Health and environmental evidence, challenges, and sustainable strategies of Planetary Health Diet: A mixed-methods review

The Planetary Health Diet (PHD) was proposed by the Lancet Commission in 2019. It is a new way of eating that aims to improve both human health and the environment simultaneously. However, recent practice demonstrates persistent cognitive gaps in terms of systematic quantification of health benefits, robust evidence of environmental impacts, and region-specific implementation pathways. This study systematically integrates epidemiological evidence to clarify the associations between PHD and reduced risks of diseases, including cardiovascular disease, diabetes, and certain cancers. Additionally, the study talks about how it affects the demand for agricultural land, the stress on freshwater resources, the release of greenhouse gases, and the imbalance in nitrogen and phosphorus cycles. The study elucidates various multidimensional obstacles to global PHD adoption, including limitations in natural resources, regional economic inequalities, scaling challenges in food technology innovation, and resistance to cultural and intergenerational transmission. To tackle these issues, the study proposes a four-dimensional synergistic approach: encouraging innovation in food production systems, creating fair food distribution systems, building policy intervention toolkits, and designing behavioral incentives. These evidence-based solutions offer both theoretical foundations and actionable paradigms for sustainable food system transformation. • Evidence synthesis confirms PHD reduces chronic disease risks (CVD, cancer, etc.). • PHD relieve environmental stress: farmland, freshwater, GHG, energy, N&P cycles. • Identify global barriers: resource limits, econ gaps, tech bottlenecks, cultural resist. • Propose integrated strategy: production innovation, fair access, policy tools, incentives.