PlanetDiet: Sustainable diets and cardiometabolic health, study protocol for a six-month parallel-group randomized controlled trial in middle-aged adults at cardiovascular risk

Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide. Diet plays a key role in CVD prevention while linking human health with environmental sustainability. The EAT-Lancet Commission proposed the Planetary Health Diet (PHD), a predominantly plant-based dietary pattern emphasizing high-quality foods and reduced meat consumption. Despite growing interest in the PHD, no randomized controlled trial (RCT) has evaluated its effects using the PHD index on established and novel cardiometabolic biomarkers. Methods: The PlanetDiet study is a six-month, three-arm parallel

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