Towards a sustainable diet combining economic, environmental and nutritional objectives

An overview of approaches for assessing the environmental sustainability of diets - a scoping review for Nordic Nutrition Recommendations 2023

Assessing the environmental impacts of food, food systems and diets is highly complex due to the multitude of processes involved, the uncertainty in assessment models, the variability in production systems and the large range of products available. No single assessment method alone can provide a complete evidence base. The increasing number of Life Cycle Assessment and food system analyses, and more recently the integration of planetary boundaries offer insights from which we can draw some robust high-level conclusions, whilst recognising there is a need for more detailed analysis to capture the inherent nuances of more location and context-specific situations. Despite the complexity of assessing the environmental sustainability of food, diets and food systems, there are a number of key considerations that could be used to guide this process, and in doing so, they help to increase utility of the outcomes and limit unintended adverse consequences. We identified five key considerations that can be applied (consider the thresholds, consider the system, consider the variables, consider the context and consider the spillover) to ensure assessments are comprehensive.

Regional food consumption in Italy, a life cycle analysis

Urbanization and globalization have led to an increasing concern and focus on the sustainability of the food sector, particularly in discussing the composition of consumers' diets. This study examines Italian consumption habits, categorizing them into four macro-geographical areas (North-West, North-East, Center, South, and Islands), utilizing public data obtained from surveys including 3323 individuals, and assesses their environmental impacts through the application of the Life Cycle Assessment methodology. The findings unveil distinct dietary patterns across Italian macro-regions, indicative of cultural disparities, and present avenues for promoting environmentally sustainable dietary choices. The study identifies meat consumption as the primary environmental concern across all macro-regions, with fish emerging as a secondary contributor to particulate matter formation. Pork and poultry exhibit notable impacts within toxicity-related categories. Additionally, the research underscores challenges in data collection, notably the absence of a site-specific Italian database, and underscores the necessity for more recent consumption data to accurately capture contemporary Italian dietary habits. Finally, the study demonstrates that addressing the issue from a macro-regional perspective allows for more targeted and dedicated cultural interventions.

Digital Biohacking Approach to Dietary Interventions: A Comprehensive Strategy for Healthy and Sustainable Weight Loss

The rising obesity epidemic requires effective and sustainable weight loss intervention strategies that take into account both of individual preferences and environmental impact. This study aims to develop and evaluate the effectiveness of an innovative digital biohacking approach for dietary modifications in promoting sustainable weight loss and reducing carbon footprint impact. A pilot study was conducted involving four participants who monitored their weight, diet, and activities over the course of a year. Data on food consumption, carbon footprint impact, calorie intake, macronutrient composition, weight, and energy expenditure were collected. A digital replica of the metabolism based on nutritional information, the Personalized Metabolic Avatar (PMA), was used to simulate weight changes, plan, and execute the digital biohacking approach to dietary interventions. The dietary modifications suggested by the digital biohacking approach resulted in an average daily calorie reduction of 236.78 kcal (14.24%) and a 15.12% reduction in carbon footprint impact (-736.48 gCO2eq) per participant. Digital biohacking simulations using PMA showed significant differences in weight change compared to actual recorded data, indicating effective weight reduction with the digital biohacking diet. Additionally, linear regression analysis on real data revealed a significant correlation between adherence to the suggested diet and weight loss. In conclusion, the digital biohacking recommendations provide a personalized and sustainable approach to weight loss, simultaneously reducing calorie intake and minimizing the carbon footprint impact. This approach shows promise in combating obesity while considering both individual preferences and environmental sustainability.

Select dietary changes towards sustainability: Impacts on dietary profiles, environmental footprint, and cost

Healthy sustainable diets have the power to improve dietary intakes and environmental resource use. However, recommendations for improving food choices need to consider the effects of any changes across multiple dimensions of health, environmental sustainability, and dietary cost to promote long-lasting behaviour change. The aim of this study was to identify differences between original diets, and the diets that can be achieved through the implementation of select small dietary changes towards sustainability. Twelve hypothetical sustainable actions were investigated for the potential effects of these actions on dietary markers (protein, saturated fat, sugars, salt, iron, and calcium), environmental footprints (greenhouse gas emissions, freshwater withdrawals, and land use), and dietary cost. Dietary data from 1235 individuals, aged 19-94 years, participating in the UK National Diet and Nutrition Survey (2017/19) provided the original diet. Dietary changes were implemented as required by each sustainable action, and differences between the original diet and each new diet were investigated. Results revealed benefits to dietary markers and environmental characteristics from eleven sustainable actions (range: F(1,728) = 5.80, p < .001 to F(1,506) = 435.04, p < .001), but effects were stronger for some actions than for others. Greatest benefits for all three outcomes were found for actions which reduced meat consumption and/or replaced meat with pulses or eggs. The remaining sustainable actions tended to be beneficial for improving outcomes individually or to some degree. Our results demonstrate the possible impacts of a number of small sustainable dietary actions for dietary, environmental, and cost outcomes, and provide a hierarchy of actions based on benefit. Findings may facilitate dietary behaviours towards improved health, whilst also offering fruitful contributions towards environmental footprint targets in the UK.

A community focused approach toward making healthy and affordable daily diet recommendations

Introduction

Maintaining an affordable and nutritious diet can be challenging, especially for those living under the conditions of poverty. To fulfill a healthy diet, consumers must make difficult decisions within a complicated food landscape. Decisions must factor information on health and budget constraints, the food supply and pricing options at local grocery stores, and nutrition and portion guidelines provided by government services. Information to support food choice decisions is often inconsistent and challenging to find, making it difficult for consumers to make informed, optimal decisions. This is especially true for low-income and Supplemental Nutrition Assistance Program (SNAP) households which have additional time and cost constraints that impact their food purchases and ultimately leave them more susceptible to malnutrition and obesity. The goal of this paper is to demonstrate how the integration of data from local grocery stores and federal government databases can be used to assist specific communities in meeting their unique health and budget challenges.

Methods

We discuss many of the challenges of integrating multiple data sources, such as inconsistent data availability and misleading nutrition labels. We conduct a case study using linear programming to identify a healthy meal plan that stays within a limited SNAP budget and also adheres to the Dietary Guidelines for Americans. Finally, we explore the main drivers of cost of local food products with emphasis on the nutrients determined by the USDA as areas of focus: added sugars, saturated fat, and sodium.

Results and discussion

Our case study results suggest that such an optimization model can be used to facilitate food purchasing decisions within a given community. By focusing on the community level, our results will inform future work navigating the complex networks of food information to build global recommendation systems.

Focus of Sustainable Healthy Diets Interventions in Primary School-Aged Children: A Systematic Review

Research and public policy interest regarding Sustainable Healthy Diets (SHDs) have increased during the last decades, as nutrition recommendations and diet practices should align with growing environmental concerns. SHDs encompass sociocultural, economic and environmental components of nutrition and health and raising awareness across all these dimensions, as well as providing relevant education, especially to young children, is important for adopting SHD practices. Primary school students (5-12 years old) are often the target population for interventions, as they are considered agents of change for educating the community. The objective of this systematic review is to map the SHD indicators addressed by such interventions in order to identify gaps and opportunities for future interventions in this population. Scopus, PubMed and Web of Science were searched for available publications, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020) methodology. After screening for eligibility, thirteen intervention studies were included and reviewed. Results showed that indicator definitions and measuring methods were not harmonized across research efforts. Implemented SHD interventions address predominantly food waste and diet quality, while social and economic indicators are underrepresented. The standardization of SHD, focusing on measurable harmonized indicators, should be a priority for policy actors in order to enable impactful research efforts. Future interventions should incorporate clear SHD indicators to raise awareness and consider the application of composite tools or indexes to evaluate outcomes and maximize impact in the community.

Nutrient-sensitive approach for sustainability assessment of Australian macronutrient dietary recommendations

BACKGROUND

Dietary guidelines that form the basis for food and nutrition policies in most countries are focused mainly on the social dimensions of health. Efforts are needed to incorporate environmental and economic sustainability. As the dietary guidelines are formulated based on nutrition principles, understanding the sustainability of dietary guidelines in relation to nutrients could support the better incorporation of environmental and economic sustainability aspects into dietary guidelines.

OBJECTIVES

This study examines and demonstrates the potential of integrating an input-output analysis with nutritional geometry to assess the sustainability of the Australian macronutrient dietary guidelines (AMDR) relating to macronutrients.

METHODS

We used daily dietary intake data of 5345 Australian adults from the most recent Australian Nutrient and Physical Activity Survey 2011-2012 and an input-output database for the Australian economy to quantify the environmental and economic impacts associated with dietary intake. Then, we examined the associations between environmental and economic impacts and dietary macronutrient composition using a multidimensional nutritional geometry representation. Thereafter, we assessed the sustainability of the AMDR regarding its alignment with key environmental and economic outcomes.

RESULTS

We found that diets adhering to the AMDR were associated with moderately high greenhouse gas emissions, water use, cost of dietary energy, and the contribution to wages and salaries of Australians. However, only about 20.42% of respondents adhered to the AMDR. Furthermore, high-plant protein diets adhering to the lower limit of recommended protein intake in the AMDR were associated with low environmental impacts and high incomes.

CONCLUSIONS

We conclude that encouraging consumers to adhere to the lower limit of the recommended intake of proteins and meeting the protein requirement through protein-dense plant sources could improve dietary environmental and economic sustainability in Australia. Our findings provide a means of understanding the sustainability of dietary recommendations concerning macronutrients for any country where input-output databases are available.

Carbon dioxide (CO2) emissions and adherence to Mediterranean diet in an adult population: the Mediterranean diet index as a pollution level index

BACKGROUND

Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment.

AIM

To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of CO₂ emitted in an older adult population.

DESIGN AND POPULATION

Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO₂ emissions in 6646 participants was assessed.

METHODS

Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO₂ emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO₂ emissions expressed in kg/day: Q1 (≤2.01 kg CO₂), Q2 (2.02-2.34 kg CO₂), Q3 (2.35-2.79 kg CO₂) and Q4 (≥2.80 kg CO₂).

RESULTS

More men than women induced higher dietary levels of CO₂ emissions. Participants reporting higher consumption of vegetables, fruits, legumes, nuts, whole cereals, preferring white meat, and having less consumption of red meat were mostly emitting less kg of CO₂ through diet. Participants with higher adherence to the Mediterranean Diet showed lower odds for dietary CO₂ emissions: Q2 (OR 0.87; 95%CI: 0.76-1.00), Q3 (OR 0.69; 95%CI: 0.69-0.79) and Q4 (OR 0.48; 95%CI: 0.42-0.55) vs Q1 (reference).

CONCLUSIONS

The Mediterranean diet can be environmentally protective since the higher the adherence to the Mediterranean diet, the lower total dietary CO₂ emissions. Mediterranean Diet index may be used as a pollution level index.

Position of the Society for Nutrition Education and Behavior: Nutrition Educator Competencies for Promoting Healthy Individuals, Communities, and Food Systems: Rationale and Application

It is the position of the Society for Nutrition Education and Behavior that to improve the health of individuals, communities, and food systems, it is essential that nutrition educators meet each of 6 content competencies (basic food and nutrition knowledge, nutrition across the life cycle, food science, physical activity, food and nutrition policy, and agricultural production and food systems) and 4 process competencies (behavior and education theory; nutrition education program design, implementation and evaluation; written, oral, and social media communication; and nutrition education research methods). These competencies reflect the breadth of the nutrition education field and are grounded in peer-reviewed research. The rationale and evidence base for these competencies are presented. They are designed for educational institutions to plan curricula and programs; public, private, and nonprofit organizations for training; individuals for professional development; and policymakers and advocates to inform strong, comprehensive nutrition education policy.

Changes in terms of risks/benefits of shifting diets towards healthier and more sustainable dietary models

Food production and therefore human diet are identified as important sources of environmental impact. Unhealthy and unsustainable diets with high intake of meat and low intake of plant-based products are predominant worldwide. On the other hand, a balance between health and sustainability is necessary, since diets that are environmentally sustainable could lack essential macro- and micronutrients and result in nutrient deficiencies, non-communicable diseases and malnutrition. The aim of this project was to investigate the nutritional adequacy and environmental impact of adults' diet by comparing current dietary habits and new alternative dietary scenarios. First, a systematic review was conducted following PRISMA guidelines to assess the environmental impact of current diets and sustainable dietary scenarios such as vegan, vegetarian, pescatarian, omnivorous and optimised dietary patterns worldwide. In the second part of the project, an optimisation study was conducted, based on a multi-objective optimisation approach, with the purpose of creating the optimal diet based on nutritional and environmental constraints for the adult Italian population. The dietary scenarios of the optimised models were developed in accordance with the Italian food-based dietary guidelines. Food consumption data was extracted from the INHES study and used as baseline diet. A clear evaluation of the current environmental impact because of diet and potential sustainable dietary scenarios globally is challenging. Finally, national food-based guidelines should be adjusted by suggesting healthy and sustainable dietary recommendations in line with traditional eating habits and local food availability in order the desirable dietary shifts towards sustainability to be feasible.

True Cost Accounting of a healthy and sustainable diet in Italy

It is widely upheld that global food systems are unsustainable. Sustainable diets are gaining prominence as key components to entangle global food system challenges, as well as to transition towards the pathway of the 2030 Agenda and the Sustainable Development Goals (SDGs). Hence, sustainable and healthy diets are at the core of much research with the aim to bring together nutritional adequacy, cultural acceptability, environmental sustainability, economic affordability, and shape future consumption patterns. This article contributes to advancing knowledge on sustainable diets by proposing a True Cost Accounting method to assess the cost and impact of the adoption of a more sustainable and healthier diet, using Italy as an illustration. The research analyses the complexity of a diet from an environmental, health, and socioeconomic point of view and defines a new assessment framework that can be replicated and adapted to other contexts. Results show that in Italy, the adoption of a sustainable and healthy diet has a 47% lower carbon footprint and 25% lower water footprint than the current diet, while impacting 13% less on the average income and food monthly expenditure. Also, the desirable diet has a 21% lower impact on the sanitary costs related to cardiovascular disease. This study corroborates that the consumption of the desirable diet would provide a total cost saving of 741 EUR per year per capita, if we consider its impact on the environment, health, and socio-economic costs.

Dietary Change and Global Sustainable Development Goals

Food production for human consumption is a leading cause of environmental damage in the world and yet over two billion people suffer from malnutrition. Several studies have presented evidence that changes in dietary patterns across the world can lead to win-win outcomes for environmental and social sustainability and can complement ongoing technological and policy efforts to improve the efficiency of agricultural production. However, the existing evidence have been compiled in “silos” by a large range of researchers across several disciplines using different indicators. The aim of this quantitative review is to bring together the existing knowledge on heterogeneity of current dietary patterns across the world and how a transition toward healthy diets in different countries can aid in progress toward multiple global Sustainable Development Goals (SDGs). We first summarize the nutritional quality, economic cost, and environmental footprint of current diets of over 150 countries using multiple indicators. Next, we review which shifts in dietary patterns across different world regions can help toward achievement of SDG2 (Zero hunger), SDG3 (Good health and wellbeing), SDG 6 (Clean water and sanitation), SDG13 (Climate action), SDG14 (Life below water), and SDG15 (Life on land). Finally, we briefly discuss how to enable the shift toward sustainable dietary patterns and identify the research and data gaps that need to be filled through future efforts. Our analysis reveals that dietary change is necessary in all countries as each one has unique priorities and action items. For regions such as Sub-Saharan Africa and South Asia, increased intake of nutrient dense foods is needed to address deficiency of essential nutrients like folate, potassium, and vitamin A. For North America and Europe, shifting toward more plant-based diets would be healthier and simultaneously reduce the per capita environmental footprints. The results can be useful for policymakers in designing country-specific strategies for adoption of sustainable dietary behaviors and for food industry to ensure the supply of sustainable food items customized with regions' need.

Nutrient-sensitive approach for sustainability assessment of different dietary patterns in Australia

BACKGROUND

Understanding the relation between sustainability and nutrients is important in devising healthy and sustainable diets. However, there are no prevailing methodologies to assess sustainability at the nutrient level.

OBJECTIVES

The aim was to examine and demonstrate the potential of integrating input-output analysis with nutritional geometry to link environmental, economic, and health associations of dietary scenarios in Australia with macronutrients.

METHODS

One-day dietary recalls of 9341 adult respondents (age ≥18 y) of the latest available cross-sectional National Nutrition and Physical Activity Survey-2011/12 of Australia were integrated with the input-output data obtained from the Australian Industrial Ecology Virtual Laboratory to calculate the environmental and economic impacts of dietary intakes in Australia. Australian adults' dietary intakes were classified into 3 dietary scenarios: "vegan," "pescatarian," and "omnivorous." Then, the relations between nutritional, economic, and environmental characteristics of the 3 dietary scenarios were demonstrated with the diets' macronutrient composition in a multidimensional nutritional geometry representation to link the sustainability indicators with macronutrients.

RESULTS

Nutrient density and economic and environmental indicators increased as the percentage of energy from proteins increased and decreased as the percentage of energy from fats increased for the 3 dietary scenarios, except for the nutrient density and water use of the "vegan" dietary scenario. Energy density increased as the percentage of energy from fats increased and decreased as the percentage of energy from proteins increased for "pescatarian" and "omnivorous" dietary scenarios. In the "vegan" dietary scenario, nutrient density and water use increased as the percentage of energy from proteins increased; however, these decreased as the percentage of energy from carbohydrates increased, instead of fats.

CONCLUSIONS

The study presents a new approach to analyzing the relations between sustainability indicators, foods, and macronutrients and establishes that proteins, irrespective of the source of protein, are driving dietary environmental and economic impacts.

Dietary diversity, environment and health-related factors of under-five children: evidence from cassava commercialization households in rural South-West Nigeria

Diverse and quality diets are crucial to sustainable growth and development of under-five children, especially those of rural farming households. This study investigated the dietary diversity, environment, and health-related factors of young children. The study employed the use of cross-sectional survey data from 140 under-five children of cassava farming households in Ogun and Oyo states, South-West Nigeria. The study estimated factors influencing dietary diversity of under-five children and assessed children dietary diversity, and the availability of some environment and health-related factors of the farming households. The findings indicated that 98.7% and 97.5% of children consumed grains, with roots and tubers while 36.7% and 36.3% consumed legumes in Ogun and Oyo states respectively. The results also found that 48.6% of children sampled met the minimum cut-off point of 4 food groups with dietary diversity mean score of 3.28. The logit regression analysis indicated that child's age, mothers' age, distance to farm, and food expenditure were among the significant determinants of children dietary diversity. Therefore, this study seeks the collaborative efforts of stakeholders in providing nutrition-sensitive intervention programs for household members, especially mothers and young children in order to promote consumption of diversified diets and enhance healthy living of rural farming households.

Sustainable Diets as Tools to Harmonize the Health of Individuals, Communities and the Planet: A Systematic Review

Background. Climate change and global health are inextricably linked. Thus, health systems and their professionals must adapt and evolve without losing quality of care. Aim(s). To identify health and environmental co-benefits derived from a sustainable diet and promotion strategies that favor its implementation. Methods. A systematic search for articles published on sustainable diets and human/planetary health published between 2013 and 2020 was conducted on the databases PubMed, Cinahl, Scopus and Trip from 4 to 7 May 2020 in accordance with the PRISMA guideline. Results. A total of 201 articles was retrieved, but only 21 were included. A calorie-balanced diet mainly based on food of plant origin that would allow the attainment of 60% of daily caloric requirements and a low protein intake from animal foods (focusing in fish and poultry) could significantly reduce global morbi-mortality and the dietary environmental impact maintaining a framework of sustainability conditioned by the consumption of fresh, seasonal, locally produced and minimally packaged products. Discussion. The implementation of sustainable diets requires working on the triangulation of concepts of food–health–environment from schools and that is permanently reinforced during all stages of the life by healthcare workers, who should establish the appropriate modifications according to the age, gender and health situation.

Intergroup Sensitivity and Promoting Sustainable Consumption: Meat Eaters Reject Vegans’ Call for a Plant-Based Diet

Reducing meat consumption can make immediate contributions to fighting the climate crisis. A growing minority adheres to meat-free diets and could convince others to follow suit. We argue, however, that recipients’ social identification as meat eaters may impede the effectiveness of such calls (i.e., an intergroup sensitivity effect based on dietary groups). Indeed, meat eaters in our experiment (N = 260) were more likely to reject calls for dietary change from a vegan than from a fellow meat eater. This effect was also evidenced in evaluations of and engagement with an initiative to promote a vegan diet (“Veganuary”), providing some indication for behavioral impact. In contrast, our societal dietary norm manipulation had no consistent effects on observed outcomes. Exploratory moderation analyses show a limited impact of participants’ social identification as meat eaters but highlight the role of peoples’ general willingness to engage in environmentally friendly behavior. We discuss theoretical and practical implications, including how our results challenge existing approaches to promoting a meat-reduced diet.

Dietitians Australia position statement on healthy and sustainable diets

It is the position of Dietitians Australia that to promote human and planetary health, a food system transformation is needed that enables the population to adopt healthy and sustainable diet-related practices. A healthy and sustainable diet must (i) be nutritionally adequate, healthy and safe, (ii) have low environmental impact and be protective of natural resources and biodiversity, (iii) be culturally acceptable and (iv) be accessible, economically fair and affordable. Dietitians Australia acknowledges that it is critical to prioritise Indigenous knowledges in consultation, policy-making and implementation processes to achieve these recommendations. In facilitating the uptake of healthy and sustainable diets, dietitians are contributing to the transformation of our current food system that is urgently required to nourish present and future generations within planetary boundaries. In developing this position statement, opportunities for future research have been identified including those to advance the professions' capacity to improve environmental sustainability outcomes across all areas of practice. To achieve a population-level shift towards this diet, Dietitians Australia recommends: (i) the development of a National Food and Nutrition Strategy which honours Indigenous knowledges on food systems, (ii) the integration of sustainability principles in Australia's dietary guidelines, (iii) the reorientation of our food environment to prioritise access to healthy and sustainable foods, and (iv) investment in capacity building activities to equip the current and future nutrition and dietetics workforce.

A Scoping Review of Indicators for Sustainable Healthy Diets

Introduction: Diets are currently unsustainable in many countries as evidenced by the growing burden of malnutrition, degradation of natural resources, contributions to climate change, and unaffordability of healthy diets. Agreement on what constitutes a healthy and sustainable diet has been debated. In 2019, FAO and WHO published the Sustainable Healthy Diets Guiding Principles, defining what qualifies as a sustainable healthy diet. While valuable, these principles require measurable indicators to support their operationalization. Our scoping review aims to describe how sustainable healthy diets have been assessed in the literature since 2010.

Methods: A search for English-language articles published in peer-reviewed journals was conducted from January 2010 through February 2020 across three databases. Out of the 504 articles initially identified, 103 articles were included. Metadata were extracted from each article on: publication year, country of study, study aims, methods, main data sources, indicators used to assess sustainable healthy diets, reported indicator strengths or limitations, and main study findings. A qualitative content analysis identified major conceptual themes across indicators and their frequency of use.

Findings: From the 103 empirical articles included in our review, 57.3% were published after 2017. Most studies were carried out in high-income countries (74%). Approximately 42% of the articles assessed the sustainability of diets using solely health and environmental indicators; &lt;25% assessed the sustainability of diets across health, environmental, and sociocultural aspects of sustainability. We found a substantial number of unique indicators used for assessing health (n = 82), environmental (n = 117), and sociocultural (n = 43) aspects of diets. These indicators covered concepts related to health outcomes, aspects of diet quality, natural resources, climate change, cultural acceptability, and cost of diets. The preponderance of indicators currently used in research likely poses challenges for stakeholders to identify the most appropriate measures.

Conclusion: Robust indicators for sustainable healthy diets are critical for understanding trends, setting targets, and monitoring progress across national and sub-national levels. Our review highlights the geographical imbalance, the narrow focus on health and environmental aspects, and the lack of common measures used in research. Measures registries could provide the decision-support needed by stakeholders to aid in the indicator selection process.

Shifting to a Sustainable Dietary Pattern in Iranian Population: Current Evidence and Future Directions

The need for a shift in diet toward a more sustainable one has reached an urgency in certain regions, including Iran, due to more rapid climate change and a higher level of vulnerability. This study was undertaken to identify and summarize available data on changes required in the current Iranian diet to make it more sustainable and the extent to which current policies in the country have addressed such a shift. In this study, PubMed, Scopus, and Web of science, as well as Iranian scientific search engines, including Scientific Information Database and Magiran, were systematically searched from January 1990 to July 2021. A total of 11 studies and policy analyses were included in this study. Based on the findings, moving Iranian diet toward sustainability will require increase in consumption of dairy, fruits, vegetables, cereals, poultry, and legumes and decrease in consumption of bread, rice, pasta, red meat, eggs, fats, sugars, and sweets. There has been a great deal of effort and investment on policies and strategies to decrease the amount of sugar, salt, and fat (specifically trans-fatty acids) in the Iranian diet, which makes it more sustainable healthwise. Several policies and programs have been implemented to tackle non-communicable diseases (NCDs) by reducing access to unhealthy foods, which is in line with health dimension of a sustainable diet. However, there is almost no direct address to ecological aspect of sustainable diet in the food and nutrition policy documents in the ccountry. Development of an enabling environment to a sustainable diet will require policy and actions to improve public awareness, support study to provide evidence and identify possible alternatives, and plan and implement interventions/programs to promote and facilitate healthy and sustainable diets.

Secular trends in diet-related greenhouse gas emission estimates since 2000 - a shift towards sustainable diets in Sweden

Objective:

This study examines secular changes in diet-related greenhouse gas emissions (GHGE) in younger and older Swedish adults, since the turn of this century.

Design:

Two cross-sectional health examination surveys were conducted in 2001–2004 (T₁) and 2014–2018 (T₂). At both times, an eighty-six-item FFQ was embedded in the survey. From the food frequencies and age-standardised portion sizes, GHGE estimates (kg CO₂e/year) were calculated. GHGE was modelled as a function of time period and covariates, for five distinct age groups.

Setting:

The municipality of Gothenburg, in western Sweden.

Participants:

Women and men aged 25–34, 35–44, 45–54, 55–64 and 65–75 years were randomly selected from the population registry and recruited for examinations. After exclusion of participants with incomplete dietary data, the analytic sample consisted of 2569 individuals at T₁ and 2119 at T₂.

Results:

Lower dietary GHGE scores were observed at T₂ compared with T₁, in each age group, adjusting for sex, BMI and education. The largest differences in GHGE were observed in the youngest age group (approximately 30 % reduction). Decreasing trends in GHGE from animal-based foods were observed at all ages and were accompanied by smaller increases from plant-based sources in younger groups only. At all ages, GHGE from discretionary foods decreased, and prevalence of overweight remained stable.

Conclusions:

Optimal dietary trends should support both human health and planetary health. Our results suggest that Swedish adults have moved in this direction, e.g. through less intake of red meat products and stable weight status.

A Life Cycle Assessment Approach for Vegetables in Large-, Mid-, and Small-Scale Food Systems in the Midwest US

Although vegetables are important for healthy diets, there are concerns about the sustainability of food systems that provide them. For example, half of fresh-market vegetables sold in the United States (US) are produced in California, leading to negative impacts associated with transportation. In Iowa, the focus of this study, 90% of food is imported from outside the state. Previous life cycle assessment (LCA) studies indicate that food consumption patterns affect global warming potential (GWP), with animal products having more negative impacts than vegetables. However, studies focused on how GWP, energy, and water use vary between food systems and vegetable types are less common. The purpose of this study was to examine these environmental impacts to inform decisions to buy locally or grow vegetables in the Midwest. We used a life cycle approach to examine three food systems (large-, mid-, and small-scale) and 18 vegetables commonly grown in/near Des Moines, Iowa. We found differences in GWP, energy, and water use (p ≤ 0.001 for each) for the three food systems with the large-scale scenario producing more emissions. There were also differences among vegetables, with the highest GWP for romaine lettuce (1.92 CO2eq/kg vegetable) approximately three times that of leaf lettuce (0.65 CO2eq/kg vegetable) at the large scale. Hotspots and tradeoffs between GWP, energy, and water use were also identified and could inform vegetable production/consumption based on carbon and water use footprints for the US Midwest.

Exploring adults' motives for food choice of sustainable diet components: a qualitative study in Tehran Metropolis

BACKGROUND

Todays, due to the impact of human food choices on increasing greenhouse gas emissions, water consumption and environmental degradation, there is a new approach about changing the pattern of food production and consumption, including sustainable food and nutrition system related to consumption. This study aimed to explore the components of a sustainable diet among the factors that affect people's food choices.

METHODS

This qualitative study was carried out using an in-depth interview with 33 individuals aged 30-64 years old living in different areas of Tehran. Data collection, data analysis and theoretical conceptualization were performed simultaneously. MAXQDA 10 software was used for managing and organizing the data.

RESULTS

In this paper, the findings are categorized according to the key components of a sustainable diet in five themes: "Health and Nutrition", "Food and Agriculture Security", "Environment and Ecosystems", "Markets, food trade and production chains", "social, cultural, and policy factors" were categorized. Meanwhile, the components of the "Health and Nutrition" domain had the highest contribution and the components of the two domains "food and agriculture" and "environment and ecosystems" had the lowest role based on the participants' perception in this study.

CONCLUSION

Considering to the low importance of the components of a sustainable diet in food choices of the community, promoting the individual awareness of sustainable diet components, clarifying the importance of food choices in creating environmental impacts and leading the national macro policies in the field food and nutrition toward sustainable diet goals are essential.

Changing Patterns of Sustainable Food Consumption Regarding Environmental and Social Impact-Insights From Slovakia

Food consumption accounts for almost one-third of households' total environmental impact. Nowadays, consumption patterns throughout Europe are totally different from those of couple years ago, Slovakia is no exception. At an individual level, people's consumption patterns are shaped by their needs, abilities and opportunities. Exploring and understanding consumers' attitudes toward sustainable food consumption tendences is a key element to a better future for every country. This paper presents an analysis of the current situation regarding sustainable food habits among Slovak consumers. The main aim is to determine the level of consumer awareness for sustainable food consumption and food waste through purchasing decisions. Marketing research was conducted as a part of European project in five partner countries, we present results for Slovakia. Based on the analysis, we will be able in future to define limitations and opportunities in the form of recommendations in future. The findings of this paper have significant contributions and may encourage the process for the discussions and to provide the basis for educational content to help adults develop their skills and behaviors to make food consumption more sustainable.

Promoting Sustainable and Healthy Diets to Mitigate Food Insecurity Amidst Economic and Health Crises in Lebanon

Introduction: Lebanon, a middle-income Eastern Mediterranean country, continues to face detrimental economic, health and socio-political challenges that are further exacerbated by the COVID-19 pandemic. In parallel, the country has been experiencing a remarkable nutrition transition that has contributed to the burden of malnutrition and non-communicable diseases, all imposing serious repercussions on people's livelihoods, food security, and health. Such circumstances have prodded public demand for guidance on affordable, healthy, and sustainable dietary choices to alleviate the burden to this emerging unfortunate situation. Objective: The purpose of this study is to provide evidence-based sustainable and healthy dietary recommendations which balance the tradeoffs among the health, environmental footprint and cost dimensions of sustainability, while closely resembling the usual food consumption pattern. Methodology: Data from the latest available national food consumption survey was used as the usual food consumption pattern of Lebanese adults. Optimized dietary patterns were calculated using the optimization model Optimeal which produced patterns most similar to the usual diet and simultaneously satisfying the three main sets of constraints: health, environmental footprints, and cost. The identified healthy and sustainable dietary options were vetted by multiple key stakeholders from the government, academia, international, and national non-governmental organizations. Results: Compared to the usual intake, the optimized diet included higher intakes of whole grain bread, dark green vegetables, dairy products, and legumes, and lower intakes of refined bread, meat, poultry, added sugars, saturated fat, as compared to usual national mean consumption. The optimized dietary model resulted in a decrease in the associated environmental footprints: water use (-6%); and GHG (-22%) with no change in energy use. The cost of the optimized diet was not different from that of the usual intake. Conclusion: An evidence-based sustainable and healthy diet was developed for Lebanon providing the population and policy makers with some answers to a complex situation. Findings highlight the need for the development of sustainable food based dietary guidelines for Lebanon to promote diets that are healthy, sustainable, culturally acceptable, and affordable and that can alleviate food insecurity among the general population.

Cost and greenhouse gas emissions of current, healthy, flexitarian and vegan diets in Aotearoa (New Zealand)

Objective

To compare the costs and climate impact (greenhouse gas emissions) associated with current and healthy diets and two healthy and environmentally friendly dietary patterns: flexitarian and vegan.

Design

Modelling study

Setting

Aotearoa (New Zealand).

Main outcome measures

The distribution of the cost and climate impact (kgCO₂e/kg of food per fortnight) of 2 weekly current, healthy, vegan and flexitarian household diets was modelled using a list of commonly consumed foods, a set of quantity/serves constraints for each, and constraints for food group and nutrient intakes based on dietary guidelines (Eating and Activity Guidelines for healthy diets and EAT-Lancet reference diet for vegan and flexitarian diets) or nutrition survey data (current diets).

Results

The iterative creation of 210–237 household dietary intakes for each dietary scenario was achieved using computer software adapted for the purpose (DIETCOST). There were stepwise differences between diet scenarios (p<0.001) with the current diet having the lowest mean cost in New Zealand Dollars (NZ$584 (95% CI NZ$580 to NZ$588)) per fortnight for a family of four) but highest mean climate impact (597 kgCO₂e (95% CI 590 to 604 kgCO₂e)), followed by the healthy diet (NZ$637 (95% CI NZ$632 to NZ$642), 452 kgCO₂e (95% CI 446 to 458 kgCO₂e)), the flexitarian diet (NZ$728 (95% CI NZ$723 to NZ$734), 263 kgCO₂e (95% CI 261 to 265 kgCO₂e)) and the vegan diet, which had the highest mean cost and lowest mean climate impact (NZ$789, (95% CI NZ$784 to NZ$794), 203 kgCO₂e (95% CI 201 to 204 kgCO₂e)). There was a negative relationship between cost and climate impact across diets and a positive relationship within diets.

Conclusions

Moving from current diets towards sustainable healthy diets (SHDs) will reduce climate impact but generally at a higher cost to households. The results reflect trade-offs, with the larger constraints placed on diets, the greater cost and factors such as nutritional adequacy, variety, cost and low-emissions foods being considered. Further monitoring and policies are needed to support population transitions that are country specific from current diets to SHD.

Conservative to disruptive diets for optimizing nutrition, environmental impacts and cost in French adults from the NutriNet-Santé cohort

Improving the sustainability of diets requires the identification of diets that meet the nutritional requirements of populations, promote health, are within planetary boundaries, are affordable and are acceptable. Here we explore the extent to which dimensions of sustainability could be optimally aligned and identify more sustainable dietary solutions, from the most conservative to the most disruptive, among 12,166 participants of the NutriNet-Santé cohort. We aim to concomitantly lower environmental impacts (including greenhouse gas emissions, cumulative energy demand and land occupation), increase organic food consumption and study departure from observed diets (considered as a proxy for acceptability). From the most conservative to the most disruptive scenario, optimized diets were gradually richer in fruits, vegetables and soya-based products and markedly poorer in animal-based foods and fatty and sweet foods. The contribution of animal protein to total protein intake gradually decreased by 12% to 70% of the observed value. The greenhouse gas emissions from food production for the diets gradually decreased across scenarios (as a percentage of observed values) by 36-86%, land occupation for food production by 32-78% and energy demand by 28-72%. Our results offer a benchmark of scenarios of graded dietary changes against graded sustainability improvements.

Factors Influencing Consumer Behavior in Sustainable Fruit and Vegetable Consumption in Maramures County, Romania

The article explores consumer behavior in the context of sustainable consumption and the changes related to healthy food that have occurred during the pandemic. The study seeks to identify the factors that influenced consumer behavior on the consumption of fruits and vegetables. For this purpose, a questionnaire was applied to a sample of 1230 people from Maramures County, Romania. This study evaluates consumer behavior and attitudes on sustainable healthy food consumption; determining factors of consumer behavior are established by the needs, knowledge, selection of quality products, and the degree of culture and education in health diet issues. The study also presents a specific classification for fruits and vegetables in terms of consumer preferences and the clustering of local consumers by their interest in healthy food habits according to consumer culture, consumer loyalty, consumer needs, and consumer knowledge. In this study, it was revealed that consumer behavior consumption is not influenced by age, gender, or education. As a result of the correlation analysis, a positive relation was identified between the consumer preference, consumer attitude, and consumer behavior variables. The results of this study offer practical solutions and directions for future research on redesigning sustainable development of local, traditional foods. The new trend focuses on brand offerings and consumer needs for quality food and shows the consumer’s ethnocentrism and orientation for practical solutions.

Impact of sustainability and nutritional messaging on Italian consumers' purchase intent of cereal bars made with brewery spent grains

This work focuses on the reuse of brewery spent grains (BSGs), the most abundant by-product of the beer industry, today mainly used as animal feed. BSGs are rich in fibers and proteins as well as phenolic compounds, all of which are beneficial for human nutrition. Cereal bars containing 12% BSG were formulated and characterized instrumentally. Moreover, 159 panelists representative of young Italian consumers evaluated the bars in a central location test, along with a commercial cereal bar. Products were first evaluated blind, and then in an informed condition where additional product-specific nutritional and sustainability information was revealed, thus the purchase intent was determined. While the control product outperformed the BSG bar in most of the hedonic and sensory measures, the BSG sample was perceived as "natural/made with natural ingredients" by a significantly higher number of panelists (49%) compared to the control (30%). Additionally, even in the lower performing formulation, a significant positive effect on purchase intent was observed when providing either nutrition (fiber content) or sustainability (use of upcycled ingredients) information. The acceptable price range for the BSG and the commercial bar was very similar, whereas the optimal pricing point for the BSG was lower than the control. For the BSG product, sustainability information had significantly higher impact on purchase intent than nutrition-based information. Results highlight the importance of understanding consumer attitudes toward upcycling and the use of byproducts as ingredients in new food formulations. PRACTICAL APPLICATION: Results show how providing information on product nutrition and sustainability can increase purchase intent in the context of a cereal bar containing upcycled ingredients. The findings of this study can help food and consumer researchers to develop acceptable products that include BSG as an ingredient, potentially replacing other cereals in the recipe. The use of this brewery by-product could add value to the beer supply chain and to the final product as well, being also aligned with the current market trend of sustainability and functional health benefits.

Risk-benefit in food safety and nutrition - Outcome of the 2019 Parma Summer School

Risk-benefit assessment is the comparison of the risk of a situation to its related benefits, i.e. a comparison of scenarios estimating the overall health impact. The risk-benefit analysis paradigm mirrors the classical risk analysis one: risk-benefit assessment goes hand-in-hand with risk-benefit management and risk-benefit communication. The various health effects associated with food consumption, together with the increasing demand for advice on healthy and safe diets, have led to the development of different research disciplines in food safety and nutrition. In this sense, there is a clear need for a holistic approach, including and comparing all of the relevant health risks and benefits. The risk-benefit assessment of foods is a valuable approach to estimate the overall impact of food on health. It aims to assess together the negative and positive health effects associated with food intake by integrating chemical and microbiological risk assessment with risk and benefit assessment in food safety and nutrition. The 2019 Parma Summer School on risk-benefit in food safety and nutrition had the objective was to provide an opportunity to learn from experts in the field of risk-benefit approach in food safety and nutrition, including theory, case studies, and communication of risk-benefit assessments plus identify challenges for the future. It was evident that whereas tools and approaches have been developed, more and more case studies have been performed which can form an inherent validation of the risk-benefit approach. Executed risk-benefit assessment case studies apply the steps and characteristics developed: a problem formulation (with at least 2 scenarios), a tiered approach until a decision can be made, one common currency to describe both beneficial and adverse effects (DALYs in most instances). It was concluded that risk-benefit assessment in food safety and nutrition is gaining more and more momentum, while also many challenges remain for the future. Risk-benefit is on the verge of really enrolling into the risk assessment and risk analysis paradigm. The interaction between risk-benefit assessors and risk-benefit managers is pivotal in this, as is the interaction with risk-benefit communicators.

Multi-Objective Optimization of Nutritional, Environmental and Economic Aspects of Diets Applied to the Spanish Context

Current food consumption patterns must be revised in order to improve their sustainability. The nutritional, environmental, and economic consequences of these dietary patterns must be taken into consideration when diet guidelines are proposed. This study applied a systematic optimization methodology to define sustainable dietary patterns complying with nutritional, environmental, and economic issues. The methodology was based on a multi-objective optimization model that considered a distance-to-target approach. Although the three simultaneous objectives (maximal nutritional contribution, minimal greenhouse gas emissions, and minimal costs) could be divergent, the proposed model identified the optimal intake of each food product to achieve the maximal level of nutritional, environmental, and economic diets. This model was applied to six different eating patterns within the Spanish context: one based on current food consumption and five alternative diets. The results revealed that dietary patterns with improved nutritional profiles and reduced environmental impacts could be defined without additional costs just by increasing the consumption of vegetables, fruits, and legumes, while reducing the intake of meat and fish.

Designing a healthy, low-cost and environmentally sustainable food basket: an optimisation study

OBJECTIVE

Sustainable diets are diets with low environmental impacts and high affordability which contribute to food and nutrition security. The present study aimed to develop a healthy, low-cost and environmental-friendly food basket for Iran based on current consumption.

DESIGN

The Households Income and Expenditure Survey data were used. Linear Programming was utilised to obtain the optimal diets, separately, for each goal of the sustainable food basket: (1) Diet with maximum Nutrient Rich Food (NRF) index, (2) Diet with minimum cost, (3) Diet with the minimum water footprint and (4) Diet with the minimum carbon footprint. Goal Programming techniques were used to optimise the sustainable food basket by considering all goals simultaneously.

SETTING

Iran.

PARTICIPANTS

Households (n 100 500) in urban and rural areas of Iran, nationally representative.

RESULTS

In the 'optimal model', compared with the usual consumption, the amount of the 'bread, cereal, rice, and pasta', 'meat, poultry, fish, eggs, legumes, and nuts' and 'fats, oils, sugars, and sweets' groups was decreased. Inside those food groups, cereals, poultry and vegetable oil subgroups were increased. Also, dairy, fruits and vegetable groups were increased. In this model, there was a 14 % reduction in the total water footprint, a 14 % decrease in the total carbon footprint, a 23 % decrease in the cost and a 7 % increase in NRF of diet compared with the usual consumption.

CONCLUSIONS

Increasing the consumption of dairy, fruits and vegetables and reducing the consumption of bread, rice, pasta, meat, fish, eggs, legumes, nuts, hydrogenated fats and sugars are required to achieve a sustainable food basket.

Adherence to the Mediterranean Diet and Environmental Impact of the Diet on Primary School Children Living in Parma (Italy)

The key role of diet in both human health and environmental sustainability is well known. However, there is a lack of studies investigating the environmental impact of children's dietary behavior. The aim of this observational study was to investigate the dietary environmental impact in a sample of primary school children living in Parma (Italy, n = 172, 8-10 years), in relation to their adherence to the Mediterranean diet (MD). Children completed a 3-day food record in both winter and spring. Dietary records were processed to obtain: (i) adherence to the MD and (ii) mean daily carbon and ecological footprints. Adherence to the MD was similar in winter and spring, with almost half of the participants showing a medium MD score. Carbon and ecological footprints were higher during winter, and the main dietary contributors were red and processed meat for both indexes. A small positive correlation was observed between adherence to the MD and total carbon and ecological footprints. This study provided the first analysis of the relationship between adherence to the MD and environmental impact of primary school children. Further research is needed to better investigate the environmental impact of primary school children's diet and the possible relationship between the MD and environmental sustainability.

Could Dietary Goals and Climate Change Mitigation Be Achieved Through Optimized Diet? The Experience of Modeling the National Food Consumption Data in Italy

Objective: The aim of this study is to define a healthy and sustainable diet model with low GHGE, fulfilling dietary requirements, and considering current Italian food consumption patterns. Design: A duly designed database was developed, linking food nutritional composition and GHGE based on 921 food items consumed in Italy according to the last national food consumption survey (INRAN-SCAI 2005-2006). Linear programming was used to develop new diet plans separately for males and females, aged 18-60 years (n = 2,098 subjects), in order to minimize GHGE. The program is based on dietary goals and acceptability constraints as well as on 13 nutrient requirement constraints aiming to reach a healthy and acceptable diet for the Italian population. Results: Diet optimization resulted in a nutritionally adequate pattern minimizing GHGE values (4.0 vs. 1.9 kg CO2e/day for males and 3.2 vs. 1.6 kg CO2e/day for females). In both sexes, the nutrient intake of the optimized diet was at the established lower bound for cholesterol and calcium and at the established upper bound for free sugar and fiber. In males, intake of zinc was at the established lower bound whereas iron was at the established upper bound. Consumption of red meat and fruit and vegetables was at the established lower and upper bound, respectively, in both males and females. Despite the decrease in meat consumption, especially red meat, in the optimized diet with respect to the observed diet, levels of iron intake in females increased by 10% (10.3 vs. 11.3 mg/day) but remained below the adequate intake established in Italian national DRIs. Conclusions: An attainable healthy dietary pattern was developed that would lead to the reduction of GHGE by 48% for males and by 50% for females with respect to current food consumption in the Italian adult population. Health-promoting dietary patterns can substantially contribute to achieve related Sustainable Development Goals.

Drivers of the Growing Water, Carbon and Ecological Footprints of the Chinese Diet from 1961 to 2017

In the past decades, food consumption in China has undergone a rapid increase and a significant structure transition, as a result of population growth and economic development. The food system is increasingly threatening the environment by depleting water resources, deteriorating water bodies, aggravating climate change, degrading ecosystems, etc. It is significant to understand how food consumption affected the environment and how its impacts were driven in the historical period. This study reveals the environmental impacts of China's food system from 1961 to 2017 from a consumption perspective by assessing water, carbon, and ecological footprints. The logarithmic mean Divisia index method was used to examine the drivers of the growing environmental footprints. The assessment results show that all three environmental footprints have had a drastic increase of more than two times during the studied period, which indicates the high environmental pressure posed by food consumption. We also found that, before the 1980s, the main driving forces of the increasing footprints were population and per capita energy intake. From 1984, the diet pattern started to take a positive effect and then became the dominant driver of the growing environmental footprints after the end of the 1990s.

Addressing the carbon footprint, healthfulness, and costs of self-selected diets in the USA: a population-based cross-sectional study

BACKGROUND

The role of diet in health is well established and, in the past decade, more attention has been given to the role of food choices in the environment. The agricultural sector produces about a quarter of the world's greenhouse gas emissions (GHGE), and meat production, especially beef, is an important contributor to global GHGE. Our study aimed to address a fundamental gap in the diet-climate literature: identifying consumers who are receptive to making dietary changes, and the effect of their potential changes on GHGE, diet healthfulness, and diet costs.

METHODS

Dietary data on US individuals from a nationally representative survey were linked to food-related GHGE. We identified individuals receptive to changing their diets (potential changers) as those who reported trying US dietary guidance and were likely to agree that humans contribute to climate change. We assessed GHGE, diet healthfulness measured by the Healthy Eating Index (HEI), and diet costs before and after hypothetical changes replacing either beef or meats with poultry or plant-protein foods.

FINDINGS

Our sample comprised 7188 individuals, of whom 16% were potential changers. These were disproportionately women, highly educated, or had higher income compared with individuals deemed not likely to change. Replacing 100% of beef intake in potential changers with poultry reduced mean dietary GHGE by 1·38 kg CO₂-equivalents per person per day (95% CI 1·19-1·58), a 35·7% decrease. This replacement also increased mean HEI by 1·7% and reduced mean diet costs by 1·7%. We observed the largest changes when replacing all beef, pork, or poultry intake with plant-protein foods (GHGE decreased by 49·6%, mean HEI increased by 8·7%, and dietary costs decreased by 10·5%). Hypothetical replacements in the potential changers alone resulted in whole population reductions in 1-day dietary GHGE of 1·2% to 6·7%, equivalent to 22-126 million fewer passenger vehicle km.

INTERPRETATION

Individual-level diet studies that include a variation in response by consumers can improve our understanding of the effects of climate policies such as those that include sustainability information in national dietary guidance. In our study, we found that changes by a small percentage of motivated individuals can modestly reduce the national dietary GHGE. Moreover, these substitutions can modestly improve diet healthfulness and reduce diet costs for individuals who make these changes.

FUNDING

Wellcome Trust.

Best compromise nutritional menus for childhood obesity

Childhood obesity is an undeniable reality that has rapidly increased in many countries. Obesity at an early age not only increases the risks of chronic diseases but also produces a problem for the whole healthcare system. One way to alleviate this problem is to provide each patient with an appropriate menu that is defined by a mathematical model. Existing mathematical models only partially address the objective and constraints of childhood obesity; therefore, the solutions provided are insufficient for health specialists to prepare nutritional menus for individual patients. This manuscript proposes a multiobjective mathematical programming model to aid in healthy nutritional menu planning that may prevent childhood obesity. This model provides a plan for combinations and amounts of food across different schedules and daily meals. This approach minimizes the major risk factors of childhood obesity (i.e., glycemic load and cholesterol intake). In addition, this approach considers the minimization of nutritional mismatch and total cost. The model is solved using a deterministic method and two metaheuristic methods. Test instances associated with children aged 4–18 years were created with the support of health professionals to complete this numerical study. The quality of the solutions generated using the three methods was similar, but the metaheuristic methods provided solutions in a shorter computational time. These results are submitted to statistical hypothesis tests to be validated. The numerical results indicate proper guidelines for personalized plans for individual children.

Mediterranean Diet and its Environmental Footprints amid Nutrition Transition: The Case of Lebanon

Many Mediterranean countries, including Lebanon, are experiencing a shift in food consumption away from the traditional Mediterranean diet (MD), concomitant with the escalating burden of non-communicable diseases and dwindling environmental resources. Objective: to examine the adherence to the MD and its association with environmental footprints (EFPs), including water use, energy use, and greenhouse gas (GHG) emissions, among Lebanese adults. Data of Lebanese adults were drawn from the national food consumption survey (n = 2610). Assessment of dietary intake was conducted using a food-frequency questionnaire. Adherence to the MD was examined using four published MD scores. Metrics for the EFPs were calculated using a review of existing life cycle assessments (LCAs). For all MD scores, less than 13% of participants were in the highest tertile. After adjustments for covariates, two of the MD scores were associated with lower water use. For GHG, significant inverse associations were observed with all MD scores. Energy use was not associated with MD scores. Overall, low adherence to the MD among Lebanese adults was observed, together with an inverse association between adherence to the MD and water use and GHG emissions. These findings support and enforce ongoing efforts that aim to increase adherence to the MD in order to address health issues, as well as tackle environmental sustainability.

Healthy and Sustainable Diets and Food Systems: the Key to Achieving Sustainable Development Goal 2?

The Sustainable Development Goals (SDGs) are considered a unifying global goal setting agenda that every country is meant to achieve. One of those goals, SDG2, promises to ensure food security and nutrition within sustainable food systems. However, achieving that goal is riddled with uncertainty because of the way in which the world currently produces and consumes foods. The global trends of diets and the food systems that produce those diets suggest that they are neither healthy nor sustainable, which has implications for achieving SDG2. This paper characterizes the current state of global diets and food systems, the concept of “healthy and sustainable diets,” and the ethical considerations to achieving healthy and sustainable diets for sustainable development.

Achieving Healthy and Sustainable Diets: A Review of the Results of Recent Mathematical Optimization Studies

Climate protection and other environmental concerns render it critical that diets and agriculture systems become more sustainable. Mathematical optimization techniques can assist in identifying dietary patterns that both improve nutrition and reduce environmental impacts. Here we review 12 recent studies in which such optimization was used to achieve nutrition and environmental sustainability aims. These studies used data from China, India, and Tunisia, and from 7 high-income countries (France, Finland, Italy, the Netherlands, Sweden, the United Kingdom, and the United States). Most studies aimed to reduce greenhouse gas emissions (10 of 12) and half aimed also to reduce ≥1 other environmental impact, e.g., water use, fossil energy use, land use, marine eutrophication, atmospheric acidification, and nitrogen release. The main findings were that in all 12 studies, the diets optimized for sustainability and nutrition were more plant based with reductions in meat, particularly ruminant meats such as beef and lamb (albeit with 6 of 12 of studies involving increased fish in diets). The amount of dairy products also tended to decrease in most (7 of 12) of the studies with more optimized diets. Other foods that tended to be reduced included: sweet foods (biscuits, cakes, and desserts), savory snacks, white bread, and beverages (alcoholic and soda drinks). These findings were broadly compatible with the findings of 7 out of 8 recent review articles on the sustainability of diets. The literature suggests that healthy and sustainable diets may typically be cost neutral or cost saving, but this is still not clear overall. There remains scope for improvement in such areas as expanding research where there are no competing interests; improving sustainability metrics for food production and consumption; consideration of infectious disease risks from livestock agriculture and meat; and researching optimized diets in settings where major policy changes have occurred (e.g., Mexico's tax on unhealthy food).

Linking environmental sustainability and nutritional quality of the Atlantic diet recommendations and real consumption habits in Galicia (NW Spain)

Today's society is increasingly aware of food consumption patterns. Under the perspective that real consumption trends are often not in line with healthy recommendations, this research focuses on the study of the environmental and nutritional sustainability of two types of food consumption habits present in the northern Atlantic area of Spain (Galicia). The main objective is, therefore to detect the existing deviations between the current Galician diet (GD) and the traditional and increasingly relevant Recommended Atlantic Diet (RAD), allowing verifying whether current consumption patterns ensure an optimal and sustainable nutritional profile. In this sense, the carbon footprint from a Life Cycle Assessment perspective has been estimated as environmental indicator of both dietary patterns and, the nutritional quality has been determined by the Nutrient Rich Diet 9.3 index and the Health gain score. The carbon footprint of both dietary models is moderately high compared to recommended diets such as the Mediterranean one. Comparing the two scenarios, the associated greenhouse gas emissions are about 15% higher for GD than for RAD, mainly due to the higher intake of beef and dairy products. On the other hand, nutritional quality is comparatively higher for RAD than for GD, associated with higher consumption of vegetables and fruits. An additional objective of this work has been to consider a sensitivity analysis to determine the effect of replacing beef with alternative sources. Having in mind this study, it can be concluded that the real consumption pattern in Galicia is far from the recommended one, with worse environmental and nutritional quality. The promotion of social awareness policies to guide consumers in the choice a healthier and more environmentally sustainable dietary pattern should be advisable for regional decision-makers as well as for those who wish to promote adherence to the Atlantic diet in other regions and countries.

Prospects of orphan crops in climate change

MAIN CONCLUSION

Orphan crops can contribute to building resilience of marginal cropping systems as a climate chnage adaptation strategy. Orphan crops play an important role in global food and nutrition security, and may have potential to contribute to sustainable food systems under climate change. Owing to reports of their potential under water scarcity, there is an argument to promote them to sustainably address challenges such as increasing drought and water scarcity, food and nutrition insecurity, environmental degradation, and employment creation under climate change. We conducted a scoping review using online databases to identify the prospects of orphan crops to contribute to (1) sustainable and healthy food systems, (2) genetic resources for future crop improvement, and (3) improving agricultural sustainability under climate change. The review found that, as a product of generations of landrace agriculture, several orphan crops are nutritious, resilient, and adapted to niche marginal agricultural environments. Including such orphan crops in the existing monocultural cropping systems could support more sustainable, nutritious, and diverse food systems in marginalised agricultural environments. Orphan crops also represent a broad gene pool for future crop improvement. The reduction in arable land due to climate change offers opportunities to expand the area under their production. Their suitability to marginal niche and low-input environments offers opportunities for low greenhouse gas (GHG) emissions from an agro-ecosystems, production, and processing perspective. This, together with their status as a sub-set of agro-biodiversity, offers opportunities to address socio-economic and environmental challenges under climate change. With research and development, and policy to support them, orphan crops could play an important role in climate-change adaptation, especially in the global south.

Optimizing School Food Supply: Integrating Environmental, Health, Economic, and Cultural Dimensions of Diet Sustainability with Linear Programming

There is great potential for reducing greenhouse gas emissions (GHGE) from public-sector meals. This paper aimed to develop a strategy for reducing GHGE in the Swedish school food supply while ensuring nutritional adequacy, affordability, and cultural acceptability. Amounts, prices and GHGE-values for all foods and drinks supplied to three schools over one year were gathered. The amounts were optimized by linear programming. Four nutritionally adequate models were developed: Model 1 minimized GHGE while constraining the relative deviation (RD) from the observed food supply, Model 2 minimized total RD while imposing stepwise GHGE reductions, Model 3 additionally constrained RD for individual foods to an upper and lower limit, and Model 4 further controlled how pair-wise ratios of 15 food groups could deviate. Models 1 and 2 reduced GHGE by up to 95% but omitted entire food categories or increased the supply of some individual foods by more than 800% and were deemed unfeasible. Model 3 reduced GHGE by up to 60%, excluded no foods, avoided high RDs of individual foods, but resulted in large changes in food-group ratios. Model 4 limited the changes in food-group ratios but resulted in a higher number of foods deviating from the observed supply and limited the potential of reducing GHGE in one school to 20%. Cost was reduced in almost all solutions. An omnivorous, nutritionally adequate, and affordable school food supply with considerably lower GHGE is achievable with moderate changes to the observed food supply; i.e., with Models 3 and 4. Trade-offs will always have to be made between achieving GHGE reductions and preserving similarity to the current supply.

Integrating Protein Quality and Quantity with Environmental Impacts in Life Cycle Assessment

Life cycle assessment (LCA) evaluates environmental impacts of a product from material extraction through disposal. Applications of LCA in evaluating diets and foods indicate that plant-based foods have lower environmental impacts than animal-based foods, whether on the basis of total weight or weight of the protein content. However, LCA comparisons do not differentiate the true biological value of protein bioavailability. This paper presents a methodology to incorporate protein quality and quantity using the digestible indispensable amino acid score (DIAAS) when making comparisons using LCA data. The methodology also incorporates the Food and Drug Administration’s (FDA) reference amounts customarily consumed (RACCs) to best represent actual consumption patterns. Integration of these measures into LCA provides a mechanism to identify foods that offer balance between the true value of their protein and environmental impacts. To demonstrate, this approach is applied to LCA data regarding common protein foods’ global warming potential (GWP). The end result is a ratio-based score representing the biological value of protein on a GWP basis. Principal findings show that protein powders provide the best efficiency while cheeses, grains, and beef are the least efficient. This study demonstrates a new way to evaluate foods in terms of nutrition and sustainability.

A comparison of the Mediterranean diet and current food consumption patterns in Spain from a nutritional and water perspective

The promotion of responsible consumption is a key strategy to achieve environmental benefits, sustainable food security, and enhance public health. Countries like Spain are making efforts to reverse growing obesity and promote healthy diets, such as the recommended and traditional Mediterranean, recognized as a key strategy to improve the population's health with locally grown, traditional, and seasonal products like fruits, vegetables, olive oil, and fish. With a view to connecting water, agriculture, food security, nutrition and health, this research aims to investigate and compare the nutritional and water implications of the current food consumption of Spanish households with the recommended Mediterranean diet. Besides, we calculate their nutritional composition, compare their water footprints, and develop a new methodological approach to assess nutritional water productivity (i.e. the nutritional value per unit of embedded water). Results show that the current Spanish diet is shifting away from the recommended Mediterranean towards an alternative one containing three times more meat, dairy and sugar products, and a third fewer fruits, vegetables, and cereals. The Mediterranean diet is also less caloric, as it contains smaller amounts of proteins and fats and is richer in fiber and micronutrients. Due to the high-embedded water content in animal products, a shift towards a Mediterranean diet would reduce the consumptive WF about 750 l/capita day. Additionally, the Mediterranean diet has better water-nutritional efficiency than the current one: it provides more energy, fiber, and nutrients per liter of consumptive water. The study confirms the Mediterranean diet is a healthier and more sustainable diet with strong cultural heritage.

Healthy and sustainable diets that meet greenhouse gas emission reduction targets and are affordable for different income groups in the UK

OBJECTIVE

To model dietary changes required to shift the UK population to diets that meet dietary recommendations for health, have lower greenhouse gas emissions (GHGE) and are affordable for different income groups.

DESIGN

Linear programming was used to create diets that meet dietary requirements for health and reduced GHGE (57 and 80 % targets) by income quintile, taking account of food budgets and foods currently purchased, thereby keeping dietary change to a minimum.Setting/ParticipantsNutrient composition, GHGE and price data were mapped to 101 food groups in household food purchase data (UK Living Cost and Food Survey (2013), 5144 households).

RESULTS

Current diets of all income quintiles had similar total GHGE, but the source of GHGE differed by types of meat and amount of fruit and vegetables. It was possible to create diets with a 57 % reduction in GHGE that met dietary and cost restraints in all income groups. In the optimised diets, the food sources of GHGE differed by income group due to the cost and keeping the level of deviation from current diets to a minimum. Broadly, the changes needed were similar across all groups; reducing animal-based products and increasing plant-based foods but varied by specific foods.

CONCLUSIONS

Healthy and lower-GHGE diets could be created in all income quintiles but tailoring changes to income groups to minimise deviation may make dietary changes more achievable. Specific attention must be given to make interventions and policies appropriate for all income groups.