Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland; Department of Agrifood Business and Spatial Analysis, Teagasc Food Research Centre, Ashtown, Dublin, Ireland.
Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
Adv Nutr. 2023 Nov;14(6):1270-1296. doi: 10.1016/j.advnut.2023.07.007. Epub 2023 Jul 31.
Improving diet quality while simultaneously maintaining planetary health is of critical interest globally. Despite the shared motivation, advancement remains slow, and the research community continues to operate in silos, focusing on certain pairings (diet-climate), or with a discipline-specific lens of a sustainable diet, rather than examining their totality. This review aimed to summarize the literature on adherence to a priori defined dietary patterns in consideration of diet quality, metabolic risk factors for noncommunicable diseases (NCDs), environmental impacts, and affordability. A methodology using PRISMA guidelines was followed, and searches were performed in 7 databases as of October 2022. The Appraisal tool for Cross-Sectional Studies (AXIS) and the National Institutes of Health (NIH) quality assessment tool for observational cohort studies were employed for quality appraisal. The evidence was narratively synthesized according to the characteristics of the diet quality metrics. The review includes 24 studies published between 2017-2023. Thirteen distinct diet quality scores were identified, with those measuring adherence to national dietary guidelines the most reported. Thirteen distinct environmental impact indicators were identified, with greenhouse gas emissions (n=23) reported most. All studies reported on body mass index, and 7 studies assessed the cost of adherence. Our results are consistent with previous findings that healthier diets can reduce environmental impacts; however, incongruities between population and planetary health can occur. Hence, the "sustainability" of dietary patterns is dependent on the choice of indicators selected. Further, healthy, lower impact diets can increase financial cost, but may also provide a protective role against the risk of obesity. Given the Global Syndemic, strategies to reduce obesity prevalence should emphasize the win-win opportunities for population and planetary health through dietary change. Research should identify diets that address multiple environmental concerns to curtail burdens potentially transferring, and harmonize this with sociocultural and equity dimensions. This review was registered at PROSPERO as CRD42021238055.
在全球范围内，提高饮食质量的同时保持行星健康是至关重要的。尽管动机相同，但进展仍然缓慢，研究界仍然各自为政，专注于某些特定的搭配（饮食与气候），或者从可持续饮食的特定学科角度来看待问题，而不是全面考虑这些问题。本综述旨在总结关于在考虑饮食质量、非传染性疾病代谢风险因素、环境影响和可负担性的情况下，遵循预先定义的饮食模式的文献。采用 PRISMA 指南的方法，并于 2022 年 10 月在 7 个数据库中进行了检索。使用横断面研究评价工具（AXIS）和美国国立卫生研究院（NIH）观察性队列研究质量评估工具对研究进行质量评估。根据饮食质量指标的特点对证据进行叙述性综合。综述包括 2017 年至 2023 年期间发表的 24 项研究。确定了 13 种不同的饮食质量评分，其中报告最多的是衡量对国家饮食指南的遵守程度的评分。确定了 13 种不同的环境影响指标，其中温室气体排放量（n=23）的报告最多。所有研究均报告了体重指数，7 项研究评估了遵守饮食的费用。我们的研究结果与之前的发现一致，即更健康的饮食可以减少环境影响；然而，人口健康和行星健康之间可能存在不一致。因此，饮食模式的“可持续性”取决于所选指标的选择。此外，健康、影响较小的饮食可能会增加经济成本，但也可能对肥胖风险提供保护作用。鉴于全球综合征，减少肥胖患病率的策略应通过饮食改变强调人口健康和行星健康的双赢机会。研究应确定解决多种环境问题的饮食，以减少潜在的负担转移，并将其与社会文化和公平维度相协调。本综述在 PROSPERO 上注册为 CRD42021238055。
