Diet and nutrition are essential factors in promoting good health throughout life. Their role as determinants of chronic non-communicable diseases is widely recognized. Additionally, the demand for food involves relevant environmental burdens that have to be taken into account on the way to achieving the Sustainable Development Goals. As an important part of nutrition policy, food-based dietary guidelines (FBDGs) have been revised. The key question is: Are environmental considerations being incorporated into them? To address this issue, we modeled and compared both the main environmental indicators in terms of carbon footprint (CF) and water footprint (WF), and nutritional quality (according to the Nutrient Rich Diet index, NRD9.3 and a health gain score) of dietary guidelines from Northern and Southern Europe and America. Particularly, the FBDGs compared were Dutch Dietary Guidelines (DDG), New Nordic Diet (NND), Spanish Strategy for Nutrition, Physical Activity and Obesity Prevention (NAOS), Mediterranean Diet (MD), Italian Dietary Guidelines (IDG) and American Dietary Guidelines (DGA).The IDG and MD offered the best profiles from a climate change perspective (2.04 and 2.21 kgCO2eq·day−1). Overall, DGA had the highest CF (2.98 kgCO2eq·day−1). WF presented greater fluctuations, not only due to daily-recommended amounts, but also because of different climate conditions and production systems of the reference countries. Hence, WF ranged from 1760 L·person−1·day−1 in IDG to 3181 L·person−1·day−1 in NAOS. Finally, the nutritional value of MD, which had the highest NRD9.3 (477) and health gain score (178), has been demonstrated when the comparison was made with DDG, the one with the lowest health gain score (97) and DGA, the worst in terms of NRD9.3 (391).To go ahead of the FBDGs that bet on all dimensions of sustainability, multi-criteria analysis is needed. Nutrition and environmental performance are not the only aspects of the problem; economy and sociocultural variables should be considered.