Reports – Page 9 – Sustainability

Plant-Based Meat and Dairy Substitutes as Appropriate Alternatives to Animal-Based Products? (2020)

Khandpur N, Martinez-Steele E, Sun Q. Plant-Based Meat and Dairy Substitutes as Appropriate Alternatives to Animal-Based Products? The Journal of Nutrition. 2020;151(1):3-4. DOI: 10.1093/jn/nxaa351 (open archive)

Relevant to:

All Dietitians-Nutritionists.

Question:

This commentary poses practice and research questions about the nutrition and environmental consequences of the increased production and intake of ultra-processed plant-based meat and dairy substitutes. Their commentary reflects upon results from a study also reviewed on this website:

Gehring J, Touvier M, Baudry J, Julia C, Buscail C, Srour B, et al. Consumption of Ultra-Processed Foods by Pesco-Vegetarians, Vegetarians, and Vegans: Associations with Duration and Age at Diet Initiation. The Journal of Nutrition. 2020;151(1):120-31. https://doi.org/10.1093/jn/nxaa196 (open archive)

Bottom line for nutrition practice:

The Gehring et al. (2020) article illustrated a high intake of plant-based meat and dairy substitutes (PMDSs) by vegetarians. The study classified these foods as ultra-processed foods (UPFs), based on the NOVA classification of foods by level of processing (see: of additional interest). The authors of the commentary suggest that the substantial increase in the development and marketing of these products over the last few years has the potential to have a large impact on the nutritional quality of diets for vegetarians (and we would argue for any transitioning to a more plant-based diet).

The authors of this commentary argue that we need a greater knowledge of PMDSs, including their degree of processing and the nutrient profile of the individual foods and the dietary patterns within which they are consumed. They also call for more research on the health and environmental impacts of PMDSs, as well as research instruments to examine these questions.

Abstract:

N/A (Commentary)

Details of results:

Research trends in Europe suggest that the market for PMDSs will grow by almost 75% between 2018-2023. While the authors note that these products help in the transition toward a plant-based diet, they suggest that it is important to examine how this increase will affect nutritional intake. For example, while eating high quality plant-based foods rather than red meat has shown health benefits, this may not be true for replacing meat with low quality plant-based carbohydrates.

On one hand, the authors cite an industry-funded trial showing several beneficial effects of the plant-based substitutes (when compared with equivalent animal products), including lowering LDL-cholesterol. However, the authors also cite a 2019 Food and Agriculture Organization (FAO) report linking the intake of both plant and animal origin UPFs with chronic diseases (see “Additional Information”). They suggest that evidence about nutritional quality and the health impacts may also influence how these products are scored by measurement tools such as Alternative Healthy Eating Index and the Dietary Approaches to Stop Hypertension.

The authors also note that the environmental impacts of this shift need to be examined, including the production systems for PMDSs, which may differ from current systems and thus have the potential for different impacts.

Of additional interest:

The four NOVA levels of food by level of processing include: 1. Unprocessed and minimally processed foods; 2. Processed culinary ingredients; 3. Processed foods; and 4. Ultra-processed foods. For more information on the NOVA classification see: Monteiro, C.A., Cannon, G., Lawrence, M., Costa Louzada, M.L. and Pereira Machado, P.2019. Ultra-processed foods, diet quality, and health using the NOVA classification system. Rome, FAO. http://www.fao.org/3/ca5644en/ca5644en.pdf

Food and Agriculture Organization. Ultra-processed foods, diet quality, and human health. Rome, Italy: FAO; 2019. Available from: http://www.fao.org/publications/card/en/c/C A5644EN/

Editor’s comment:

There is such a wide variation in PMDS products. For example, some plant-based “meat” patties have many additives, whereas some have a minimal amount of ingredients. It seems that there should be a way to differentiate between these foods. A discussion about this term can be found at:
https://www.tabledebates.org/building-blocks/what-ultra-processed-food-and-why-do-people-disagree-about-its-utility-concept

The shift toward more PMDSs also has the potential to shift overall intake toward specific foods. For example, rice can be a significant ingredient in some of these foods. As some rice has naturally occurring arsenic, does this pose a problem?

We would also note that social sustainability of these shifts also needs to be considered. For example, the increased intake of quinoa by the West is purported to have decreased the availability of the food for local consumption where originally grown.

See also on this site a synopsis of: Smetana S, Mathys A, Knoch A, Heinz V. Meat alternatives: life cycle assessment of most known meat substitutes. The International Journal of Life Cycle Assessment. 2015 2015/09/01;20(9):1254-67. (pay wall)

Conflict of interest/ Funding:

No conflicts declared

External relevant links:

n/a

Corresponding author:

neha.khandpur@usp.br

updated 2024 October

WWF Consumer Meat Guides for the Baltic Region (2021)

The World Wide Fund for Nature (WWF) Meat Guides for Sweden, Finland, and Germany can be downloaded as PDFs, or as a mobile app. This project is retiring, but it is currently still available as a page with links to the countries.

As a consumer, you can contribute to more sustainable meat consumption by making wise food choices that take into account nature, climate, and animal welfare. What we eat has significance, and you as a consumer can make a difference. Meat consumption globally contributes to reduced biodiversity, increased greenhouse gas emissions, and increased use of pesticides.

At the same time, meat can contribute important nutrients to our diet, and grazing animals are important for biodiversity. Therefore, it is important to choose the right one. By eating less but environmentally better meat and choosing more plant-based protein, you, as a consumer, can contribute to more sustainable meat consumption.

WWF is transparent about its funding, sources of information, and partner organizations. These guides contribute to a deeper understanding of the nuanced dietary guidance for one European region. The website is dynamic in that it is updated regularly and actively, the guides themselves (especially the PDF version) are relatively static with no indication of updating cycles. The guides are based on rigorously produced and peer-reviewed evidence.

The 2024 report: “Evaluation Study of the WWF Sustainable Protein / Meat Guides Final Report,” is useful for lessons from the project.

updated October 2024, reviewed 2026 February

Marine Stewardship Council (website)

The international organization MSC (Marine Stewardship Council), a non-profit organization that aims to ensure the sustainability of the oceans and ensure that they are truly “the great pantry” of humanity in the future, is responsible for this product. MSC is a third-party certification for sustainable seafood that assesses population health, impact on marine environment and management of fisheries around the world. MSC’s blue-fish label is intended to help eaters identify sustainable seafood. It indicates to the consumer that its catch has been obtained through a technique that respects the environment, conservation and biodiversity.

This website is available in 18 different languages. MSC has certified 300 fisheries and 25,000 products from around the world. Evidence regarding the quality of their standards is included on the website. Their website offers information on the certification process as well as recipes, food guides, educational materials and support for supply chain actors about sustainable seafood in 18 languages. Information about specific fisheries is not available.

updated 2026 February

Nourishing Australia: A decadal plan for the science of nutrition. Realising health, environmental and economic opportunities to benefit all Australians (2019)

Nourishing Australia is a decadal plan for the science of nutrition that aims to reduce the presence of the double burden of malnutrition in Australia through the use of a sustainable food system. The document emphasizes the relationship between nutrition and health, while identifying potential targets to reach in the food system to reduce the double burden, while also helping the environment. It was developed by the Australian Academy of Science’s Australian Research Council with an Expert Working Group, National Committee for Nutrition. The information presented in this article is both reliable and adaptable.

EAT (website)

EAT is a non-profit founded by the Stordalen Foundation, Stockholm Resilience Centre, and the Wellcome Trust, dedicated to transforming our global food system through sound science, impatient disruption, and novel partnerships. EAT is governed and managed by a board of trustees, while the advisory board provides management with strategic advice. EAT partners with a range of foundations, academic institutions, organizations, and companies with whom we collaborate on programs and who provide strategic advice, knowledge, and financial support to EAT.

EAT-Lancet Report: Healthy Diets from Sustainable Food Systems (2025)

The 2025 EAT-Lancet Commission Report on Healthy, Sustainable, and Just Food Systems, presents the most comprehensive global scientific evaluation of food systems to date. Key findings:

Shifting global diets could prevent up to 15 million premature deaths per year.
Food systems are the largest contributor to the transgression of five planetary boundaries.
Food systems currently account for roughly 30% of total greenhouse gas emissions globally. Transforming food systems could cut these emissions by more than half.
Fewer than 1% of the world’s population is currently in the ‘safe and just space’, where people’s rights and food needs are met within planetary boundaries.
The wealthiest 30% of people drive more than 70% of food-related environmental impacts.

Building on its influential 2019 report, the new Commission – comprising leading international experts in nutrition, climate, economics, health, social sciences, and agriculture from more than 35 countries across six continents – finds that shifting global diets could prevent approximately 15 million premature deaths per year. At the same time, concerted global efforts to transform food systems could bring us back within planetary boundaries and cut annual greenhouse gas emissions from food systems by more than half compared with a business-as-usual scenario.

The Commission’s findings stress that just food systems will be essential to achieving improved health and social development outcomes. Fewer than 1% of the world’s population is currently in the ‘safe and just space’, where people’s rights and food needs are met within planetary boundaries. According to the report, currently almost a third (32%) of food systems workers earn below a living wage. Meanwhile, the wealthiest 30% of people drive more than 70% of food-related environmental impacts, and despite global calorie sufficiency, more than 1 billion people remain undernourished.

In this moment of increasing instability,
food systems still offer an unprecedented opportunity
to build the resilience of environmental, health, economic, and social systems,
and are uniquely placed to enhance human wellbeing
while also contributing to Earth-system stability.

The analysis warns that even with a complete global transition away from fossil fuels, food systems could still push temperatures beyond 1.5°C. The planetary boundaries framework defines nine key Earth system processes that regulate life on Earth. The world has already passed six of these nine boundaries: climate, biodiversity, land, freshwater, nitrogen and phosphorus pollution, and novel entities (pesticides, antimicrobials, and microplastics). Food systems are the largest contributor to five of these transgressions and contribute around 30% of greenhouse gas emissions globally.

Other EAT Initiatives

To translate knowledge into scalable action, EAT programs, partnerships, and communities of action focus on indigenous peoples, youth, children, countries, cities, chefs, farmers/fishers, health professionals, businesses, policymakers, trade, and finance aiming to bring about change.

Below are highlights of a few initiatives that are useful for Dietitians-Nutritionists, but there are many. Do visit their website!

EAT Brief for Healthcare Professionals Download PDF

EAT Brief for Healthcare Professionals (2024)

This is a 2-page flyer with key points from the report, useful for busy professionals. Download under the image.

Note: A slight tweak in the brief would have been ideal, as ‘a food’ can be sustainable or not sustainable – it depends on the system the food comes from and how much we use. At the end of the brief there is a great point about “Focusing on sustainably grown [and processed] food to provide healthy foods and beverages from sustainable food systems to a high standard.” This could have been moved to page 1 and slightly edited to include processing to set the tone of ‘sustainable systems’ throughout the brief, along with a few other edits to match.

EAT-GlobeScan Grains of Truth report (2024)

The report offers a comprehensive look at the evolving global food landscape through the eyes of consumers. Highlighting a growing interest in plant-based diets, the report explores how economic factors, taste preferences, and regional differences are shaping—and sometimes slowing—the shift toward more sustainable eating habits. Based on a robust online survey of over 30,000 adults across 31 countries conducted in mid-2024, the findings reveal both the optimism driving change and the challenges that remain on the path to a global dietary transformation. Download the report here.

EAT Communities for Action (2025)

From Knowledge to Action: Driving the Food System Change We Need. In the lead up to the October release of the 2025 EAT-Lancet Commission report, EAT, working in collaboration with global partners, is running a series of structured dialogues to accelerate progress towards healthy, sustainable, and just food systems. At the center of this initiative are nine Communities for Action, each representing a distinct stakeholder group within the global food system. These communities are composed of frontline actors working to improve how food is produced, distributed, and consumed. Click through to join.

Updated February 2026