Sustainable Dietary Patterns Research Articles

Plant-based dietary patterns and ultra-processed food consumption: a cross-sectional analysis of the UK Biobank

Dietary shift towards more plant-based options is increasingly popular, but the quantity of ultra-processed foods (UPFs) they contain is largely unknown. This study assessed the level of UPF and minimally processed food consumption among regular and low red meat eaters, flexitarians, pescatarians, vegetarians and vegans in a large dataset of United Kingdom (UK) adults. This is a cross-sectional analysis of the UK Biobank participants recruited between December 19, 2006, and October 1, 2010. Responses to food frequency questions were used to identify diet types for vegans (never eating any animal-based foods); vegetarians (never eating meat/fish); pescatarians (never eating meat); flexitarians (consumed fish/meat under twice a week); low red meat eaters (consumed fish/poultry more than once a week but red/processed meat under twice a week); and regular red meat eaters (consumed red/processed meat more than once a week). Consumption of all food and drinks collected in 24-h recalls between April 29, 2009, and June 28, 2012, were categorised using the Nova classification. The primary outcomes are the consumption of UPFs and minimally processed foods, expressed as a percentage of daily food intake (grams/day). Multivariable linear regression assessed the mean percentage point difference in UPF and minimally processed food consumption between diet types. This study included 199,502 UK Biobank participants (mean age 58.2 [standard deviation 7.9] years; 55.1% women). The mean UPF consumption was 24.2%, 21.9%, 22.0%, 20.4%, 23.8%, and 22.7% among 75,091 regular red meat eaters, 70,144 low red meat eaters, 45,057 flexitarians, 4932 pescatarians, 4119 vegetarians and 159 vegans, respectively. The adjusted results suggested that compared with regular red meat eaters, UPF consumption was 1.3 percentage points higher among vegetarians (95% confidence interval [CI]: 0.9, 1.7) and lower among low red meat eaters (-1.3, 95% CI:-1.4,-1.1), flexitarians (-0.8, 95% CI:-1.0,-0.7), and pescatarians (-1.6, 95% CI:-1.9,-1.2). The UPF consumption in vegans were not significantly different from regular red meat eaters (1.2 percentage points, 95% CI:-0.7, 3.2). Minimally processed food consumption was higher in all other types of diet than regular red meat eaters, with an adjusted percentage point difference ranged from 0.4 (95% CI: 0.005, 0.9) for vegetarians to 3.2 (95% CI: 1.0, 5.5) for vegans compared with regular red meat eaters. This UK-based study found higher UPF consumption in vegetarian diets and lower in diets with a modest amount of meat or fish. It is important that policies which encourage the urgently needed transition to more sustainable dietary patterns also promote rebalancing diets towards minimally processed foods. National Institute for Health and Care Research (NIHR) School for Public Health Research, World Cancer Research Fund.

Risk ranking of mycotoxins in plant-based meat and dairy alternatives under protein transition scenarios

While reducing the consumption of animal-source foods is recommended for planetary and human health, potential emerging food safety risks associated with the transition to dietary patterns featuring plant-based meat (PBMA) and dairy alternatives (PBDA) remain unexplored. We assessed the exposure to mycotoxins and ranked the associated health risks related to the consumption of PBMA and PBDA. We simulated diets by replacing animal-source proteins with their plant-based alternatives. A risk ratio method, based on the hazard quotient (HQ), was applied to rank mycotoxin-related food safety risks. An aggregated dataset containing contamination data of 45 mycotoxins distributed over 182 PBDA and 131 PBMA samples, collected and analyzed in Europe, representing a convenience sample, was used as input in our risk assessment. The highest risk mycotoxins identified for PBMA in the lower bound scenario (LB) were the sum of aflatoxins (sum AF), alternariol monomethyl ether (AME), aflatoxin B1 (AFB1) and alternariol (AOH), with HQs for children of 121.3, 66.8, 24.0 and 4.3, respectively. In the milk substitution model (LB), HQs of 4.9 (sum AF) and 1.4 (AFB1) were calculated for children, indicating a potential food safety risk. Further analysis demonstrated that soy-based meat alternatives are the highest risk food products, in particular for sum AF, AME, AOH and AFB1. With regard to PBDA, highest HQs were found for sum AF in almond and oat drink, and AFB1 in oat drink. This research presents an approach to overcome the lack of data in the assessment of emerging risks associated with the shift to more sustainable dietary patterns.

Examining the association of climate change worry and awareness of ecological footprint reduction behaviours with Mediterranean diet adherence and climate-friendly food choices

PurposeConsumers’ preferences for more sustainable dietary patterns and more climate-friendly foods can play a significant role in mitigating the effects of climate change. Accordingly, the present cross-sectional study aimed to examine the role of climate change worry and awareness of ecological footprint reduction behaviours in undergraduate consumers’ adherence to the Mediterranean diet and climate-friendly food choices.Design/methodology/approachThis cross-sectional study was carried out with 600 healthy undergraduate students, including 255 (42.5%) males and 345 (57.5%) females. They completed the climate change worry scale, the awareness scale for reducing ecological footprint and the Mediterranean diet adherence scale. In addition, participants’ climate-friendly diet scores (CFDS) were calculated to evaluate climate-friendly food choices. Data were analysed using SPSS software.FindingsLinear regression models indicated that climate change worry was positively associated with adherence to the Mediterranean diet (β = 0.121, p = 0.003) and CFDS (β = 0.087, p < 0.001). Similarly, a positive association was observed between the awareness of ecological footprint reduction behaviours and adherence to the Mediterranean diet (β = 0.179, p < 0.001) and CFDS (β = 0.098, p < 0.001).Research limitations/implicationsThe results may indicate that worry about climate change and awareness of ecological footprint reduction behaviours can promote higher adherence to the Mediterranean diet and more climate-friendly food choices, but the observed associations do not imply causality, and further studies are required to determine whether causal links exist.Originality/valueThis study examined the relationships between climate change worry, awareness of ecological footprint reduction behaviours, adherence to the Mediterranean diet and climate-friendly food choices in a single study on undergraduate students.

Water footprint and Med-Diet adherence: preliminary results from MedDietMenus4Campus

Abstract Background The Mediterranean Diet (MedD) is widely recognized as a health-promoting and sustainable dietary pattern. This study evaluated the environmental impacts of higher education institutes (HEI) menus via water footprint and the compliance with MedD in Croatia, Portugal and Turkey. Methods Water footprint calculation followed the methodology of Mekonnen and Hoekstra (2012). Adherence to the Med-Diet was evaluated using the Med-Diet Compliance Index (MeDCIn). All available options were considered, except for restrictions such as vegetarian, considering a 5-day/week and 1-meal/day menu. Menus spanning a two-week period were analyzed from two distinct HEI in each country. Results Mean water footprints varied across three countries (1213.9-2297.4 L/person). Turkish HEI 1 (2297.4 L/person) and 2 (1934.2 L/person) exhibited the highest water footprints, while Croatian HEI 2 (1213.9 L/person) and Portugal HEI 2 (1308.6 L/person) had the lowest. MedDiet index scores ranged from 0.50 to 5.50. Portugal University 1 (5.5) and 2 (4.5) scored the highest, whereas Croatia University 1 (0.5) scored the lowest. Conclusions In the preliminary results, Portugal presented a lower water footprint and higher MedD adherence, possibly due to the higher use of seafood. The higher water footprint in Turkey might be due to more balanced servings of vegetables and fruits and significant portions of red meat. The low MedD compliance scores in Croatia can be attributed to insufficient fresh fruits, whole grains and pulses, and the low water footprint related to the use of ready-made desserts and soup powders not included in the water footprint database.

Sustainable Dietary Patterns and Alternative Food Sources

Sustainable nutrition ensures optimal dietary intake by evaluating the life cycle of foods and their environmental impacts, aiming to meet current needs without jeopardizing the ability of future generations to do the same. It is characterized by low greenhouse gas emissions, minimal water footprint, efficient energy and land use, and reduced food waste. Sustainable dietary models, which have become increasingly important in the face of rising food demand and climate change challenges, include the Mediterranean Diet, Nordic Diet, DASH Diet, Double Pyramid Model, Flexitarian Diet, EAT-Lancet Commission Reference Diet, and Vegetarian and Vegan diets. Alternative protein sources such as algae, insects, and cultured meat are also significant. Algae offer sustainability through ocean use but have unclear metabolic impacts. Insects are efficient and environmentally friendly but require safety assessments. Cultured meat promises environmental benefits but faces cost and acceptance hurdles. Promoting sustainable eating habits requires a collective effort and is a shared responsibility towards our planet and ourselves.

TEMPORARY REMOVAL: Effect of soy isoflavones on measures of estrogenicity: A systematic review and meta-analysis of randomized controlled trials

BackgroundDespite recommendations to increase plant food consumption for public and planetary health and the role that soy foods can play in plant-predominant diets, controversies around the effects of soy foods and especially soy isoflavones, are a barrier to their intake. Given their cardioprotective effects and ability to alleviate menopausal symptoms, addressing these concerns is particularly relevant to women. ObjectiveThis systematic review and meta-analysis of randomized controlled trials aimed to determine the effect of soy isoflavones on measures of estrogenicity in postmenopausal women. MethodsMEDLINE, Embase, and Cochrane Library were searched through August 2024 for randomized trials 3-months investigating soy isoflavones versus non-isoflavone controls in postmenopausal women. Outcomes included endometrial thickness (ET), vaginal maturation index (VMI), follicle-stimulating hormone (FSH), and estradiol. Independent authors extracted data and assessed risk of bias. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess certainty of evidence. ResultsWe included 40 trials (52 trial comparisons, n=3285) assessing the effect of a median reported dose of 75mg/day of soy isoflavones in substitution for non-isoflavone controls over a median of 24 weeks. Soy isoflavones had no statistically significant effect on any measure of estrogenicity; ET (mean difference, -0.22mm [95% confidence interval, -0.45, 0.01mm], PMD=0.059), VMI (2.31 [-2.14, 6.75], PMD=0.310), FSH (-0.02IU/L [-2.39, 2.35IU/L], PMD=0.987), and estradiol (1.61pmol/L [-1.17, 4.38pmol/L], PMD=0.256). The certainty of evidence was high-to-moderate for all outcomes. ConclusionsCurrent evidence suggests that soy isoflavones do not exhibit estrogenic effects compared to non-isoflavone controls on 4 measures of estrogenicity in postmenopausal women. This synthesis supports that soy isoflavones likely act as selective estrogen receptor modulators, differing clinically from the hormone estrogen. Addressing public health concerns may promote soy foods as high-quality plant protein sources with low environmental impact and cost, particularly benefiting postmenopausal women, and aligning with sustainable dietary patterns and guidelines. RegistrationPROSPERO (CRD42023439239)

Adherence to EAT-Lancet reference diet and risk of premature coronary artery diseases: a multi-center case-control study.

In 2019, a globally sustainable dietary pattern that primarily emphasizes the consumption of plant-based foods was proposed by the EAT-Lancet Commission. However, there is limited evidence regarding the association of this diet with coronary events. To determine the association between the EAT-Lancet Reference Diet (ELD) and premature coronary artery disease (PCAD) risk and its severity. This multi-center, case-control study was conducted within the framework of the Iran premature coronary artery disease (I-PAD). A total of 3185 participants aged under 70 years in women and 60 years in men were included. Cases were those whose coronary angiography showed stenosis ≥ 75% in at least one vessel or ≥ 50% in the left main artery (n = 2033), while the controls had normal angiography results (n = 1152). Dietary intake was assessed using a validated food frequency questionnaire. Logistic regression was utilized to examine the association between ELD and presence of PCAD. Compared with individuals in the first quartile, those in the highest quartile of ELD (OR = 0.29, 95% CI: 0.21, 0.39; P for trend < 0.001) and ELD calculated with minimum intake (OR = 0.39, 95% CI: 0.29, 0.52; P < 0.001) had lower risk of PCAD. Individuals in the highest quartile of adherence to the ELD and ELD with minimum intake had 78% and 72% lower risk of having severe PCAD compared with those in the lowest quartile, respectively. An inverse association was observed between adherence to the ELD and PCAD risk and its severity. Large-scale prospective cohort studies are required to confirm these findings.

Associations of the EAT-Lancet reference diet with metabolic dysfunction-associated steatotic liver disease and its severity: A multicohort study.

The EAT-Lancet Commission devised a globally sustainable dietary pattern to jointly promote human health and sustainability. However, the extent to which this diet supports metabolic dysfunction-associated steatotic liver disease (MASLD) has not yet been assessed. This study aimed to investigate the association between the EAT-Lancet diet and the risk of MASLD and its severity. This prospective multicohort study included 15,263 adults from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) cohort, 1137 adults from the Guangzhou Nutrition and Health Study (GNHS) cohort, and 175,078 adults from the UK Biobank. In addition, 228 Chinese adults from the Prospective Epidemic Research Specifically of Non-alcoholic Steatohepatitis (PERSONS) with biopsy-proven MASLD were included. An EAT-Lancet diet index was created to reflect adherence to the EAT-Lancet reference diet. The TCLSIH cohort recorded 3010 MASLD cases during 53,575 person-years of follow-up, the GNHS cohort documented 624 MASLD cases during 6454 person-years of follow-up, and the UK Biobank developed 1350 MASLD cases during 1,745,432 person-years of follow-up. In multivariable models, participants in the highest tertiles of the EAT-Lancet diet index had a lower risk of MASLD compared with those in the lowest tertiles (TCLSIH: HR = 0.87, 95% CI: 0.78, 0.96; GNHS: HR = 0.79, 95% CI: 0.64, 0.98; UK Biobank: HR = 0.73, 95% CI: 0.63, 0.85). Moreover, liver-controlled attenuation parameter decreased with increasing the diet index in individuals with biopsy-proven MASLD (β = -5.895; 95% CI: -10.014, -1.775). Adherence to the EAT-Lancet reference diet was inversely associated with the risk of MASLD as well as its severity.

The Planetary Health Diet and Its Association with Asthma and Airway Inflammation in School-Aged Children.

Poor dietary choices have been rising concurrently with an increase in asthma prevalence, especially in children. Dietary indexes that simultaneously measure the healthiness and sustainability of dietary patterns have emerged to address the dual concerns of human and planetary health. Accordingly, we aimed to evaluate adherence to a sustainable dietary pattern and its impact on airway inflammation and asthma. In this study, 660 school-aged children (49.1% females, 7-12 years) were considered. A cross-sectional analysis was performed to assess the association between diet and asthma and airway inflammation according to overweight/obesity. Diet was evaluated through the Planetary Health Diet Index (PHDI). Higher scores represent a healthier and more sustainable diet. Three definitions of asthma were considered based on a self-reported medical diagnosis, symptoms, asthma medication, measured lung function, and airway reversibility. Airway inflammation was assessed by exhaled fractional nitric oxide (eNO). We considered two categories of body mass index: non-overweight/non-obese and overweight/obese. The associations between diet with asthma and airway inflammation were estimated using adjusted binary logistic regressions. The odds of having airway inflammation decreased with the increase in PHDI score. Moreover, children in the non-overweight/non-obesity group in the fourth quartile of the PHDI had lower odds of having airway inflammation compared to children in the first quartile. Our study indicates that a healthier and sustainable diet is associated with lower levels of eNO, but only among children without overweight/obesity.

Adherence to Mediterranean Diet and Health Outcomes in Adolescents: An Umbrella Review.

Proper nutrition represents 1 of the domains of adolescents' well-being. In this context, the Mediterranean diet (MD), as a healthy, traditional, and sustainable dietary pattern, plays a crucial role in promoting adequate growth and preventing chronic noncommunicable diseases. The currently available evidence on the effects of adherence to the MD (AMD) in association with several physical health outcomes in adolescence is summarized in this review. Five electronic databases were searched. Systematic reviews with or without meta-analysis of observational studies and randomized clinical trials, published in English during 2013-2022, and that assessed the health impact of AMD among adolescents were eligible. Details on study design, methods, population, assessment of dietary patterns, health outcomes, and main results were extracted. The search yielded 59 references after removal of duplicates. Applying PICOS criteria, 4 systematic reviews and 3 meta-analyses ultimately were included in this review. The AMD was evaluated in association with overweight/obesity and adiposity in 2 studies, musculoskeletal health in another 2, inflammation in 1 study, and cardiometabolic health in 1 study. The seventh review examined all mentioned health outcomes (overweight and obesity, musculoskeletal health, inflammation, and cardiometabolic health) in relation to AMD. Overall, this umbrella review showed limited evidence and a lack of consistency about the relation between AMD and health outcomes of interest in adolescence, indicating the need for more studies to better understand it. PROSPERO registration no. CRD42023428712.

Perceptions and preferences for environmentally sustainable food and associated factors: a cross-sectional analysis of a nationally representative survey of United States consumers

BackgroundConsumers are increasingly interested in environmentally sustainable dietary patterns. However, specific signals (e.g., language, labels, logos, or packaging) American consumers use to identify environmentally sustainable products are yet to be explored. ObjectivesTo determine perception and preferences for environmentally sustainable food and associated health and demographic factors associated with consumers’ use of signals for environmentally sustainable food products in a nationally representative survey of United States consumers. MethodsRepeated cross-sectional data were collected for the 2019 and 2020 annual online Food and Health Survey by the International Food Information Council. Three questions were analyzed: 1) the stated importance of environmentally sustainable food products, 2) signals consumers use to identify environmentally sustainable food/beverage products, and 3) the impact of environmental sustainability on food/beverage purchase decisions. Questions 2 and 3 were asked only from participants who stated environmental sustainability is important in question 1. Options provided for signals for environmentally sustainable products were recyclable packaging, minimal packaging, labeled organic, labeled locally grown, labeled sustainably sourced, and labeled non-genetically modified organisms (GMOs)/not bioengineered. Poisson regression and logistic regressions were performed to assess associations. ResultsOf 1905 completers, 1059 (55.6%) answered that it was somewhat or very important that food products purchased/consumed were environmentally sustainable. Of those, 94% used ≥1 of the 6 signals to determine environmental sustainability when shopping. Some signals were selected despite little association with environmental sustainability (e.g., locally grown and non-GMO/not bioengineered). The number of signals consumers used was associated with education, race/ethnicity, health status, and the level of impact they reported that sustainability plays in their decisions. Associations between consumer characteristics and the use of different signals for environmental sustainability were heterogeneous. ConclusionsEven among consumers who value environmental sustainability in food products, specific signals used by different respondents varied across demographics and health characteristics.

Adherence to mediterranean diet and aromatic plants intake are related with gustatory function: A case-study from a Portuguese region

The Mediterranean Diet has been recognized as one of the healthiest and most sustainable dietary patterns and is flavor rich due to the use of different seasonings, such as aromatic plants, in dish confection. Based on the hypotheses that: 1) gustatory function will affect food choices; 2) seasoning flavors may be differently accepted according to individuals’ gustatory functions; the aim of the present study was to assess the association between taste sensitivity and/or preference with Mediterranean Diet adherence and seasoning consumption. A total of 383 adults (18–59 years old; 198 female, 185 male) from North Alentejo region of Portugal were enrolled in this study, with 291 (145 female and 146 male) also evaluated for gustatory function. Recognition thresholds were obtained for four tastes (sweet, sour, salty, and bitter) and astringency, as well as preference level for the highest concentration of each stimulus tested. A validated Food Frequency Questionnaire was filled out, and MD adherence was extrapolated from the answers of the Food Frequency Questionnaire according to the Mediterranean Diet Adherence Screener (MEDAS) score.In total, 20.8% of the individuals presented low, 58.2% medium, and 21.0% high adherence. Adherence was higher in women than men and in older individuals than younger adults. Adherence to the Mediterranean Diet was positively correlated with aromatic plants consumption but not spices. Seasonings were associated with gustatory function, and the cluster with higher consumption presented higher preferences for bitter and salty tastes. Total sodium intake was also higher in this cluster, suggesting that these individuals prefer stronger oral sensations. In conclusion, this study shows that MD adherence is not high, even in regions with rural characteristics. The observed association of MD and seasoning intake with gustatory function do underline the usefulness of this information in strategies aimed at promoting healthy and sustainable eating patterns.

Pork Meat Composition and Health: A Review of the Evidence.

Meat has been part of the human diet for centuries and it is a recognizable source of high-biologic-value protein and several micronutrients; however, its consumption has been associated with an increased risk of non-communicable diseases (e.g., cardiovascular diseases, cancer). These concerns are mostly related to red meat. However, meat composition is quite variable within species and meat cuts. The present study explores the composition of pork meat, and the differences among different pork meat cuts and it reviews the evidence on the influence of its consumption on health outcomes. Pork meat contributes to 30% of all meat consumed worldwide and it offers a distinct nutrient profile; it is rich in high-quality protein, B-complex vitamins, and essential minerals such as zinc and iron, though it contains moderate levels of saturated fat compared to beef. Additionally, research on sustainability points out advantages from pork meat consumption considering that it is a non-ruminant animal and is included in one of the five more sustainable dietary patterns. In what concerns the data on the influence of pork meat consumption on health outcomes, a few clinical studies have shown no harmful effects on cardiovascular risk factors, specifically blood lipids. Several arguments can justify that pork meat can be an option in a healthy and sustainable diet.

Mediterranean Dietary Pattern for Healthy and Active Aging: A Narrative Review of an Integrative and Sustainable Approach.

The global population is on a trajectory of continuous growth, with estimates projecting an increase from 7.7 billion in 2019 to approximately 9.7 billion by 2050. Longevity is also expected to rise rapidly, with advancements in healthcare contributing to increased life expectancies and an increase in the maximum lifespan. The aging process is accompanied by different changes, often leading to a decline in daily life activities and an increased susceptibility to disease. Age-related changes can cause cellular damage and subsequent cellular death. Oxidative stress and inflammation play significant roles in this process contributing to molecular damage and mitochondrial dysfunction. Active aging has been associated with improved quality of life and a reduced risk of morbidity and premature mortality. In this context, the Mediterranean diet has emerged as a promising approach to promoting healthy aging and sustainability. The phytochemical compounds within the Mediterranean diet have been linked to a lower risk of developing cardiovascular disease, type 2 diabetes, obesity, cancer and neurodegenerative diseases. The findings of peer-reviewed articles regarding the use of the Mediterranean diet as a healthy and sustainable dietary pattern written in Portuguese, Spanish or English were included in this narrative literature review. This dietary pattern's emphasis on the consumption of fresh and local food aligns with both health and environmental sustainability goals. This work provides a comprehensive review of the benefits of the Mediterranean diet and its components in a healthy aging process and highlights the importance of this dietary pattern as a sustainable approach.

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

BackgroundPromoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors.MethodsMD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed.ResultsA sample of 1485 participants (median (IQR) age 21.0 (19.0–22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen.ConclusionsEncouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.

The Future of Plant-Based Diets: Aligning Healthy Marketplace Choices with Equitable, Resilient, and Sustainable Food Systems.

The future of plant-based diets is a complex public health issue inextricably linked to planetary health. Shifting the world's population to consume nutrient-rich, plant-based diets is among the most impactful strategies to transition to sustainable food systems to feed 10 billion people by 2050. This review summarizes how international expert bodies define sustainable diets and food systems and describes types of sustainable dietary patterns. It also explores how the type and proportion of plant- versus animal-source foods and alternative proteins relate to sustainable diets to reduce diet-related morbidity and mortality. Thereafter, we synthesize evidence for current challenges and actions needed to achieve plant-based sustainable dietary patterns using a conceptual framework with principles to promote human health, ecological health, social equity, and economic prosperity. We recommend strategies for governments, businesses, and civil society to encourage marketplace choices that lead to plant-rich sustainable diets within healthy, equitable, and resilient agroecological food systems.

Transition towards sustainable diets: Multi-objective optimization of dietary pattern in China

Global diversity in food cultures has led to a variety of dietary patterns, the evolution of which can significantly impact greenhouse gas (GHG) emissions. To address the dual challenge of climate change and malnutrition, we need to examine feasible pathways towards sustainable diets that balance nutritional adequacy, environmental impact, and cultural acceptability. We propose an optimized dietary transition pathway in China, which aligns with the nation's dietary guidelines (DGs) while aiming to reduce diet-associated GHG emissions and maintain the cultural food preferences. We also examine how the current dietary patterns will change under three different scenarios: 1) meeting nutritional needs (N), minimizing GHG emissions while maintaining nutritional standards (NE), and sustaining cultural acceptance and maintain GHG emissions at a low level while ensuring standard nutrient intake (NEC). We analyze data from 31 provinces in China between 2000 and 2020 to explore sustainable dietary patterns. In this period, plant-based food consumption has experienced a substantial 12 % decrease, in contrast to the 68 % increase in animal-sourced food intake. Meanwhile, diet-associated GHG emissions in China have increased by 17 %. However, dietary nutrition remains below national standards. The diet-associated GHG emission under NEC is 63.43% lower than N and is 7.04% higher than NE, while NEC in cultural unacceptability is 28.39% lower than NE. Our optimized dietary patterns demonstrate the potential to achieve the national nutrition standard, significantly cut GHG emissions, and retain higher cultural acceptability. Acknowledging the regional disparities in sustainable dietary pathways, we propose the implementation of customized provincial directives aimed at fostering compliance with these favorable trends. Our study offers critical policy implications towards achieving a sustainable diet in China, which contributes to managing the complex trade-offs among nutrition, cultural preferences, and environmental impact.

Aligning health, environment, and cost aspects of diets: Identifying sustainable dietary patterns in China

Considering the adverse effects of agricultural-food systems on both human health and the environment, this research aimed to identify sustainable diets, which are nutritious, culturally acceptable, affordable, and have low environmental impacts, based on self-reported diets in China. Dietary data was collected with a 3-day 24-h dietary recall and weight food record combined method among 10,324 subjects aged 18–64 year, who participated in the China Health Nutrition Survey 2011. Diet quality was assessed by the Chinese Healthy Eating Index 2016 (CHEI2016). Environmental impact was measured by greenhouse gas emissions (GHGE), total water use (TWU), and land use (LU), and diet costs were calculated using market prices of community surveys. Reduced rank regression derived dietary patterns with 34 food groups as predictor variables, and used CHEI2016 score, dietary greenhouse gas emissions (GHGE), total water use (TWU), land use (LU), and cost of the diet as response variables. Four dietary patterns were identified. Participants with the highest adherence (decile 10) to the “High animal-based food” pattern showed higher dietary GHGE (+57%), TWU (+51%), and LU (+54%) and dietary costs (+64%), compared to the average population's diets. The diet in decile 10 for the “High fruit, low ruminant meat” pattern displayed a 21% higher CHEI2016 score, and higher dietary environmental impact (GHGE +17%; TWU +22%; LU +19%) and dietary costs (+46%) than the average diets. Diets of participants who followed the “High fish, low beverages” pattern showed higher environmental impact (GHGE +39%; TWU +32%; LU +28%) and dietary costs (+19%), but the CHEI2016 score was similar (+0.1%). Finally, the “High wheat, low pork” pattern demonstrated lower environmental impacts (GHGE -17%, TWU -12%, LU -2%) and lower cost of the diet (−2%) but also lower CHEI2016 score (−1%) compared to average population. This study reveals the complex trade-offs between diet quality, environmental sustainability, and dietary costs of current dietary patterns. None of the four patterns achieved the desirable combination of high CHEI2016 scores, reduced environmental impact, and reduced dietary costs. The findings offer insights into sustainable diet choices within the current food system, suggesting dietary guidelines should consider environmental sustainability and cost-effectiveness.

Factors that facilitate consumer uptake of sustainable dietary patterns in Western countries: a scoping review

ObjectivesThis scoping review aims to describe factors that facilitate consumer-level transitions to more environmentally sustainable diets.MethodsUsing scoping review methods, four databases were searched for articles published in English examining facilitators to consuming an environmentally sustainable diet and focused on consumers, using data collected in Western countries, and were published between 2012 and 2022. Researchers extracted study characteristics and factors influencing adoption or uptake of sustainable foods or dietary patterns. Using this data, researchers conducted a thematic analysis to determine five main themes describing leverage points (modifiable) for dietary transitions.ResultsResults are reported per PRISMA guidelines: 21 studies were included with data from the U.K., U.S., Australia, and Europe. The results of this review indicate that values, knowledge, marketing, consumer-product relationships, and support networks, along with their respective subthemes, may be central drivers of consumer adoption of sustainable dietary patterns. Consumers are more likely to purchase and consume products which are familiar and appealing and align with their values. Cost, lack of knowledge, and lack of social support act as barriers to dietary change to more sustainable food choices. Income, education, ethnicity, sex, and employment were common individual-level characteristics identified as influential over likelihood of adopting environmentally sustainable dietary patterns. Individual-level characteristics create nuances in both likelihood to adopt, and the experience of barriers to adopting, sustainable dietary patterns.ConclusionKnowledge of leverage points and individual-level nuances is useful in informing strategies to facilitate transitions to more sustainable diets.

Assessing the sustainability of cultured meat in optimized Danish diets

Reducing animal-sourced foods in diets saves a significant share of environmental impacts. Sustainable dietary patterns have proposed large reductions in red meats in particular. Foods with the potential to reduce the environmental impacts of diets are under increasing investigation, and cultured meat, produced by culturing animal cells, could play a key role, especially for diet transitions away from high red meat consumption. In this paper, the inclusion of cultured meat in optimized Danish diets is explored through minimizing climate impact in greenhouse gas emissions measured through Global Warming Potential (GWP) with ±30 %, 60 %, and 90 % stepwise changes from current diets while meeting nutritional requirements; the total consumer diet costs were also assessed. Three optimization models were run, one with a cultured meat diet (all animal-sourced meats are replaced with cultured meat), an omnivore diet (with conventional animal-sourced foods and no cultured meat), and a vegan diet (neither cultured meat nor other animal-sourced foods are allowed). Results revealed that both omnivore diets with and without cultured meat and vegan diets can achieve impact improvements compared to current diets. The greatest GWP reductions can be seen in the cultured meat diet (8.0 Mt CO2 eq./yr) and vegan diets (9.8 Mt CO2 eq./yr) with 90 % deviation in both from current diets. These reductions could represent potential Danish national emissions decrease of 21 % and 25 %, respectively, in 2022 impacts. Cultured meat diets resulted in the highest costs (11.58€/day) compared to the current diets (8.05€/day), vegan diets (6.49€/day), and omnivore diets (6.11 €/day). This paper provides key information about diet shifts and the potential of novel foods to reduce carbon emissions compared with the current diets. Although the socio-cultural acceptability and technological readiness of cultured meat, which represent crucial prerequisites to its inclusion in diets, still need to be assessed.