Environmental sustainability in national food-based dietary guidelines: a global review (2022)

Citation: James-Martin G, Baird DL, Hendrie GA, et al. Environmental sustainability in national food-based dietary guidelines: a global review. Lancet Planet Health 2022; 6: e977–86. https://doi.org/10.1016/S2542-5196(22)00246-7


Food-based dietary guidelines (FBDGs) provide country-specific guidance on what constitutes a healthy diet. With increasing evidence for the synergy between human and planetary health, FBDGs have started to consider the environmental sustainability of food choices. However, the number of countries that discuss environmental sustainability in their guidelines is unknown.

The purpose of this Review was to identify countries with government-endorsed FBDGs that made explicit mention of environmental sustainability and to examine the breadth and depth of the inclusion of sustainability in FBDGs. The Food and Agriculture Organization of the UN identified 95 countries with FBDGs.

We assessed 83 countries against our inclusion criteria, of which 37 mentioned environmental sustainability. Relevant content was assessed against a set of criteria based on the Food and Agriculture Organization’s guiding principles for sustainable healthy diets.

The depth to which environmental sustainability was discussed varied and it was often restricted to general explanations of what a sustainable diet is. Few FBDGs addressed why sustainability is important, how dietary changes can be made, or provided quantified advice for implementing sustainable diets.

Key messages

  • Food-based dietary guidelines (FBDGs) are increasingly including content to address the relationship between dietary intake and environmental sustainability. At present, this information is more likely to be reported in background documents than consumer documents, restricting its visibility to users of the consumer documentation.
  • The principles most commonly addressed in FBDGs are associated with culture, inclusion of animal-based and plant-based foods in the diet, environmental effect, biodiversity, and food waste. However, information is general, and practical, specific advice, or quantified recommendations for action are scarce.
  • To achieve the transformation to food systems needed to curb the accelerating environmental decline globally, more countries need to commit to developing FBDGs that explicitly emphasise the crucial link between diet and planetary health and provide specific and practical advice to address these issues.

37 countries with environmental sustainability in their FBDG:

  1. Argentina
  2. Australia
  3. Belgium‡
  4. Brazil
  5. Canada
  6. Colombia
  7. Costa Rica
  8. Denmark
  9. Ecuador
  10. El Salvador
  11. Estonia
  12. Finland
  13. France
  14. Germany
  15. Greece
  16. Guatemala
  17. Iceland
  18. Italy
  19. Japan
  20. Kenya
  21. Malta
  22. Mexico
  23. Netherlands
  24. New Zealand
  25. North Macedonia
  26. Norway
  27. Peru
  28. Poland
  29. Qatar
  30. Sierra Leone
  31. South Africa
  32. Sweden
  33. Switzerland
  34. Türkiye
  35. UK
  36. Uruguay
  37. Venezuela

Centre for Sustainable Healthcare (CSH)

Since 2008 the Centre for Sustainable Healthcare (CSH) has engaged healthcare professionals, patients, and the wider community to understand the connections between health and the environment and reduce healthcare’s resource footprint.

CSH’s work is guided by the principles of sustainable clinical practice:

  • Prevention
  • Patient empowerment and self care
  • Lean systems
  • Low carbon alternatives

CSH programmes equip healthcare professionals and organisations with methods and metrics for sustainable models of care:

  • Sustainable Specialties Programme
  • Carbon Footprinting and Triple Bottom Line Analysis
  • Education and Training
  • Sustainability in Quality Improvement
  • The Green Team Competition
  • Green Space for Health
  • Sustainable Healthcare Peer Networks

CSH was born in and will always have its heart in Oxford, England, but our expanding team of international experts is situated all over the UK, the EU and beyond. CSH has grown into the world’s foremost institution for sustainable healthcare in research and practice and has had a positive impact on so much of the healthcare system in the UK and beyond.

From measuring and reducing our own carbon footprint to prioritising the health, wellbeing, and work/life balance of those in our team, the CSH team practices what they preach every day. In line with our sustainable ethos, we minimise the daily commute by working online. This provides us with the freedom and efficiency to tap into the best and brightest minds in their fields while making a positive impact on the environment in the way we work.

By building its own research base, best practice recommendations and an ever-growing bank of case studies, it has fulfilled its goal of bringing all of that expert knowledge into action, changing clinical care and influencing policy at the highest level.

As CSH goes from strength to strength, so too does its message that healthcare can be sustainable.

German Nutrition Society (DGE): DGE position statement on a more sustainable diet (2021)

Renner B, Arens-Azevêdo U, Watzl B, Richter M, Virmani K, Linseisen. J for the German Nutrition Society (DGE): DGE position statement on a more sustainable diet. Ernahrungs Umschau 2021; 68(7): 144–54. DOI: 10.4455/eu.2021.030


Our understanding of the term sustainability has evolved considerably over the last 50 years and is now a key element of social action. An essential part of sustainable development is a more sustainable diet. In this position paper, the German Nutrition Society states that advocating for and promoting a more sustainable diet is an integral part of its activities. Health is a key goal of a more sustainable diet since health, quality of life, and well-being are affected by what people eat and drink. The goal dimensions of environment, animal welfare, and social aspects are explicitly added to the goal dimension of health (in their various definitions).

The food environment is also immensely important for nutritional behaviour. The DGE relies on statements from the report of the Scientific Advisory Board on Agricultural Policy, Food and Consumer Health Protection at the Federal Ministry of Food and Agriculture (WBAE) to present a comprehensive form of the various aspects of a more sustainable diet. The position paper ensures a common basis for developing an understanding of a more sustainable diet, and enables the different fields of nutritional science to pursue a differentiated development from their specific perspectives. This paper should provide the DGE with an orientation and a commitment for its work in the future.

Sustain: the alliance for better food and farming (website)

Sustain is a powerful alliance of organisations and communities working together for a better system of food, farming and fishing, and cultivating the movement for change. Together, they advocate food and agriculture policies and practices that enhance the health and welfare of people and animals, improve the working and living environment, enrich society and culture, and promote equity.

The Sustain alliance works to influence government, local authorities, businesses, organisations and decision-makers in a position to influence or achieve change. We advocate for transparency, legal responsibilities, good governance and accountability. We work with sister alliances and organisations in the UK Nations and support experts and groups working on specialist issues where we can lend our weight. We also work with leaders, food partnerships and communities in places across the UK – and internationally – to improve health and sustainability through the mobilisation and celebration of local action on food.

The main sister alliances that Sustain works with include:

  • Eating Better, is a movement for change of sixty organisations working to accelerate the transition from producing and eating too much meat and dairy to a fairer, healthier and more sustainable food system that is better for animal welfare and for nature.
  • Food Sense Wales is built on the foundations of Food Cardiff, a multi-award-winning food partnership and founding member of the Sustainable Food Places Network managed in partnership with the Soil Association, Food Matters and Sustain. Food Sense Wales delivers pioneering programmes such as Sustainable Food Places, Peas Please, and Food Power – bringing people together through food.
  • Green Alliance is an independent think tank and charity focused on ambitious leadership for the environment. It works with influential leaders in business, NGOs and politics to accelerate political action and create transformative policy for a green and prosperous UK. Sustain has worked extensively with Green Alliance members, and during the Brexit process with the Greener UK coalition hosted by the Green Alliance, to integrate food and farming into key environmental, fisheries and agriculture policy initiatives.
  • Green Care Coalition, was established in 2016 to promote the commissioning and use of Green Care services, and to give voice to the many organisations in the UK that are committed to delivering or supporting the delivery of high-quality and cost-effective Green Care services. Green Care refers to structured therapy or treatment programmes that take place in natural surroundings and recognise the instinctive connection between nature and health.
  • Nourish Scotland works across Scotland for a fair, healthy and sustainable food system that truly values nature and people. Nourish takes a systems approach to food. This means they work across a wide range of issues and levels: from production to consumption, from practice to policy, and from grassroots to national. They champion integrated approaches to solving the big challenges of the current food system: hunger and malnutrition, diet-related disease, exploitation, loss of biodiversity, and climate change.
  • The Obesity Health Alliance is a coalition of over 40 organisations working together to reduce obesity by influencing government policy. The goal of the Obesity Health Alliance is to prevent obesity-related ill-health by supporting evidence-based population-level policies to help address the wider environmental factors that lead to excess body weight.
  • The Sustainable Soils Alliance is a partnership of farming organisations, businesses, NGOs, applied science and academia working together to restore our soils to health within one generation. The alliance pursues this aim by bringing together the community of stakeholders interested in soil management to debate the scale and nature of the problem, agree on the appropriate indicators and determining factors and identify the relevant policy mechanisms and levers for reform. They engage media and stakeholders, educate the general public and lobby government for a policy framework that will bring about the transformational step change needed to support the development of healthy soil for generations to come.
  • The Trade Justice Movement is a UK coalition of nearly sixty civil society organisations, with millions of individual members, calling for trade rules that work for people and the planet. Trade Justice Movement members include trade unions, aid agencies, environment and human rights campaigns, Fair Trade organisations and consumer groups. 
  • Wildlife and Countryside Link is the largest environment and wildlife coalition in England, bringing together 57 organisations to use their strong joint voice for the protection of nature. Link’s members campaign to conserve, enhance and access our landscapes, animals, plants, habitats, rivers and seas.

Food as Medicine Global

Vision – A collaborative global community of farmers, health care providers, healers, hospitals, clinics, educators, schools, academic centers, students, cooks and consumers united in a vision for a healthy world.

Mission – To facilitate educational conversations and collaborative engagement for unifying agriculture and medicine to promote health and healing for all. Food as Medicine Global (FAMG) is about community. We facilitate conversations leading to increased collaborations and individual actions to promote health and healing for all. We host events for continued cooperative engagement, brainstorming, and learning from each other to advance the Food as Medicine movement.

Why? Many of our current world challenges have a common root: the way food is grown and consumed. Farming practices impact the health of people, animals, and the environment. Healthier soil leads to healthier food, healthier people, a healthier ecosystem, and healthier climate. There is already a great deal of work happening globally in these areas; however, much of it is in isolation. Our intent is to gather information, build bridges, advance conversations, strengthen engagement, highlight success stories, and amplify efforts to energize a global movement. 

Exploring the barriers and facilitators for following a sustainable diet: A holistic and contextual scoping review (2024)

Abstract: Changing current dietary patterns to more sustainable ones is paramount to decrease the pressure food systems are putting onto the planet and people’s health and wellbeing. However, modifying consumers’ behaviour is extremely challenging since multiple factors of variable nature (i.e., personal, socioeconomic, cultural, external…) influence food choices.

Fig. 2. Number of mentions from the literature review concerning internal and external factors influencing individuals following a sustainable and healthy diet. The dark blue bar (internal factors) are the sum of factors in light blue bars.

For this reason, we aim to identify consumers’ barriers and facilitators for following a sustainable and healthy diet, and explore how these are perceived among people from different socioeconomic backgrounds. To do so, we conducted a scoping review of the literature with a consultation phase with citizens from Barcelona with different socioeconomic backgrounds.

Results revealed one hundred intricate factors that influence people food behaviour, which were grouped into internal, and external factors. Although the literature generally agreed on the direction of influence from the identified factors, the consultation phase generated substantial disagreements given the participants’ diverse perspectives and motivations.

Fig. 3. Number of mentions from the consultation phase concerning internal and external factors influencing individuals following a sustainable and healthy diet. The dark blue bar (internal factors) are the sum of factors in light blue bars.

However, some limiting factors were commonly mentioned across groups which corresponded to feelings of distrust towards the food industry, lack of time, disgust towards specific foods, and the high cost of foods. Differences across socioeconomic groups were not observed except for the latter. All participants agreed that cost acted as a barrier, although participants from higher socioeconomic backgrounds were more capable to find arguments to overcome the price barrier. Results are necessary to acknowledge the particularities embedded in each person and the need to design context-based interventions to effectively overcome people’s barriers and enhance their facilitators.

Citation: Muñoz-Martínez, J., Cussó-Parcerisas, I., & Carrillo-Álvarez, E. (2024). Exploring the barriers and facilitators for following a sustainable diet: A holistic and contextual scoping review. Sustainable Production and Consumption, 46, 476-490. https://doi.org/10.1016/j.spc.2024.03.002

The Economics of the Food System Transformation (2024)

On 29 January 2024, leading experts from the Food System Economics Commission (FSEC) unveiled a new economic model that maps the impacts of two possible futures for the global food system. The report is extremely useful for Dietitians and Nutritionists, with diet central to improving our food system.

The text emphasizes the urgent need for a transformation of food systems, highlighting the economic, environmental, and social benefits of such a transformation. It outlines the negative impacts of current food systems on health, the environment, and climate change, identifying unaccounted costs estimated at 15 trillion USD a year. The report also discusses the unsustainable trajectory of the global food system and the potential economic benefits of a transformation, estimating them to be worth 5 to 10 trillion USD a year.

Proposed Solutions for Food System Transformation:

  1. Shifting consumption patterns towards healthy diets: The report suggests regulating the marketing of unhealthy foods to children, providing front-of-pack nutritional guidance, targeting public food procurement on healthy options, taxing sugar-sweetened beverages and unhealthy foods, and reformulating packaged food to encourage healthier dietary choices.
  2. Resetting incentives by repurposing government support for agriculture: It is recommended to repurpose subsidies to improve access to healthy diets and make them more affordable. This involves reforming agricultural support to incentivize choices in line with the goals of the food system transformation, with a focus on lowering the hidden costs of food systems.
  3. Targeting revenue from new taxes to support food system transformation: The report recommends taxing carbon and nitrogen pollution to help achieve positive outcomes and align with expert recommendations from bodies such as the IPCC and OECD. Designing new taxes to suit the local context and targeting resulting revenues towards direct and progressive benefits for poorer households is essential to ensure inclusive outcomes and garner political support for a food system transformation.
  4. Innovating to increase labor productivity and workers’ livelihood opportunities: Public institutions can accelerate the development and diffusion of innovations that meet the needs of poorer producers and remove barriers to their adoption. Priority areas for public research and innovation include improving plant breeding, supporting environmentally sustainable, biodiversity-friendly, and low-emission farming systems, and developing digital technologies useful to small farmers.
  5. Scaling-up safety nets to keep food affordable for the poorest: Developing and strengthening safety nets is crucial to making food system transformations inclusive and politically feasible. Countries should prioritize targeting limited transfer resources on children’s nutritional needs and mobilizing more resources to put in place comprehensive safety nets.

Additionally, the report addresses various tensions and obstacles in transforming food systems, highlighting the need to manage concerns such as fears of food price rises, job losses, policy siloes, global inequalities, and entrenched vested interests. It emphasizes the importance of addressing these concerns to facilitate change and ensure that the benefits of food system transformation can be realized. The report also highlights the rising visibility of transforming food systems as a policy priority, as well as the new ambition to seize the opportunities offered by such transformation, as evidenced by the COP28 UAE declaration on Sustainable Agriculture, Resilient Food Systems, and Climate Action signed by over 150 countries.

Source: Food Systems Economics. (2024). The Economics of the Food System Transformation. Knowledge for policy.

Teaching nutrition and sustainable food systems: justification and an applied approach (2023 Sep)

Four pillar method of analysis. Prompts to consider when evaluating characteristics of a food product using the sustainable, resilient, healthy food and water system framework.

Campbell, C., & Feldpausch, J. (2023). Teaching nutrition and sustainable food systems: justification and an applied approach. Frontiers in Nutrition. https://www.frontiersin.org/articles/10.3389/fnut.2023.1167180.

Systems thinking is an essential skill for solving real-world problems, supporting lasting, impactful change, and creating desired futures. Transdisciplinary teaching and learning should be integrated into higher education to ensure students have the knowledge and skills to prosper in an ever-changing world. Education that addresses the interconnectedness of food systems is fundamental in cultivating future generations equipped to mitigate complex problems, such as hunger, nutrition-related chronic disease, and the climate crisis.

Connecting the food, agriculture, and nutrition sectors is vitally important for improving human and planetary health and well-being. While we continue to acknowledge that it is critically important to teach systems thinking in the context of sustainable food systems limited resources are available to facilitate this type of learning. Historically, a “triple-bottom-line” approach focusing on economic, environmental, and social perspectives has been used to define sustainability. In contrast, including nutrition and health may provide a more robust view and even greater consideration for the system in its entirety.

The sustainable, resilient, healthy food and water system framework, addressing all four pillars, can be used in higher education to help evaluate the sustainability of food and compare methods of production, place, and dietary patterns. This paper justifies the need for addressing sustainability issues in the context of nutrition and provides an educational approach to support student understanding and application of a systems thinking approach.

In addition to the resources cited in the descriptions of the four pillars; the Food Systems Dashboard, Our World in Data, and the Center for Science in the Public Interest may be beneficial references to consider for multiple pillars.

Note: Even though the article is written from the perspective of and with examples from the USA, the teaching approach could easily use other examples from any region of the world.

Innovative Food Systems Teaching and Learning (IFSTAL)

IFSTAL (Innovative Food Systems Teaching and Learning) is a cross-university, interdisciplinary food systems training programme for postgraduate students to address global food challenges.

There is an urgent need to train a cohort of professionals who can address and resolve the increasing number of fundamental failings in the global food system. The solutions to these systemic failings go far beyond the production of food and are embedded within broad political, economic, business, social, cultural, and environmental contexts. The challenge of developing efficient, socially acceptable, and sustainable food systems that meet the demands of a growing global population can only be tackled through an interdisciplinary systems approach that integrates social, economic, and environmental dimensions.

IFSTAL is designed to improve post-graduate level knowledge and understanding of food systems from a much broader interdisciplinary perspective, which can be applied to students’ studies. Ultimately, these graduates should be equipped to apply critical interdisciplinary systems thinking in the workplace to understand how problems are connected, their root causes, and where critical leverage points might be.

Led by the Food Systems Research Programme at Oxford University’s Environmental Change Institute, IFSTAL is a pioneering consortium of institutions: Oxford University, Warwick University, Royal Veterinary College, London School of Hygiene and Tropical Medicine, and the School of Oriental and African Studies (SOAS)

Food Systems Transformation WhatsApp Community (2024)

The Food Systems Transformation WhatsApp Community grew out of Food Systems at COP28. It is now a year-round meeting place for food systems folks who will bring information from and back to our homes and communities. There are different channels within it to suit your interests and to limit notifications to only what you really want to see.

💼 Job Opportunities
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Join at: https://chat.whatsapp.com/Cx88Tny19mG8dP7tLNDF14

See you there!