Identification of data-driven Dutch dietary patterns that benefit the environment and are healthy

More sustainable dietary patterns are needed to mitigate global warming. This study aims to identify data-driven healthy dietary patterns that benefit the environment. In EPIC-NL, diet was assessed using a 178-item FFQ in 36,203 participants aged 20-70 years between 1993 and 1997. The Dutch Healthy Diet index 2015 (DHD15-index) was used to score healthiness of the diet. As proxy for environmental impact, greenhouse gas (GHG) emissions were calculated using life cycle analysis. To determine patterns that are both healthy and environmentally friendly, reduced rank regression was applied. A Plant-based Pattern characterized by high consumption of fruits, vegetables, and legumes, and low consumption of fries, red meat, and processed meat and a Dairy-based Pattern characterized by high consumption of dairy, and nuts and seeds and low consumption of coffee and tea, sugar-containing sodas, low-fiber bread, and savory sauces were derived. At equal energy intake, the diet of adherents (highest quartile) to the Plant-based Pattern were significantly healthier (89.8 points on the DHD15-index, p < 0.0001) and more sustainable (3.96 kg C0(2)-eq/day, p < 0.0001) compared to the average diet (76.2 points, 4.06 kg C0(2)-eq/day), whereas the Dairy-based Pattern was somewhat healthier (77.9 points, p < 0.0001), but less sustainable (4.43 kg C0(2)-eq/day, p < 0.0001). When deriving dietary patterns based on health and environmental aspects of the diets, a Plant-based and a Dairy-based pattern were observed in our study population. Of these, the plant-based diet benefits health as well as the environment.