• Energy Research

Promoting both a healthy diet and at the same time considering the environmental sustainability aspects of production and consumption of the diet are urgent global issues. We developed the WISH (World Index for Sustainability and Health) to evaluate diets for healthiness and sustainability. The WISH seeks to measure two complex multidimensional concepts, diet quality and environmental sustainability, in one scoring system. The WISH is based on the EAT-Lancet recommendations for a healthy and sustainable diet in the general population with global applicability across multiple settings. Thirteen food groups are scored between 0 and 10, based on their association with disease and impact on environmental indicators. The scoring system was applied using a dataset of duplicate 24 h dietary recalls from 396 urban Vietnamese men and women. Out of a maximum score of 130, the mean total WISH score was 46 (SD 11), and scores for the healthy and high-environmental impact sub-scores were mean 25 (11) (out of 100) and mean 26 (8) (out of 70) respectively. A higher score was observed for the less-healthy (mean 20 (2) out of 30) sub-score. Our initial analysis shows that the WISH is able to differentiate between the healthiness and the environmental sustainability of a Vietnamese diet.

This paper aims to identify changes in food group consumption that may improve both health and sustainability scores of low-scoring population subgroups. As a case study, we assessed the impacts of the diets of a representative sample of Dutch consumers (age 18–75 y, n = 1242). The health impact of their diets was assessed using the Dutch Healthy Diet-index (DHD) and the environmental impact by greenhouse gas emissions (GHGEs). As expected, a significant negative correlation was found between DHD and the GHGEs, indicating that health and sustainability can, to some extent, be improved in synergy with one another. Looking at population subgroups, (young) employed males were identified as an important target group (lowest DHD and highest GHGEs). Four food groups and energy were observed of which a reduced intake makes a diet healthier and more environmentally sustainable: meat, energy, cheese, snacks (cakes, pastry, biscuits, salted and fried snacks, potato chips), and alcohol. Besides, three food groups were observed of which an increased intake makes a diet healthier, but less environmentally sustainable when they do not replace other food groups: fruit, fish, and vegetables. Based on real-life differences in dietary patterns, four transition strategies were formulated that can raise the DHD and lower GHGEs: (I) Replacing snacks with fruit, especially between meals, (II) Replacing cheese with vegetables, during lunch as well as dinner, (III) Partly replacing meat with fish, (IV) Lowering the total energy intake, through reducing the consumption of alcoholic drinks. If deriving the highest environmental gain is the purpose of dietary adjustment, then halving the portions of meat consumed is a strategy (V). Actual unsustainable diet practices of specific subgroups require dedicated transition strategies. The study provides insights into the opportunities for improving both health and environmental sustainability scores of different population subgroups and underlines that these cannot be successfully achieved by adopting a single strategy.

Adherence to the Mediterranean Diet (MedDiet) has been suggested to reduce the risk of age-related cognitive decline. Therefore, we hypothesized that adults consuming a more Mediterranean-like diet were more likely to have better cognitive scores. We investigated cross-sectional associations between MedDiet adherence and cognitive performance using data of 1607 Dutch men and women aged 20-70 years. Dietary intake was assessed using a 183-item Food Frequency Questionnaire. MedDiet adherence was defined by a 0-9 point scale; which was based on intakes of vegetables, legumes, fruits/nuts, cereals, fish/seafood, meat/poultry, dairy, ethanol and the MUFA:SFA ratio. Cognitive function was assessed with a neuropsychological test battery. Linear regression analyses adjusted for relevant covariates showed a significant inverse association between MedDiet adherence and everyday memory: specifically β = -0.107 ± 0.046 points (P = .02) for the total population and β = -0.139 ± 0.055 points (P = .01) for those aged ≥50 years. Further exploration of the individual MedDiet food groups suggested that the association between MedDiet and every day memory was predominantly driven by the MUFA:SFA ratio. Moreover, associations were observed between higher ethanol intake with better semantic memory and language production (β = 0.016 ± 0.008 P = .05), higher vegetable intake with better processing speed (β = 0.005 ± 0.002, P = .02), and higher legumes intake with poorer processing speed (β = -0.014 ± 0.006, P = .03). Thus, in this Dutch cohort, higher MedDiet adherence was associated with poorer everyday memory.