EAT-Lancet Commission Research Articles

EAT-Lancet Healthy Reference Diet score and diabetes incidence in a cohort of Mexican women.

To improve the health of our planet and develop sustainable food policies, it is important to understand the health impact of a diet pattern that considers planetary and population health. We used data from the Mexican Teachers' Cohort (MTC) to estimate the association between the EAT-Lancet healthy reference diet (EAT-HRD) and type 2 diabetes (T2D) incidence. We included 74,671 women aged ≥25 years, free of T2D at baseline. A validated food frequency questionnaire (FFQ) was used to assess dietary intake. We created an EAT-HRD score based on 15 food groups recommended by the EAT-Lancet Commission (range from 0 to 15). T2D cases were identified through self-report and cross-linkage with clinical and administrative databases. We used Cox proportional hazards models to estimate the association between categories of the EAT-HRD score with T2D incidence. During a median follow-up of 2.16 y (IQR 1.8-4.3 y), we identified 3241 T2D incident cases. The median EAT-HRD score was 6 (IQR 5-7). In multivariable analyses, when comparing extreme categories, higher adherence to the EAT-HRD score was associated with lower T2D incidence (HR 0.90; 95% CI 0.75, 1.10), yet, the estimation was imprecise. Compared to those who did not meet the EAT-HRD recommendations, adhering to the red meat, legumes, and fish recommendations was associated with lower T2D incidence. Meeting the recommendation of dairy and added sugars was associated with an increased incidence of T2D. Higher adherence to a diet designed to promote environmental and human health may help prevent T2D incidence among women in a middle-income country.

Food System for Sustainable Healthy Diets: Global and Local Efforts.

Global efforts for sustainable healthy diets include the Sustainable Development Goals by the United Nations in 2015, the Sustainable Healthy Diets by the Food and Agriculture Organization of the United Nations and the World Health Organization in 2019 and the Planetary Health Diet by the EAT-Lancet Commission. The food system is a dynamic and complex system, and systems approach is useful in providing stakeholders and policymakers with a comprehensive understanding of the broader food system. As local efforts, some of the recent articles using systems approach are introduced. They include systems modelling for local sustainability, policy activities for healthy and sustainable diets, food-related policymaking processes, low fruit and vegetable intake in children, and livestock-derived food system. In light of the existence of various stakeholders and policymakers, redesigning of the food system using systems approach may help mitigate climate change.

Does Mexico have the agricultural land resources to feed its population with a healthy and sustainable diet?

Reaching healthy and sustainable diets for all people with the world's limited resources is one of the biggest challenges of humanity. The Healthy Reference Diet (HRD) is a recent proposal by the Eat-Lancet Commission for addressing this problem. Mexico has a high burden of obesity and persistent malnutrition. Recent national policies have focused on different strategies to transform the food system which include designing new dietary guidelines using the HRD adapted for the Mexican context and supporting small farmers to reduce food imports. The aim of the paper is to explore whether Mexico has enough land resources to produce food for a healthy and sustainable diet for its population, with no international trade, and what changes are needed to reach this in terms of diets, the food system, and in land use. Four scenarios are explored for changing the food system to reduce agricultural land use. The results show that Mexico has enough agricultural land to produce food for all its population to ensure healthy and sustainable diets with the current food supply chain. A healthy and sustainable diet demands 20 % to 50 % less agricultural land, depending on the type of dietary recommendation, than the present average diet of the Mexican population. But changes are needed in the food system in terms of land use such as exchanging pasture for cropland and changing the type of crop production like reducing cropland for sugar cane and feed for livestock, and increasing cropland for legumes and nuts. Furthermore, reducing losses in the supply chain and increasing crop yields reduces considerably the demand of agricultural land. Further research is needed to explore the socioeconomic issues and policies for reaching these changes. The insights of this paper should be considered when designing policy strategies and recommendations to reach a sustainable food system.

Adherence to the EAT-Lancet sustainable reference diet and cardiometabolic risk profile: cross-sectional results from the ELSA-Brasil cohort study.

The EAT-Lancet Commission released a reference sustainable diet to improve human health and respect the planetary boundaries. The Planetary Health Diet Index (PHDI) was developed with the purpose of evaluate the adherence to this reference diet. The aim of the present study was to evaluate the association between adherence to the EAT-Lancet diet with cardiometabolic risk profile. We used the cross-sectional baseline data from 14,155 participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter ongoing cohort study. Dietary data were collected using a 114-item validated food frequency questionnaire. The PHDI was used to assess the adherence to the EAT-Lancet diet. It consists of 16 components and the total score can range from 0 to 150 points. Linear, logistic and quasi-Poisson regression models were built to evaluate the associations between PHDI and the outcomes. Individuals with higher adherence to EAT-Lancet diet (PHDI, 5th quintile) had lower values for systolic blood pressure (β -0.84; 95% CI -1.66: -0.01), diastolic blood pressure (β -0.70; 95% CI -1.24: -0.15), total cholesterol (β -3.15; 95% CI -5.30: -1.01), LDL-c (β -4.10; 95% CI -5.97: - 2.23), and non-HDL-cholesterol (β -2.57; 95% CI -4.62: -0.52). No association was observed for HDL-c, triglycerides and HOMA-IR. Our results indicate that higher adherence to the EAT-Lancet diet is associated with lower levels of blood pressure, total cholesterol, LDL-c, and non-HDL-c.

Adherence to the EAT-Lancet Diet: Unintended Consequences for the Brain?

In January 2019, the EAT–Lancet Commission defined a universal reference diet to promote human and environmental health. However, in doing so, the potential consequences for brain health were not considered. Whilst plant-based diets are generally associated with better cognitive and affective outcomes, those that severely limit animal products are not. Therefore, the potential ramifications of the EAT–Lancet diet on cognition, mood, and heart rate variability were considered (N = 328). Adherence to the Alternative Healthy Eating Index (AHEI) was associated with having a better mood, focused attention, working and episodic memory, and higher heart rate variability. However, when the EAT–Lancet diet was considered, the effects were either smaller or not significant. Cluster analysis identified a dietary style characterised by a strong adherence to the EAT–Lancet recommendation to limit meat intake, representing a sixth of the present sample. This group had a lower Mean Adequacy Ratio (MAR); did not meet the Recommended Nutrient Intake (RNI) for a range of nutrients including protein, selenium, zinc, iron, and folate; and reported a poorer mood. These data highlight the potential unintended consequences of the EAT–Lancet recommendations for nutritional adequacy and affective health in some individuals. There is a need to better optimise the EAT–Lancet diet to support brain health. As we move towards more sustainable diets, these findings emphasise the need to consider how such diets might affect the brain.

Association between adherence to the EAT-Lancet diet and risk of cancer and cardiovascular outcomes in the prospective NutriNet-Santé cohort

The EAT-Lancet commission proposed, in 2019, a planetary, healthy, and universal dietary pattern. However, this diet has rarely been studied in relation to various health outcomes. We aimed to prospectively estimate the association between the EAT-Lancet diet and cancer and cardiovascular disease (CVD) risk. The study was conducted in participants of the NutriNet-Santé cohort (2009-2021). The endpoints were the incident outcomes (cancer and CVDs and mortality from these diseases), combined and separately. Adherence to the EAT-Lancet diet was estimated using the EAT-Lancet Diet Index (ELD-I) modeled as quintiles (Qs). Multivariable Cox proportional hazard models were used to estimate HRs and 95% CIs, adjusted for potential confounders and moderators. A total of 62,382 subjects were included; 2475 cases of cancer and 786 cases of cardiovascular events occurred during a median follow-up of 8.1 y. The sample was 76% female, the mean±SD age at inclusion was 51.0±10.2 y. The ELD-I ranged from -162 to 332 points with a mean±SD score of 45.4±25.6 points. In multivariable models, no significant association between the EAT-Lancet diet and the risk of cancer and CVD combined, and separately, was observed. Alcohol consumption was an effect modifier of the association. A significant association was observed among low drinkers (HRQ5vs.Q1: 0.86; 95% CI: 0.73, 1.02; P-trend=0.02). A higher ELD-I was significantly associated with a lower risk of overall cancer only among females (HRQ5vs.Q1: 0.89; 95% CI: 0.75, 1.05; P-trend=0.03). Both associations were largely attenuated by BMI. Contrary to our hypothesis, our results documented significant associations between adherence to the EAT-Lancet diet and incidence of cancer only in some subgroups, and no association with CVD.This trial was registered at clinicaltrials.gov as NCT03335644.

Co-benefits of the EAT-Lancet diet for environmental protection in the framework of the Spanish dietary pattern.

The immediate need to build resilient food systems with lower greenhouse gas (GHG) emissions and protection of water resources is a global challenge. To address this, the EAT-Lancet Commission described the global reference diet with principles of nutritional quality and environmental sustainability. With this in mind, the carbon and water footprints of the current Spanish dietary pattern have been compared with the EAT-Lancet global dietary recommendations, taking into account deviations in food intake. To provide additional context, differences between the average Spanish dietary pattern and dietary guidelines applied in other countries in Europe (Italy, the Netherlands and the Mediterranean region) and America have also been analyzed and discussed from a sustainability approach. We found that the EAT-Lancet diet requires less water resources (3056 L·person-1·day-1) and lower level of GHG emissions (2.13 kgCO2eq·person-1·day-1) in comparison with the Spanish dietary pattern (3732 L·person-1·day-1 and 3.62 kgCO2eq·person-1·day-1, respectively). Starch-based products and oils and fats were identified as largest contributors to both environmental indicators in the EAT-Lancet diet. On the other hand, meat and dairy were the environmental hotspots in the Spanish dietary pattern. Comparison with other food-based dietary patterns also raises environmental concerns about the high meat consumption in Spain. Overall, this analysis suggests that reducing the consumption of beef meat and dairy to a level in line with the global environmental targets set by the EAT-Lancet Commission would ensure a shift in Spanish dietary habits towards more environmentally sustainable food consumption patterns.

Associations of Adherence to a Dietary Index Based on the EAT–Lancet Reference Diet with Nutritional, Anthropometric, and Ecological Sustainability Parameters: Results from the German DONALD Cohort Study

ABSTRACTBackgroundValidation of the EAT–Lancet reference diet (ELR-diet), recently proposed by the EAT–Lancet Commission, within the context of real-life studies is necessary to elucidate its feasibility, nutritional value, sustainability, and health effects.ObjectivesWe aimed to develop a dietary index (DI) score to measure adherence to the ELR-diet. We further aimed to study the association between the DI score and 1) nutritional characteristics, 2) indicators of ecological sustainability, and 3) anthropometric markers and biomarkers for cardiometabolic health.MethodsA DI score was constructed by comparing the categories defined by the ELR-diet with the dietary data of 2–5 sets of 3-d weighed dietary records from DONALD (Dortmund Nutritional and Anthropometric Longitudinal Designed) study participants (n = 298; ≥15 y of age). Prospective associations between the DI score and risk markers (anthropometric and cardiometabolic) in young adulthood (≥18 y old) were investigated using multivariate linear regression.ResultsAdherence to the DI score components was considerable (majority > 50%), but varied within the population (2%–100%). The highest tertile of the DI score was inversely associated with the intake of protein (tertile 3 compared with tertile 1: 13.5 compared with 14.5 energy %), added sugars (10.5 compared with 12.4 energy %), and cholesterol (100 compared with 116 mg/1000 kcal), but positively associated with fiber intake (10.0 compared with 8.82 g/1000 kcal) (all P < 0.05). The DI score was inversely associated with greenhouse-gas emissions (tertile 1 compared with tertile 3: 6.48 compared with 5.85 kg of carbon dioxide equivalents/2500 kcal; P < 0.001) and land use (8.24 compared with 7.16 m2 × y/2500 kcal; P < 0.001). Inverse associations between the DI score and anthropometric markers during young adulthood were observed (e.g., BMI: tertile 1 compared with tertile 3: 22.9 compared with 21.9 kg/m2; P = 0.03) (all P < 0.05). No associations between the DI score and cardiometabolic risk markers were found (all P ≥ 0.05).ConclusionsAdherence to the ELR-diet was associated with favorable nutritional characteristics and reduced environmental impact. Adherence to the DI score in adolescence was also beneficial with respect to anthropometric markers in early adulthood, although not for further cardiometabolic risk markers.

Differentiated responsibilities of US citizens in the country’s sustainable dietary transition

If widely adopted, the ‘planetary health diet’ (PHD), proposed by the EAT-Lancet Commission, would help to meet ambitious sustainability goals currently jeopardised by excessive and resource intensive food demand. To date, convergence of nations to the PHD has been assessed using average food consumption patterns, overlooking the influence of different consumers within this context. Using self-reported dietary intake data from a snapshot survey of the US we reveal the differentiated responsibilities of US citizens within the country’s adoption of the PHD otherwise hidden by use of country averaged dietary intake data. We show how such a granular analysis of food consumption patterns is critical to identify levers in the sustainable food transition of nations. By combining 7418 individual food intake reports from a representative cross section of the United States (US) with commodity-level impact data we estimate the overshoot of US dietary patterns in relation to the PHD and their impacts across the climate, water and land system. The net environmental impacts of PHD adoption across the US population are quantified based on realistic dietary shifts. We estimate that US overshoot of the PHD is responsible for 70% of the US dietary greenhouse gas (GHG) footprint. However, over 60% of this burden could be eliminated by just 10% of the US population following the PHD. Although we estimate PHD adoption will more than half the US dietary GHG footprint and land footprint, we find it may have unintended consequences on water demand due to increased tree nut consumption. Across almost all food categories, we show that the food choices of the top tier of consumers in the US create, and must bridge the PHD gap. As such, actions by these consumers will be of major consequences to the speed and direction of the country’s sustainable dietary transition. To avoid environmental trade-offs, dietary policies must be scrutinised across multiple sustainability criteria.

From the President and IFST News

From the President and <scp>IFST</scp> News

Healthy and sustainable diets from today to 2050-The role of international trade.

The connection between international trade and food systems (un)sustainability is both contentious and critical for policy work supporting progress towards achieving the twin goals of hunger alleviation and dietary health while improving the overall sustainability of development. We characterize the food system using a set of metrics based upon the EAT-Lancet commission dietary guidelines for both over- and under-consumption of different foods to assess country-level dietary health and sustainability in tandem. Using a partial equilibrium model of agricultural production and trade, we then project the functioning of the global agricultural system to 2050 and calculate the metrics for that year. For most regions we find increased overconsumption above the expert-defined healthy and sustainable diet thresholds, with more limited progress towards closing dietary health and sustainability gaps where they currently exist. Trade influences this dynamic into the future under certain socioeconomic conditions, and we find that under a “business as usual” trade environment, future agricultural import profiles continue to be misaligned with dietary health and sustainability outcomes, suggesting the potential for early intervention in trade policy as a means to positively influence food system outcomes.

Gathering data on food environments and food practices through photo elicitation in Copenhagen, Denmark: Implications for adapting the EAT-LANCET reference diet to local circumstances

ABSTRACT Unhealthy diets are the leading cause of mortality and morbidity globally. Simultaneously, the factors that influence diet-related ill-health also drive climate change. Acknowledging the link between health and environmental sustainability, in 2019 the EAT-Lancet Commission outlined a diet beneficial for both humans and the planet. There has since been a drive to adapt this diet for a range of settings. Thus, the Shifting Urban Diets project was initiated to support the City of Copenhagen’s move towards a planetary diet. Food environments are key to shaping dietary practices. To provide evidence on how Copenhagen residents experienced their food environments, one component of this project explored, through photo-elicitation, how residents from one neighbourhood navigated and engaged with their food environment. Ten participants attended participatory photo-elicitation workshops over three weeks in November to December 2019, photographing their food environment and discussing the implications for human and planetary health. Data from the workshops (photos, notes and captions) were analysed thematically. Participants demonstrated the myriad factors that shape food environment engagement. Beyond cost and the built environment, participants chose food outlets that allowed for socialising, that were convenient enough to make time for other activities, and that aligned with values and understandings about the role of food. Participants also naturally drew links between practices that were healthy and practices that were sustainable when considering how they would like the food environment to change. When food priorities and values align with material factors, people are more likely to purchase healthy, sustainable foods.

Low Adherence to the EAT-Lancet Sustainable Reference Diet in the Brazilian Population: Findings from the National Dietary Survey 2017-2018.

Diets are simultaneously connected with population health and environment. The EAT-Lancet Commission proposed a sustainable reference diet to improve population health and respect the planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) has been developed to assess the adherence to this reference diet. In the present study, we aimed to evaluate the adherence to the EAT-Lancet diet through the PHDI in a nationwide population-based study carried out in Brazil. We used data from the National Dietary Survey conducted through the Household Budget Survey in 2017–2018, with 46,164 Brazilians aged over 10 years old. Food consumption was evaluated with a 24 h dietary recall. The average PHDI total score in the Brazilian population was 45.9 points (95% CI 45.6:46.1) on a total score that can range from 0 to 150 points. The adherence to EAT-Lancet diet was low among all Brazilian regions. Women, elderly, those overweighed/obese, with higher per capita income and living in the urban area had higher scores in the PHDI. In general, the Brazilian population presented low adherence to a healthy and sustainable dietary pattern and seems far from meeting the EAT-Lancet recommendations.

Protein Quality Changes of Vegan Day Menus with Different Plant Protein Source Compositions.

To underline the importance of protein quality in plant-based diets, we estimated the protein quality of different exclusively plant-protein-based day menus that are based on the “planetary health diet” developed by the EAT-Lancet Commission. PDCAAS and DIAAS were used to estimate the protein quality (PQ) and fulfilling of the amino acid recommendation for adults in vegan daily menus based on the planetary health diet: 2 days with only low-quality (LQ) protein sources and 2 days with low + high-quality (HQ) protein sources. The protein quality of Day 1LQ (DIAAS 76, PDCAAS 88) was increased by the addition of high-quality protein sources (HQPS): Day 1HQ (DIAAS 94, PDCAAS 98). Day 2LQ had a low PQ (DIAAS 71, PDCAAS 74), but when HQPS were used (Day 2HQ), the PQ increased (DIAAS 83, PDCAAS 88). Scenarios (day 1HQ, day 1LQ, and day 2 HQ) were classified as of good PQ. However, day 1LQ had a low protein quality. Consuming HQPS in a vegan diet can help to fulfil the recommendation of essential amino acids. This work served to understand and apply methods to estimate protein quality that can be applied to optimize protein mixtures to fulfil amino acid requirements in the future.

Development of an EAT-Lancet index and its relation to mortality in a Swedish population

ABSTRACTBackgroundCurrent global food systems threaten human health and environmental sustainability. In 2019, the EAT-Lancet Commission on healthy diets from sustainable food systems defined the first global reference diet to improve both areas, but there is no consensus on how to quantify the EAT-Lancet reference diet as a diet index, and its relation to mortality has not been widely studied.ObjectivesWe sought to develop a new dietary index to quantify adherence to the EAT-Lancet diet and assess its association with mortality in a large, population-based Swedish cohort. We also examined food components included in the index and their individual associations with mortality.MethodsWe used the Malmö Diet and Cancer cohort (n = 22,421; 45–73 years old at baseline). Dietary data were collected using a modified diet history method. The EAT-Lancet index was developed based on intake levels and reference intervals of 14 food components defined in the EAT-Lancet diet (0–3 points per component; 0–42 points in total). Associations with mortality were examined based on registers during a mean of 20 years of follow-up and were adjusted for potential confounders.ResultsDivided into 5 adherence groups, the highest adherence to the EAT-Lancet diet (≥23 points) was associated with lower all-cause mortality (HR, 0.75; 95% CI, 0.67–0.85), cancer mortality (HR, 0.76; 95% CI, 0.63–0.92), and cardiovascular mortality (HR, 0.68; 95% CI, 0.54–0.84) than the lowest adherence (≤13 points). Several food components included in the index contributed to the observed reductions in mortality.ConclusionsWe developed a new dietary index to investigate adherence to the EAT-Lancet diet. The findings indicate a 25% lower risk of mortality among those with the highest adherence to the EAT-Lancet diet, as defined using our index, which adds to the evidence base for the development of sustainable dietary guidelines.

Compliance with EAT-Lancet dietary guidelines would reduce global water footprint but increase it for 40% of the world population.

The EAT-Lancet Commission has proposed a global benchmark diet to guide the shift towards healthy and sustainable dietary patterns. Yet it is unclear whether consumers' choices are convergent with those guidelines. Applying an advanced statistical analysis, we mapped the diet gap of 15 essential foods in 172 countries from 1961 to 2018. We found that countries at the highest level of development have an above-optimal consumption of animal products, fats and sugars but a sub-optimal consumption of legumes, nuts and fruits. Countries suffering from limited socio-economic progress primarily rely on carbohydrates and starchy roots. Globally, a gradual change towards healthy and sustainable dietary targets can be observed for seafood, milk products, poultry and vegetable oils. We show that if all countries adopted the EAT-Lancet diet, the water footprint would fall by 12% at a global level but increase for nearly 40% of the world's population.

Do not transform food systems on the backs of the rural poor.

Even prior to COVID, there was a considerable push for food system transformation to achieve better nutrition and health as well as environmental and climate change outcomes. Recent years have seen a large number of high visibility and influential publications on food system transformation. Literature is emerging questioning the utility and scope of these analyses, particularly in terms of trade-offs among multiple objectives. We build on these critiques of emerging food system transformation approaches in our review of four recent and influential publications from the EAT-Lancet Commission, the IPCC, the World Resources Institute and the Food and Land Use Coalition. We argue that a major problem is the lack of explicit inclusion of the livelihoods of poor rural people in their modeling approaches and insufficient measures to ensure that the nature and scale of the envisioned changes will improve these livelihoods. Unless livelihoods and socioeconomic inclusion more broadly are brought to the center of such approaches, we very much risk transforming food systems to reach environmental and nutritional objectives on the backs of the rural poor.

Association Between the EAT-Lancet Diet Pattern and Risk of Type 2 Diabetes: A Prospective Cohort Study.

Background:The EAT-Lancet Commission has promulgated a sustainable dietary guideline and recommended that it was designed to improve the human health and support environmental sustainability.Objective:This research was designed to explore the association between this healthy diet pattern (EAT-Lancet diet pattern, EAT-LDP) and risk of type 2 diabetes (T2D).Methods:Between 2006 and 2010, a total of 59,849 participants from the UK Biobank without diabetes, cardiovascular disease, or cancers were included at baseline. The EAT-LDP score was constructed on the sum of 14 food components and then categorized into three tertiles. Multivariable Cox proportional hazards regression models were conducted to explore the association between EAT-LDP score and the risk of incident T2D. A mediation analysis was also implemented to disentangle the role of body mass index (BMI) and waist circumference in the relationship between EAT-LDP score and T2D.Results:During a median follow-up of 10 years, 2,461 incident T2D cases were recorded. In analyses that compared tertile 3 of the EAT-LDP score (highest) with tertile 1 (lowest), the hazard ratio (HR) for T2D was 0.81 (95% CI: 0.72–0.90) after adjusting for sociodemographic status and health-related factors. Participants who reported a one-point increase in the diet score were associated with a 6% decrease in risk of T2D (HR: 0.94, 95% CI: 0.91–0.97). A significant indirect association was observed between the EAT-LDP score and T2D (β: 0.66, 95% CI: 0.65–0.67), indicating that 44% of the association of EAT-LDP score with T2D was mediated by BMI. Additionally, 40% of the association of EAT-LDP score with T2D was mediated by waist circumference was also observed.Conclusions:Our findings indicate that a higher adherence to EAT-LDP contributes to lower risk of T2D. Further independent validation is needed to be conducted before applying the EAT-LDP to inform dietary guidelines.

The EAT-Lancet Commission Planetary Health Diet Compared with Institute of Health Metrics and Evaluation Global Burden of Disease Ecological Dietary Data Analysis—Gbd Dietary Risk Factors Correlated with Noncommunicable Disease Early Deaths

The EAT-Lancet Commission Planetary Health Diet Compared with Institute of Health Metrics and Evaluation Global Burden of Disease Ecological Dietary Data Analysis—Gbd Dietary Risk Factors Correlated with Noncommunicable Disease Early Deaths

ALIMENTACIÓN Y SUSTENTABILIDAD: PROPUESTAS DIETARIAS SOSTENIBLES Y POSIBLES EN LA MESA DE LOS ARGENTINOS

Introduction: Argentina faces the challenge of increasing food insecurity rates, widespread malnutrition due to excess weight, unhealthy diets and environmental impact of food systems. The report of the EAT-Lancet Commission (2019) presented a proposal for a "Planetary Diet" laying the foundations for a predominant consumption of vegetable foods and changes in production systems. The proposal involves significant changes in the local eating pattern. This work has the objective of designing dietary proposals based on nutritional evidence recommendations and incorporating environmental impact criteria as well as being sustainable in sociocultural and economic dimensions. Methods: Food consumption recommendations were consolidated based on a review of the nutritional evidence and a matrix was built to prioritize dietary changes based on estimates of the environmental impact of foods consumed by argentine population. Two healthy and sustainable proposals were designed, one based on the characteristic consumption pattern and the second recognizing the growth of the population consuming plant-based diets. Results: The proposed consumptions have a high nutrient density and a lower theoretical environmental impact in relation to the current consumption pattern and compared to the Dietary Guidelines for the Argentine Population (GAPA) Higher consumption of vegetables, fruits, legumes, grains, whole grains and nuts and a decrease in meat, especially red meat and in foods for occasional consumption are proposed. Conclusions: The work introduces in the agenda two dietary proposals -food baskets- that meets criteria of healthy eating and the concept of sustainability. Key words: healthy eating; sustainability; diet quality; dietary proposals; plant-based diet.