Researchers studied nearly 26,000 people in Sweden to see if the EAT-Lancet diet—a way of eating that focuses on plants with some animal foods—provides enough vitamins and minerals. They found that people who followed this diet closely generally got adequate amounts of most nutrients, though the results depended on how they measured the diet. The good news: the diet didn’t increase the risk of most nutrient deficiencies. The concern: women following the diet showed a slightly higher risk of anemia (low iron in the blood). Overall, this plant-focused eating pattern appears nutritionally sound for most people.

The Quick Take

  • What they studied: Whether the EAT-Lancet diet—a mostly plant-based eating plan designed to be healthy for both people and the planet—actually provides enough essential vitamins and minerals that our bodies need.
  • Who participated: Nearly 26,000 Swedish adults who were part of a long-term health study that started in the early 1990s. Researchers looked at what they ate and checked their blood for certain nutrients.
  • Key finding: People who ate more according to the EAT-Lancet diet guidelines got adequate amounts of most vitamins and minerals (like vitamin A, B vitamins, vitamin C, calcium, magnesium, potassium, iron, and zinc). However, women who followed the diet more closely had a slightly higher chance of developing anemia.
  • What it means for you: If you’re thinking about eating more plant-based foods, this diet appears to be nutritionally complete for most people. However, women should be aware of the anemia risk and may want to monitor their iron levels or talk to a doctor about iron intake. The findings suggest this eating pattern can work well, but individual needs vary.

The Research Details

This was a cohort study, meaning researchers followed a large group of people over time and tracked what they ate. The Swedish researchers used data from nearly 26,000 adults who had been part of a health study since the early 1990s. They asked people detailed questions about their diet using a validated method (a special interview technique that’s been proven to be accurate) and then calculated exactly how many vitamins and minerals they were getting from their food. To measure how closely people followed the EAT-Lancet diet, the researchers used seven different scoring systems—basically seven different ways of measuring adherence. They also took blood samples from some participants to directly measure certain nutrients (folate, vitamin D, selenium, zinc, and iron levels).

The researchers compared nutrient intake and blood nutrient levels between people who followed the EAT-Lancet diet closely and those who didn’t. They used statistical methods to see if there were meaningful differences. They also tested how the results changed depending on which scoring method they used and whether they adjusted for total calories eaten.

Previous studies suggested the EAT-Lancet diet could provide enough nutrients, but most were computer simulations rather than real-world studies with actual people. This study is important because it looked at real people’s actual eating patterns and measured nutrients both through diet records and blood tests. By testing seven different scoring methods, it also revealed that how you measure diet adherence matters—different methods can give different answers. This helps researchers understand which measurement approaches are most reliable.

This study has several strengths: it included a very large number of people (nearly 26,000), used validated methods to measure diet, and included both dietary intake data and blood biomarkers for some nutrients. However, there are some limitations: the data is from Sweden and may not apply equally to other countries with different food availability, the study is observational (people chose their own diets rather than being randomly assigned), and it only measured some nutrients through blood tests, not all of them. The fact that results varied depending on which scoring method was used suggests that standardized approaches are needed.

What the Results Show

People who followed the EAT-Lancet diet more closely generally had higher intakes of most vitamins and minerals. Specifically, higher adherence was linked to adequate intake of vitamin A, vitamin E, thiamine (B1), vitamin B6, folate (B9), vitamin C, calcium, magnesium, potassium, iron, and zinc. When researchers adjusted their analysis for total calories eaten, the results were even stronger—people were more likely to get enough nutrients.

When looking at blood tests, higher adherence to the diet was associated with lower risk of folate deficiency, which is good news. However, women who followed the diet more closely had a slightly increased risk of anemia (low iron in the blood), which is a concern that needs attention.

For other nutrients measured in blood (selenium, zinc, and vitamin D), there were no significant differences in deficiency risk for women. Men showed a slightly lower risk of vitamin D deficiency with higher diet adherence. One of the seven scoring methods showed a lower risk of zinc deficiency with higher adherence.

The researchers found that the specific scoring method used to measure diet adherence affected the results—some methods showed stronger nutrient adequacy than others. This highlights that how we measure whether people are following a diet matters significantly.

The study revealed that energy adjustment (accounting for total calories eaten) was important for predicting nutrient adequacy. When researchers adjusted for calories, people were more likely to meet nutrient recommendations. This suggests that the EAT-Lancet diet may need to provide enough total calories to ensure adequate micronutrient intake. The variation between different scoring methods indicates that standardized ways of measuring diet adherence are needed for future research on sustainable diets.

Earlier studies using computer models suggested the EAT-Lancet diet could provide adequate nutrients, but this is one of the first large population-based studies to test this in real people using both dietary intake and blood biomarker data. The findings generally support the earlier predictions that the diet can be nutritionally adequate, but the anemia finding in women is a new concern that wasn’t highlighted in previous research. This study adds real-world evidence to the theoretical models.

The study has several important limitations to consider: (1) It was conducted in Sweden, so results may not apply equally to people in other countries with different foods available and different eating traditions. (2) It’s observational, meaning people chose their own diets rather than being randomly assigned to follow the EAT-Lancet diet, so we can’t prove cause and effect. (3) Only some nutrients were measured through blood tests; most were estimated from diet records. (4) The data is from the 1990s, so eating patterns and food composition may have changed. (5) The variation in results between different scoring methods suggests that how we measure diet adherence is still not standardized. (6) The study couldn’t determine why women showed increased anemia risk—whether it’s due to lower iron intake, lower iron absorption, or other factors.

The Bottom Line

Based on this research, the EAT-Lancet diet appears to be a nutritionally adequate way of eating for most people (moderate confidence level). It can provide sufficient amounts of most essential vitamins and minerals. However, women should be aware of the potential anemia risk and should: (1) Monitor their iron intake and consider including iron-rich plant foods (like lentils, beans, fortified cereals, and leafy greens) or pair plant iron sources with vitamin C to improve absorption; (2) Consider getting their blood iron levels checked periodically; (3) Talk to a healthcare provider if they experience fatigue, weakness, or shortness of breath. For men, the diet appears safe with no major deficiency concerns identified.

This research is relevant for anyone considering adopting a more plant-based diet, particularly those interested in the EAT-Lancet diet for environmental or health reasons. It’s especially important for women of childbearing age and women in general to be aware of the anemia finding. People with existing nutrient deficiencies, pregnant women, and those with certain health conditions should consult healthcare providers before making major dietary changes. The findings are most applicable to people in developed countries with access to diverse plant foods.

If you switch to this eating pattern, you likely won’t notice immediate changes. Nutrient status typically takes weeks to months to shift. For blood nutrient levels like folate, changes may take several weeks. For anemia risk in women, this is a longer-term concern that develops over months to years. If you’re making dietary changes, it’s reasonable to get blood work done after 3-6 months to check your nutrient status, and then annually if you’re following the diet long-term.

Want to Apply This Research?

  • Track daily iron intake (in milligrams) and pair iron-containing meals with vitamin C sources. For women, set a goal of 18 mg of iron daily (or 8 mg for men over 50). Log plant-based iron sources (beans, lentils, fortified cereals, leafy greens) and note when you consume them with vitamin C foods (citrus, tomatoes, peppers) to improve absorption.
  • If following the EAT-Lancet diet, implement a weekly meal planning feature that ensures at least 3-4 iron-rich plant meals per week, with at least 2 paired with vitamin C sources. For women, set a monthly reminder to track energy levels and any signs of fatigue, and schedule annual blood work to monitor hemoglobin and iron levels.
  • Create a long-term tracking dashboard that monitors: (1) Daily iron intake from plant sources; (2) Weekly vitamin C + iron meal combinations; (3) Monthly energy/fatigue self-assessment (especially for women); (4) Quarterly nutrient intake summaries for vitamin A, B vitamins, vitamin C, calcium, magnesium, potassium, and zinc; (5) Annual reminders for blood work to check folate, vitamin D, selenium, zinc, and hemoglobin levels. Flag when intake falls below recommended levels.

This research suggests the EAT-Lancet diet can be nutritionally adequate for most people, but individual nutritional needs vary significantly based on age, sex, health status, and other factors. Women should be particularly aware of the potential anemia risk identified in this study. This information is not a substitute for personalized medical advice. Before making major dietary changes, especially if you have existing health conditions, nutrient deficiencies, are pregnant or breastfeeding, or take medications that affect nutrient absorption, please consult with a healthcare provider or registered dietitian. If you experience symptoms of anemia (fatigue, weakness, shortness of breath, dizziness), seek medical attention. Blood work should be monitored periodically when making significant dietary changes.