Planetary Health Diet Adherence Improves Weight and Body Composition During Energy Restriction

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Main Authors: Paola Mogna‐Peláez, Naixin Zhang, Marta Guasch‐Ferré, Fermin I. Milagro, José I. Riezu‐Boj, José I. Herrero, Mariana Elorz, Alberto Benito‐Boillos, Ana Luz Tobaruela‐Resola, Amelia Marti Del Moral, Josep A. Tur, J. Alfredo Martínez, Itziar Abete, M. Ángeles Zulet
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Published: Wiley 2026
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author Paola Mogna‐Peláez
Naixin Zhang
Marta Guasch‐Ferré
Fermin I. Milagro
José I. Riezu‐Boj
José I. Herrero
Mariana Elorz
Alberto Benito‐Boillos
Ana Luz Tobaruela‐Resola
Amelia Marti Del Moral
Josep A. Tur
J. Alfredo Martínez
Itziar Abete
M. Ángeles Zulet
author_facet Paola Mogna‐Peláez
Naixin Zhang
Marta Guasch‐Ferré
Fermin I. Milagro
José I. Riezu‐Boj
José I. Herrero
Mariana Elorz
Alberto Benito‐Boillos
Ana Luz Tobaruela‐Resola
Amelia Marti Del Moral
Josep A. Tur
J. Alfredo Martínez
Itziar Abete
M. Ángeles Zulet
Paola Mogna‐Peláez
Naixin Zhang
Marta Guasch‐Ferré
Fermin I. Milagro
José I. Riezu‐Boj
José I. Herrero
Mariana Elorz
Alberto Benito‐Boillos
Ana Luz Tobaruela‐Resola
Amelia Marti Del Moral
Josep A. Tur
J. Alfredo Martínez
Itziar Abete
M. Ángeles Zulet
collection Wiley Open Access
contents Planetary Health Diet Adherence Improves Weight and Body Composition During Energy Restriction Paola Mogna‐Peláez Naixin Zhang Marta Guasch‐Ferré Fermin I. Milagro José I. Riezu‐Boj José I. Herrero Mariana Elorz Alberto Benito‐Boillos Ana Luz Tobaruela‐Resola Amelia Marti Del Moral Josep A. Tur J. Alfredo Martínez Itziar Abete M. Ángeles Zulet Obesity ABSTRACT Objective Obesity management relies on energy restriction, yet the contribution of dietary quality to weight‐loss and body composition outcomes during hypocaloric interventions remains poorly characterized. This study evaluated whether adherence to the Planetary Health Diet (PHD), as a measure of diet quality, and its key components is associated with weight loss and body composition during energy restriction. Methods Data from 403 adults with overweight or obesity were analyzed at baseline and at 3, and 6 months across two controlled dietary interventions prescribing a 30% energy deficit. PHD adherence was quantified using an energy‐adjusted score based on EAT–Lancet dietary targets. Excellent weight loss was defined as ≥ 10% body weight reduction. Associations were assessed using mixed models, logistic regression, and mediation analyses. Results Higher PHD adherence was associated with lower BMI, waist circumference, and body fat percentage. Participants in the highest‐adherence quartile had lower BMI than those in the lowest‐adherence quartile (−0.94 kg/m 2 ; 95% CI: −1.62 to −0.31; p  = 0.005). Each 10‐point increase in adherence increased odds of achieving ≥ 10% weight loss by 49% (OR = 1.49; 95% CI: 1.03–2.16). Red and processed meat reduction and higher whole‐grain intake mediated associations. Conclusions Greater PHD adherence during energy restriction was associated with greater weight loss and improved body composition. Trail registration: ClinicalTrials.gov identifiers NCT02737267 and NCT03183193 10.1002/oby.70215 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/oby.70215
format Artículo Open Access
id wiley_oa_10_1002_oby_70215
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2026
publisher Wiley
record_format wiley_oa
spellingShingle Planetary Health Diet Adherence Improves Weight and Body Composition During Energy Restriction
Paola Mogna‐Peláez
Naixin Zhang
Marta Guasch‐Ferré
Fermin I. Milagro
José I. Riezu‐Boj
José I. Herrero
Mariana Elorz
Alberto Benito‐Boillos
Ana Luz Tobaruela‐Resola
Amelia Marti Del Moral
Josep A. Tur
J. Alfredo Martínez
Itziar Abete
M. Ángeles Zulet
Obesity
Planetary Health Diet Adherence Improves Weight and Body Composition During Energy Restriction Paola Mogna‐Peláez Naixin Zhang Marta Guasch‐Ferré Fermin I. Milagro José I. Riezu‐Boj José I. Herrero Mariana Elorz Alberto Benito‐Boillos Ana Luz Tobaruela‐Resola Amelia Marti Del Moral Josep A. Tur J. Alfredo Martínez Itziar Abete M. Ángeles Zulet Obesity ABSTRACT Objective Obesity management relies on energy restriction, yet the contribution of dietary quality to weight‐loss and body composition outcomes during hypocaloric interventions remains poorly characterized. This study evaluated whether adherence to the Planetary Health Diet (PHD), as a measure of diet quality, and its key components is associated with weight loss and body composition during energy restriction. Methods Data from 403 adults with overweight or obesity were analyzed at baseline and at 3, and 6 months across two controlled dietary interventions prescribing a 30% energy deficit. PHD adherence was quantified using an energy‐adjusted score based on EAT–Lancet dietary targets. Excellent weight loss was defined as ≥ 10% body weight reduction. Associations were assessed using mixed models, logistic regression, and mediation analyses. Results Higher PHD adherence was associated with lower BMI, waist circumference, and body fat percentage. Participants in the highest‐adherence quartile had lower BMI than those in the lowest‐adherence quartile (−0.94 kg/m 2 ; 95% CI: −1.62 to −0.31; p  = 0.005). Each 10‐point increase in adherence increased odds of achieving ≥ 10% weight loss by 49% (OR = 1.49; 95% CI: 1.03–2.16). Red and processed meat reduction and higher whole‐grain intake mediated associations. Conclusions Greater PHD adherence during energy restriction was associated with greater weight loss and improved body composition. Trail registration: ClinicalTrials.gov identifiers NCT02737267 and NCT03183193 10.1002/oby.70215 http://creativecommons.org/licenses/by/4.0/
title Planetary Health Diet Adherence Improves Weight and Body Composition During Energy Restriction
topic Obesity
url https://onlinelibrary.wiley.com/doi/10.1002/oby.70215