+ diet, using a comparative risk assessment framework.

resultsCompared to PB-, in PB+ (10.7% of the population; 53% male), the prevalence of inadequacy was lower for fibre, linoleic acid, potassium, and vitamin C and higher for selenium, protein, calcium, riboflavin, vitamins A, B6, B12, iron, and iodine. We also found a higher risk of overt deficiency in PB+ for iodine and riboflavin. Fewer PB+ exceeded the upper limit for Saturated Fatty Acids (SFA), but more exceeded the one set for sugars. Shifting to a PB+ diet would benefit population health, with ~ 132,700 [~ 125,400 to  ~ 140,000, 95% UI] DALYs averted, the gain being ca. twice higher for males than females but related to the same main diseases (ischemic heart diseases, diabetes, and colorectal cancer). Benefits would stem from lower processed meat and SFA in both sexes, higher nuts consumption, and blood cholesterol reduction in females, and higher fruit consumption and fibre intake in males.

conclusionDespite suboptimal diet quality, significant nutritional risks were limited in PB+, especially regarding deficiency risk, while such diets would benefit long-term health.