SNEB Position Paper

Position of the Society for Nutrition Education andBehavior: The Importance of Including EnvironmentalSustainability in Dietary GuidanceD1X XDonald Rose, D2X XPhD1; D3X XMartin C. Heller, D4X XPhD2; D5X XChristina A. Roberto, D6X XPhD3

ABSTRACT

It is the position of the Society for Nutrition Education and Behavior that environmental sustainability should be

inherent in dietary guidance, whether working with individuals or groups about their dietary choices or in setting

national dietary guidance. Improving the nutritional health of a population is a long-term goal that requires ensuring

the long-term sustainability of the food system. Current environmental trends, including those related to climate

change, biodiversity loss, land degradation, water shortages, and water pollution, threaten long-term food security

and are caused in part by current diets and agricultural practices. Addressing these problems while producing more

food for a growing population will require changes to current food systems. Dietary choices have a significant role in

contributing to environmental impacts, which could be lessened by consuming fewer overconsumed animal products

and more plant-based foods while reducing excess energy intake and the amount of food wasted. Discussion of sus-

tainability within governmental dietary guidance is common in many countries, is consistent with previous US guide-

lines, and is within the scope of authorizing legislation. Dietary choices are a personal matter, but many American

consumers are motivated by a concern for the environment and would welcome sound advice from credentialed

nutrition professionals. More opportunities are needed for developing such interdisciplinary knowledge among

nutritionists.

KeyWords: agriculture, climate change, dietary choice, dietary guidance, environment (J Nutr Educ Behav.

2019; 51:3�15.)

Accepted July 13, 2018.

INTRODUCTION

It is the position of the Society for Nutri-tion Education and Behavior (SNEB)that environmental sustainabilityshould be inherent in dietary guidance,whether working with individuals orgroups about their dietary choices or insetting national dietary guidance.Improving the nutritional health of apopulation is a long-term goal thatrequires ensuring the long-termsustainability of the food system. Inearly 2015, the Dietary Guidelines

Advisory Committee1 (DGAC), acommittee of experts charged withdeveloping dietary guidance for theUS population, released their scien-tific advisory report to the Secretariesof Agriculture and Health andHuman Services. The DGAC devoteda section to the issue of food sustain-ability, defining a sustainable diet as“a pattern of eating that promoteshealth and well-being and providesfood security for the presentpopulation while sustaining humanand natural resources for future

generations.”1 Based on existing evi-dence, the DGAC asserted that adiet higher in plant-based foodsand lower in animal-based foods ishealthier and associated with a lowerenvironmental impact than the cur-rent U.S. diet, and that this could beachieved without excluding any foodgroups.1 However, the final DietaryGuidelines for Americans (DGA),2 pro-duced by the US Department of Agri-culture (USDA) and the Departmentof Health and Human Services, makeno mention of this issue. This raisesa series of questions the currentauthors attempt to address in thisarticle: Should we, as a society, careabout the environmental sustainabil-ity of the food system? Does what weeat have a significant impact on theenvironment? Is dietary guidancecompatible with efforts to promotesuch sustainability? Why was theDGAC discussion on sustainabilitynot included? In answering thesequestions, this article lays out thescientific rationale for the SNEB’sposition statement. After a briefdescription of current environmental

1School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA2Center for Sustainable Systems, School for Environment and Sustainability, University of

Michigan, Ann Arbor, MI3Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

Conflict of Interest Disclosure: The authors’ conflict of interest disclosures can be found online

with this article on www.jneb.org.

Address for correspondence: Donald Rose, PhD, School of Public Health and Tropical Medi-

cine, Tulane University, 1440 Canal St, Ste 2222, Mail Code 8319, New Orleans, LA 70112;

E-mail: diego@tulane.edu

� 2018 The Authors. Published by Elsevier Inc. on behalf of Society for Nutrition Education

and Behavior. This is an open access article under the CC BY license. (http://

creativecommons.org/licenses/by/4.0/)

https://doi.org/10.1016/j.jneb.2018.07.006

Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019 3

UNDER EMBARGO UNTIL JANUARY 8, 2019, 12:01 AM ET

problems, the article discusses thechallenges faced in meeting futurefood needs and the recent sciencebehind assessing the environmentalimpacts of foods and diets. A subse-quent section discusses sustainabilityand dietary guidance in this countryand others and some specific recom-mendations for dietary guidance andresearch. Throughout this article, theauthors focus on the environmentaldimension of sustainability ratherthan its health, social, or economicdimensions. It is vitally important toconsider these other dimensions ofsustainability but they are beyondthe scope of this article.

CURRENT

ENVIRONMENTAL

PROBLEMS

Global climate change is one of themost urgent problems that existstoday. In their latest report, the Inter-governmental Panel on ClimateChange,3 a United Nations scientificbody tasked with interpreting the lat-est information on climate change,indicated that despite a growingnumber of attempts to deal with thisproblem, the growth of greenhousegas emissions (GHGE) has acceleratedover the past decade. The report wasthe starkest warning to date, indicat-ing that shifts in food productionareas, more frequent and intenseheat waves and extreme precipitationevents, warming and acidifyingoceans with decreased fishery yields,and water scarcity all present risksto global food security and couldthreaten generations of gains infighting poverty and hunger if actionis not taken. The overwhelmingmajority of scientists agree regardingthe cause of climate change,3�6

although some scientists do not.7

Many of the previous predictions byclimate scientists have already beenborne out.3,6 The planet is warming:15 of the 16 warmest years on recordhave occurred during the 21st cen-tury.8 The arctic ice sheets are melt-ing, sea levels are rising, and thereare more extreme weather events.3

The urgency of the situation moti-vated the Paris Accords of 2015, ahistoric agreement between 195countries to limit GHGE.9

In addition to global climatechange, pressing environmentalproblems include loss of biodiversity,land degradation, fresh water short-ages, and water pollution. The impor-tance of biodiversity for thefunctioning of ecosystems andhuman well-being has been officiallyacknowledged since the creation ofthe Convention on Biological Diver-sity at the Earth Summit in Rio deJaneiro, Brazil, in 1992.10 Biodiver-sity, which reflects the number andvariety of living organisms, booststhe productivity, resilience, and sus-tainability of ecosystems, which inturn offers many benefits to humans,such as soil formation and retention,pollination of plants, regulation ofclimate, as well as provisioning ofresources for foods and pharmaceuti-cals.11 Unfortunately, despite conser-vation efforts by some of thesignatories to this multilateral treaty,biodiversity loss at a global scale iscontinuing and even accelerating insome cases.12,13 This biodiversity lossis likely to be human-induced and isresulting in a mass extinction, thefirst since the Cretaceous, when thedinosaurs became extinct.13 Someauthors14,15 demonstrated that theimpacts of biodiversity loss on eco-system functioning may rival theimpacts of other drivers of change,such as global climate change.

Reduction in the productivecapacity of land, or land degradation,owing to loss of soil quality, biodiver-sity loss, salinization, or water deple-tion, is another serious problem. TheUnited Nations Food and AgricultureOrganization conducted a globalassessment of the state of the planet’sland resources and found that about33% of all land is moderately orhighly degraded.16 Main contributorsto this degradation are crop and soilmanagement techniques, deforesta-tion, and overexploitation (eg, over-grazing).

Changes in water resources arealso a concern in terms of both quan-tity and quality. A global analysis ofthe freshwater systems that providewater for humans and are importantfor ecosystem functioning (asassessed by biodiversity) found that80% of the world’s population liveswhere water security for humans orfor ecosystem functioning is highly

threatened.17 Water quality isaffected by runoff of fertilizer andmanure from agricultural soils andnutrient- and toxic chemi-cal�containing effluents from indus-try. Over-enrichment of water by thenutrients nitrogen and phosphoruscan result in algal blooms, depletionof oxygen, and destruction of aquaticlife. Referred to as eutrophication,over three quarters of the assessed UScontinental coastal area, and manyinland water bodies as well, areexperiencing moderate to high levelsof this problem.18,19

A serious concern is that agricul-ture, including livestock production,is one of the largest contributors toenvironmental damage, includingextensive clearing of forests, overuseof freshwater resources, widespreadwater pollution, and global climatechange.20 Only 62% of the world’scrop production is destined directlyfor human consumption; most of therest is used for animal feed.20 TheUnited Nations Food and AgricultureOrganization estimates that GHGEassociated with the production ofmeat and dairy products aloneaccount for 14.5% of all GHGE glob-ally,21 although in the US, livestockproduction accounts for 5.6% ofGHGE owing to the greater impact ofthe transportation and energy sec-tors.22,23 Overall, agriculture isresponsible for 70% to 80% of allhuman water withdrawals globally24

and occupies about 38% of theearth’s ice-free land.20 Environmen-tal degradation can further diminishagriculture’s productivity: it is pre-dicted that up to 25% of world foodproduction may be lost during the21st century as a result of climatechange, land degradation, water scar-city, and other causes.25 A globalmodeling study26 also showed thepotential impacts of climate changeon reduced food production andrelated deleterious impacts onhuman health.

MEETING OUR FUTURE

FOODNEEDS

Currently an estimated 795 millionpeople in the world lack adequateenergy from food27 and over 2 billionpeople experience micronutrient

4 Rose et al Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019

malnutrition.28 At the same time,nearly 2 billion people in the worldare overweight or obese.29 The highprevalence of overnutrition is a rela-tively recent global phenomenonwhich has resulted in part fromincreasing household incomes andwesternization of the diet in middle-and even low-income countries.30�32

These problems are compounded byestimates that the world’s populationwill grow by an additional 2.2 billion,totaling 9.7 billion, by 2050.33 Alongwith these trends, the demand forfood is estimated to double by mid-century.20 This raises 2 interrelatedchallenges for the food, nutrition,and agricultural communities: (1)How do we meet the food and nutri-tional needs for this increased popu-lation, in addition to those whoseneeds are currently not met? (2) Howdo we accomplish this while alsoaddressing these major environmen-tal problems, which threaten todecrease the earth’s carrying capac-ity?

A number of strategies have beensuggested to meet these 2 long-termfood challenges.20,32 Two such strate-gies that come up repeatedly arechanges in consumer demand, andsustainable intensification, or achiev-ing more food production from exist-ing farmland with far lessenvironmental pressure.34 Intensifi-cation in the US dairy industry, forexample, has come with less GHGEper unit of production. In 2007, thecarbon footprint per billion kilo-grams of milk produced was only37% of what it was in 1944.35

Another study found a reduction inthe resource use and the carbon foot-print of US beef production since thelate 1970s.36

Nevertheless, repeated projectionstudies demonstrated that closingglobal yield gaps and other sustain-able intensification measures will beinsufficient to prevent further agri-cultural expansion and achieve thedeep emission cuts needed to meetthe Paris climate commitment;demand-side reductions will be nec-essary.37�39 Such demand-side reduc-tion strategies typically take the formof reducing, although not necessarilyeliminating, the amount of animalproducts in the diet, particularly inhigh-income countries.20,32,40�42

The next 2 sections review the scien-tific basis for this strategy.

LIFE-CYCLE ASSESSMENT

AND THE

ENVIRONMENTAL IMPACT

OF FOODS

Nutritionists may recognize the termlife cycle in the context of studyingnutritional needs and how theychange during the course of humanlife. Other scientists, such as industrialecologists or environmental engineers,also use the term life cycle but in refer-ence to products rather than humans.Life-cycle assessment (LCA) was devel-oped as an analytical framework toassess the potential environmentalimpacts of industrial production sys-tems across each stage of a product’slife cycle, from resource extraction(cradle), manufacturing, and distribu-tion to use and end-of-life disposal(grave).43 An LCA offers a means ofconsidering, for example, how theenergy and emissions associated withbuilding a car compare with thosefrom operating a car over its lifetimeand disposing of it at end of life. Thisallows abatement strategies to focuson where they will have the greatestconsequence. An LCA can also ensurethat efforts to reduce environmentalimpacts at 1 stage (say, manufactur-ing) do not simply shift impacts to adifferent stage (say, disposal).

Ideally, LCA includes a broadrange of environmental impact cate-gories (eg, GHGE, nonrenewableenergy use, eutrophication, acidifica-tion, ozone depletion, water use,land use) so that trade-offs betweenimpact categories can be evaluatedand potential shifts from 1 impactcategory to another can be detectedwhen comparing scenarios.43 How-ever, data availability, the scope of agiven study, and the uncertaintyintroduced with some impact assess-ment methods often limit the impactcategories that are practical or desir-able.43 Carbon footprinting typicallyrefers to a unique LCA approach thatfocuses only on GHGE over aproduct’s life cycle.43

Over the past 2 decades, the LCAframework has been applied to foodand agricultural systems, addressingmany of the unique challenges that

arise when considering these com-plex systems.44,45 Early food LCAsfocused on questions related to pack-aging: for example, comparing sin-gle-use milk cartons with disposableand refillable bottles. In the early1990s, LCAs began to emerge thatincorporated food production.44

Since then, hundreds of studies havebeen conducted on individual foods,some focused on agricultural produc-tion and others covering processing,distribution, consumption, and dis-posal aspects.46�49 The field contin-ues to grow and develop and ishosting its 11th international confer-ence on the topic of LCA of food.50

In general, results from food LCAstudies show that environmentalimpacts from food production arehigher for animal products andhigher still for ruminant animals. Forexample, the Figure displays theGHGE from the production of differ-ent foods in terms of their globalwarming potential, or carbon diox-ide-equivalents (CO2eq), from areview of studies throughout theworld. This unit of measure is used toplace carbon dioxide, methane,nitrous oxide, and other gases on thesame scale based on their relativecontributions to global climatechange. For vegetables and fruits, val-ues are typically <1 kg CO2eq/kg ofcommodity. At the other end of thespectrum, beef has a value >30. Beefand products from other ruminantanimals have such high values inlarge part because of methane gasreleased during enteric fermentation(part of ruminant digestion) andmanure management, but alsobecause of the energy used in grow-ing feed grains and nitrous oxidereleased from soils receiving nitrogenfertilizers.51 Methane and nitrousoxide have 28 and 265 times theglobal warming potential of carbondioxide, respectively, which makesrelatively small emission quantitiesof these gases impactful.52

There are important caveats tokeep in mind regarding the Figure.First, animal-based protein foods areparticularly important in undernour-ished populations.40 Second, use oforganic wastes by animals on thefarm or from the food processingindustry reduces the impact of live-stock production.53 Third, manure

Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019 Rose et al 5

digesters on livestock farms can turnthe propensity of manure to generatemethane into a resource; such biogasrecovery projects are developingthroughout the US.54 Fourth,although the data in this figure arebased on averages from a wide rangeof studies, there is sizable local varia-tion in impacts of specific foodsowing to differences in productiontechniques, soil conditions, seasonal-ity, and other factors. Fifth, weight isa convenient, but imperfect basis forcomparison of different foods. Otherbases, such as caloric or nutrient con-tent, can also be used, depending onthe purpose. Finally, the Figure doesnot consider other environmentalimpacts such as water use, whichmight show a different ranking ofimpacts across food types.

ENVIRONMENTAL IMPACT

OF TOTAL DIETS

A number of authors combinedresults from individual LCA studiesto develop databases of environmen-tal impacts. Much of this work wasmotivated by the goal of evaluatingcomplete diets. For example, a data-base of the GHGE from food wasdeveloped for use in the United King-dom.55 The environmental impacts

of diets were also studied in France,56

Germany,57 and the Nordic coun-tries.58 In the US, several teams com-piled food LCA studies to evaluatecomplete diets.59�61

Impacts Throughout the Food

System

As mentioned, LCA studies on foodcan include the production, process-ing, distribution, consumption, anddisposal phases of a food product.Some studies of complete diets com-pared the relative environmentalimpacts of these different phases orspecific processes within a phase,which are discussed subsequently.

Production-level impacts. An impor-tant issue at the production level isthe relative environmental impactsfrom differing methods of produc-tion. A comparison of organic vs con-ventional production exemplifiesthis. Recent reviews of the literaturedrawing from international produc-tion contexts indicated that theresults are mixed, varying by the spe-cific impact under consider-ation.58,62,63 For example, organicagriculture has clear benefits regard-ing local biodiversity, soil quality,and reduced ecotoxicity (the toxiceffects of pollutants on biological

organisms) from pesticide use.58,62,63

However, because yields are oftenhigher with conventional agricul-ture,58,62 the amount of land used istypically lower for conventional thanfor organic agriculture.58 As forglobal climate change, the results aremixed based on the crop. A recentreview found that for the grains stud-ied, organic agriculture had a lesserimpact on global climate changethan did conventional agriculturebut the reverse was true for poultry,eggs, beef, and some produce itemssuch as carrots and tomatoes.58 Spe-cific differences between organic andconventional agriculture depend notjust on the crop under investigationbut also on the details of the produc-tion systems being compared.62,63

Agricultural systems are complex, asare their environmental impacts, soincreasing organic agriculture maybenefit local biodiversity, soil qual-ity, and ecotoxicity levels, but thiswould not always translate intoreduced impacts on global climatechange or land use.58,62,63

Transportation and diet compositionimpacts. Several authors consideredthe relative environmental impactsresulting from the transportation offood vs the choice of specific foodsthat compose an entire diet.58,64,65 In

Figure. Greenhouse gas emissions for the production of selected foods (kilograms of CO2-eq per kilogram of edibleportion of commodity). CO2-eq indicates carbon dioxide equivalents, which puts methane, nitrous oxide, and carbondioxide, all global warming gases, on the same scale. Edible portion refers to the part of the commodity that can

be eaten: in other words, without the bone on the beef, without the shell on the peanut, without the core or stem on theapple, etc. Data are from Heller et al.60

6 Rose et al Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019

comparing the current average Dan-ish diet and a new Nordic diet thatwas developed to be healthy andenvironmentally sustainable,66

researchers found that the greatestoverall benefit of the new Nordic dietcame from the differences in dietcomposition (ie, less meat and moreplant foods), whereas transportation(ie, reduced long-distance transportof imported commodities) reducedimpact to a lesser degree.58 Modifica-tions of the average diet in theUnited Kingdom showed that reduc-ing meat consumption, particularlyof ruminant animals, had a muchgreater impact on lowering GHGEthan did reducing the imports of pro-duce from air shipping.64 In a USstudy of the transportation of food,the production phase was muchmore important; it contributed 83%of the food carbon footprint, whereastransportation represented only11%.65 Given their results, theauthors suggested that a dietary shiftaway from red meat and dairy, even amodest one, could accomplish agreater reduction in GHGE than buy-ing all foods locally.65

Other studies focused solely onfood choices. In the US, anothermodeling study found that replacingbeef with plant-based alternativescould have substantial positiveimpacts on the environment, includ-ing a significant reduction in GHGEand land use, while offering animproved intake of many importantnutrients.67 Among Seventh DayAdventists in California, estimates ofthe resources (including energy, pes-ticides, and land) needed to producefood for the diets of nonvegetarianswere greater than for vegetarians; thedifferences resulted primarily fromthe inclusion of beef.68 Similarly, thediets of vegans and vegetarians wereassociated with lower GHGE com-pared with fish eaters and meat eatersin the United Kingdom.69

Studies that consider both dietcomposition and transportationeffects showed that diet compositionhas a much greater influence on envi-ronmental impacts.58,64,65 Thesestudies, as well as those that focussolely on diet composition, were typ-ically modeling studies based onassumptions and data inputs from aparticular country. However, they

consistently showed that diets withfewer animal products, particularlyruminants, have a lower environ-mental impact.58,64,65,67�69

Food loss impacts. Another majorcontributor to negative environmen-tal impacts is food loss, the edibleamount of harvested food that is notconsumed. In the US, this is largelymade up of food waste, food that isproduced but not eaten because ofhuman behaviors (such as plate wasteby consumers or discards by consum-ers or retailers because of appearanceor expired sell-by dates), as opposedto losses owing to spoilage frommold or pests.59 Food loss is abig problem in the US and aroundthe world because of its sheer magni-tude and overall environmentalimpact.70,71 Not only does lostfood have all of the environmentalimpacts of food that is consumed, ithas additional impacts from the dis-posal process with none of the bene-fit for human nutrition.59 Food lossesappear to be an increasing problemin the US. One study analyzed thedifference between the energy valueof the US food supply and the pre-dicted energy intake of the popula-tion based on sophisticatedmetabolic equations relating intaketo body weight.72 It found a 50%increase in food losses in the 3 deca-des beginning in 1974, reachingmore than 1400 kcal/person per dayby 2003. The impact of such losses issubstantial. Another study foundthat food losses contributed about28% of the carbon footprint of theaverage US diet.59

Impacts of Diets That Meet

Government Recommendations

Another important line of researchinvestigated the potential impact onthe environment of diets that follownational dietary recommendations.In the Netherlands, the official rec-ommended diet was compared withthe current Dutch diet, using a sus-tainability score based on GHGE andland use.73 The recommended dietscored significantly better on sustain-ability, as did a number of other dietpatterns examined, including Medi-terranean, vegetarian, and vegandiets. Another study analyzed the

GHGE from the average diet in theUnited Kingdom and then used lin-ear programming optimization tech-niques to develop a diet that wouldmeet that country’s nutritional rec-ommendations while minimizingGHGE.74 The researchers found thatsuch a diet could result in a 36%decrease in emissions from the base-line diet.

A number of studies were con-ducted in other countries thateither compared average diets witha recommended diet or developed anew diet through optimizationtechniques to lower GHGE whilemeeting dietary recommendations.In France, Spain, Sweden, Germany,Denmark, and New Zealand, thosestudies all showed that diets thatmet recommendations could lowerGHGE.57,75�77 A study of all coun-tries in the European Union foundthat shifting current consumptionto diets that meet generallyaccepted dietary recommendationsand have reduced meat consump-tion could lead to an 8% reductionin the environmental impacts offood.78

In the US, 4 studies examined theimpacts of diets that meet the 2010DGA. If the USDA food plan were tobe consumed at recommendedenergy intakes, 1 study estimatedthat there would be a reduction inGHGE of about 1%.59 Adoption ofthe DGA’s vegetarian plan wouldresult in a further reduction in GHGEof 33%, or 53% for the vegan plan.59

Other analysts repeated this exercisefor the US but took a differentapproach to estimating current percapita caloric intake and concludedthat a shift to a recommended foodmixture and caloric intake wouldincrease GHGE by 6% and increasethe energy and water used by thefood system by 38% and 10%, respec-tively.61 Unlike the first study men-tioned previously, this second studydid not estimate impacts from a shiftto the vegetarian or vegan food pat-terns listed in the 2010 DGA. A thirdstudy79 examined the number of per-sons who could be fed per unit of USagricultural land (called the carryingcapacity) and found that a diet shifttoward plant-based diets had the sig-nificant potential to increase this car-rying capacity, with a lactovegetarian

Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019 Rose et al 7

diet scoring the highest. The studyemphasized that an optimal carryingcapacity includes some livestock thatcan take advantage of western range-lands and other marginal lands, butthis optimum would require signifi-cant decreases in animal-based foodsfrom the current US diet. A fourthstudy80 examined a number of envi-ronmental impacts, including cli-mate change, and land, water, andenergy use, of the DGA’s recom-mended food pattern and its vegetar-ian and vegan adaptations. Overall,the vegan diet had the lowestimpacts, and the authors concludedthat the environmental impact of adiet is mainly related to the con-sumption of animal products.

These studies, as well as othersthat analyzed different dietary sce-narios, highlight the importance thatchanges in diet composition couldhave in reducing environmentalimpacts. A systematic review of 14recent peer-reviewed diet scenariostudies conducted mostly in Euro-pean countries concluded thatchanging current diets could have asignificant impact on the environ-ment, potentially reducing GHGEand land use from diet by up to50%.81 The largest potential changeswere seen in diets that reduced theamount of meat.

PREVIOUS

INCORPORATIONOF

SUSTAINABILITY IN

DIETARY GUIDELINES

Given the research showing thatdiets that follow national dietaryguidelines for a healthy diet couldlower environmental impacts,57,75�77

it is unsurprising that a number ofdietary guidelines panels throughoutthe world have considered the sus-tainability of the food system whenproducing recommendations.82 Thishas been the case in Australia, Brazil,Denmark, Estonia, Finland, Ger-many, the Netherlands, Qatar, Swe-den, the United Kingdom, andUruguay (Table).58,82�96 The infor-mation considered and the recom-mendations made regardingsustainability vary among thesecountries. Some have suggested thatconsumers eat more food in season,

eat fish from sustainable sources, eatmore plant foods, reduce food waste,or consume only enough food tomaintain energy balance. A numberof countries have recommended con-suming less meat or eating less ani-mal food.

Nutritionists in the US have alsohad a long history of supporting suchan approach. Over 30 years ago, JoanGussow and Kate Clancy,97 membersof the Society for Nutrition Educa-tion, argued for inclusion of sustain-ability considerations in formulatingand educating consumers about die-tary guidelines. Among other things,they were concerned about the limitsof natural resources and the long-term stability of the food system.Ultimately, nutrition is not justabout the nutritional health of con-sumers, they argued, it is also aboutthe food system; we cannot have onewithout the other. Over a decadelater, Gussow98 reinforced her earlierstatements on sustainability andexpanded them to include an empha-sis on locally produced food and fairemployment for workers in the foodsystem. In 2007, the American Die-tetic Association (now Academy ofNutrition and Dietetics) took a posi-tion, encouraging “environmentallyresponsible practices that conservenatural resources, minimize thequantity of waste generated, and sup-port the ecological sustainability ofthe food system.”99

Given the mounting research onenvironmental damage and the linksbetween diet and impacts on theenvironment, as well as the acceptedpractice around the world of consid-ering sustainability in providing die-tary guidance, the DGAC1 includedsustainability in their recommenda-tions for the US population in theirscientific report published in Janu-ary, 2015. Discussing the latestresearch on this in a chapter on foodsustainability and food safety, theystated:

consistent evidence indicates that,in general, a dietary pattern thatis higher in plant-based foods,such as vegetables, fruits, wholegrains, legumes, nuts, and seeds,and lower in animal basedfoods is more health promotingand is associated with lesser

environmental impact ([green-house gas] emissions and energy,land, and water use) than is thecurrent average U.S. diet.1

This is a straightforward, evenmodest reading of the overwhelmingbody of scientific evidence on boththe relationships between diet andhealth and those between diet andthe environment, which has nowbeen reinforced with an updated sys-tematic review by these experts.100

To allay concerns that the DGAC wasrecommending exclusion of any par-ticular food or food group, they wenton to say, “a diet that is moreenvironmentally sustainable thanthe average U.S. diet can be achievedwithout excluding any foodgroups.”1

AQUESTION OF SCOPE

The Secretaries of the USDA andDepartment of Health and HumanServices decided that sustainabilityconsiderations would not beincluded in the DGA because of amatter of scope.101 For the scope oftheir mandate, they cited the 1990National Nutrition Monitoring andRelated Research Act as the provisionof “nutritional and dietary informa-tion and guidelines . . . based on thepreponderance of the scientific andmedical knowledge.”102

However, the DGAC report didprovide dietary guidance based onthe preponderance of scientific andmedical knowledge. Moreover, theoriginal authorizing legislation indi-cated that there was nothing out ofscope about including sustainabilityin the DGA.102

The National Nutrition Monitor-ing and Related Research Act has 3titles: Title 1, Nutrition Monitoringand Related Research; Title 2,National Nutrition Monitoring Advi-sory Council; and Title 3, DietaryGuidance.102 Title 3, in a page and ahalf, calls for publication of the DGAevery 5 years and is brief on the con-tent of this report, stating simplythat it should contain “nutritionaland dietary information and guide-lines for the general public.” Most ofthe rest of this Title is concernedwith the federal government being

8 Rose et al Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019

Table. Dietary Guidance Recommendations Addressing Sustainability in Various Countries

Recommendation Australia83 Brazil84 Denmark58,85 Estonia82,86 Finland87,88 Germany89,90TheNetherlands91 Qatar92 Sweden93

UnitedKingdom94,95 Uruguay96

Eat moresustainable food

X X X X

Consume minimallyprocessed/nutrient-dense foods

X X X

Eat more plant foods X X X X X X X X X

Eat fewer animalfoods

X X

Eat less meat X X X X X

Meal plan/store foodfor later use

X X

Consume only

enough caloriesfor energy balance

X X

Eat seasonally X X X X

Focus on local foodconsumption

X X X

Eat fish fromsustainable

sources

X X X

Reduce food waste X X X X X X X

Eat a diverse diet X X X

Choose foods withminimal orno packaging

X X

JournalofNutritio

nEducatio

nandBehavior

�Volume51,Number

1,2019

Roseetal

9

consistent across agencies on theguidance that is distributed.

A review of the rest of the Act, tounderstand the context for Con-gress’s approach to this topic, makesclear that the DGAC’s inclusion ofsustainability is within the scope ofthe authorizing legislation. Theintroductory definitions sectionmakes it clear that nutrition monitor-ing and related research includes foodsupply and demand determinations.Title 2 on the Advisory Council, thepresidentially established body thatassisted in carrying out this Act,includes fields of expertise as selec-tion criteria for Council members.One of the 3 sets of fields listed isfood production and distribution,which includes a number of topicssuch as agriculture, and food-systemmanagement. Taken together, thismakes it seem clear that congressio-nal intent was to take a broad view ofnutrition monitoring and dietaryguidance that included food supplyissues.

The 2015 DGAC were also consis-tent with previous developments ofthe DGA. The 2010 DGA had a Callto Action to ensure, among otherthings, that all Americans had accessto nutritious foods and promoted amultipronged strategy that includeda recommendation to

develop and expand safe, effective,and sustainable agriculture andaquaculture practices to ensureavailability of recommendedamounts of healthy foods to allsegments of the population.103

Ensuring access to healthy foodincludes consideration of food safety,a topic that has been discussed inDGA reports for over adecade.2,103,104

RECOMMENDATIONS FOR

POLICY, PRACTICE, AND

RESEARCH

Based on this evidence presented, thecurrent authors make recommenda-tions on dietary guidance policy,nutrition education practice, andresearch.

Dietary Guidance Policy

Improving the nutritional health of apopulation is a long-term goal thatrequires ensuring the long-termhealth of the food system as well.Given the serious concerns about thenatural environment, the ability tosustain expected increases in popula-tion with current dietary patterns,and the compelling nature of the sci-ence that link these issues, SNEB rec-ommends that environmentalsustainability considerations beincluded in future federal dietaryguidance.

This position paper supports theoriginal statement of the US DGACthat a diet with more plant-basedfoods than the average American dietwould represent an improvement inboth the environment and the healthof the American consumer.1

Although there is little doubt aboutthe veracity of this statement,100 it isgeneral in nature. Future guidelinesshould not only consider environ-mental sustainability but providemore specific advice, such as substi-tution away from ruminant animalfoods and toward other proteinfoods. This is partly so that consum-ers will have an easier time identify-ing specific actions they can take toimprove their own health and reducethe impact on the environment.Although it is known that the bio-availability of some nutrients (eg,iron or zinc) from plant foods islower than from animal foods,105

there are healthy vegetarian andvegan diets, which were reported inthe 2015�2020 US DGA, along witha Mediterranean eating pattern. Thebenefits to the environment of suchdiets should be made explicit. Theguidelines should also discuss reduc-ing food waste as a benefit to envi-ronmental sustainability.

Nutrition Education Practice

Dietary choices are a personal matterand there are many different dietarypatterns that can lead to health. Indiscussing dietary recommendations,nutritionists can discuss both thehealth and the environmentalimpacts of food choices. For example,reducing animal foods, particularly

ruminant animal consumption inthe US, can have beneficial healthand environmental effects, as canreducing overconsumption of foodenergy.67,81,106�111 Seafood from sus-tainable aquaculture112 can also pro-vide a rich source of nutrients andreduce the impact on the environ-ment, although feed sources foraquaculture production remain animportant concern.113

Indeed, some individuals mightfind concerns about environmentalimpact more motivating than con-cerns about health when consideringwhether to make a dietary change.Based on the nationally representa-tive American Climate Values Surveyof 2014, >75% of Americans viewclean air and water and unpolluted,toxin-free neighborhoods as rightsthat should be available to all peo-ple.114 The survey revealed that>70% of Americans are somewhat orvery convinced that climate changeis happening, and 25% claimed to betaking steps in their lives to keep cli-mate change from getting worse. Anadditional 24% of the populationworries about climate change but isunsure what to do about it. In otherwords, about half of Americansmight be disposed to dietary advicethat includes some mention of howfood choice could affect the environ-ment.

Such advice does not need to rec-ommend absolutes. As the DGACpointed out, a more environmentallysustainable diet can be achievedwithout excluding any food groups.1

Efforts to cut back on animal foods,such as Meatless Monday or the Pro-tein Flip can reduce environmentalimpacts, improve health outcomes,and provide incremental solutionsfor consumers who desirethem.115,116 The Dutch have studiedthe frequency of meat consumptionamong individuals, even developinga lexicon around flexitarianism, aterm for part-time meat eaters.117

Other suggestions, such as purchas-ing more organic products, can alsohave beneficial effects, although cur-rent research indicates that the bene-fits will not be as great as reducingconsumption of animal foods.Reducing excess energy consumptionand reducing food waste are also

10 Rose et al Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019

important suggestions that will havesignificant impacts on theenvironment.59,109�111

Expanding the knowledge ofnutritionists in sustainability andenvironmental studies is needed tofacilitate the types of dietary advicerecommended earlier. Academicinstitutions can have a role in this byincreasing such interdisciplinarytopics in the training of future dieti-tians and nutritionists. Continuingeducation opportunities are alsoneeded for current professionals.Such developments would benefitfrom collaboration with SNEB’s Sus-tainable Food Systems Division.

Research

Additional research on dietary pat-terns would assist in providing moreconcrete details for consumers aboutthe specifics of a diet that is lessimpactful to the environment. Cur-rently, the DGA publishes sugges-tions regarding several healthfuleating patterns: a healthy US-styleeating pattern, a healthy Mediterra-nean-style eating pattern, and ahealthy vegetarian eating pattern.2 Itwould be desirable for future US die-tary guidelines to include informa-tion about the environmentalimpacts of these patterns, as well asone that takes into account currentconsumption patterns in the US thatare considered more sustainable.Although much is known about whatmakes up a sustainable diet in theaggregate,118 there have been rela-tively few studies on the diets of indi-viduals who consume a moresustainable pattern, particularly inthe US.119 This type of research couldinform an environmental rating sys-tem of different diets, which wouldbe useful to the large percentage ofconsumers concerned about thistopic.

There are also significant gaps inthe food LCA literature. In a recentreview of 321 studies,60 there wereno publically available studies oncommonly eaten foods such as cornsyrup, safflower and sesame oils, kid-ney or pinto beans, and most com-mon herbs and spices. Moreover,only 12% of the entries in that reviewwere conducted in North America.Although we know from other

literature that GHGE associated withtransportation and differences inproduction practices are dwarfed bythe influence of diet composition, itwould be helpful to have more pre-cise figures on US production practi-ces of commonly eaten foods. Inaddition, the vast majority of LCAstudies focused on minimally proc-essed food commodities; furtherdevelopment of widely consumedprocessed foods and likely substitu-tions such as plant-based meat alter-natives will further improve diet-level estimates.

That review also pointed toanother gap in the LCA literature:More information is needed on envi-ronmental impacts beyond GHGE.60

Many environmental concernsbeyond GHGE, including biodiver-sity, water and land use, water qual-ity, and air pollution, are far moreregionally dependent, and US-basedassessments are necessary to providemeaningful estimates of the influ-ence of diet composition.

Finally, even the most compre-hensive, evidence-based dietaryguidelines will have only limitedinfluence on consumers if they arenot motivated to make changes andif these are not supported by otherdissemination and behavior changeefforts. Studies are needed to deter-mine what motivates specific person-ality types to change their behaviorsand whether strategies such as pricechanges, food labeling, messagingcampaigns, etc, can promote bothhealthy and environmentally sus-tainable food choices.

SUMMARYAND

CONCLUSION

People want to know what to eattoday, so it is incumbent on those ofus who are knowledgeable aboutnutritional science and educationtechniques to provide the best advicebased on the available evidence todate. Clearly this advice mightchange as nuances in the science arediscovered and resolved. To thecredit of those who formulated theinitial legislation authorizing theDGA, they required publication of areport at least every 5 years for pre-cisely this reason.

The best science we have todaymakes it clear that current environ-mental problems, including globalclimate change,3,7 biodiversityloss,10�15 land degradation,16 watershortages,17 and water pollution18,19

demand urgent attention, threatenlong-term food security, and are inpart caused by current food choicesand agriculturalpractices.20,21,24�26,32,34,37�42

Addressing these problems while pro-ducing more food for the growingpopulation will require changes tothe food systems.20,21,24�26,32,34,37�42

Dietary choices have a significantrole in contributing to environmen-tal impacts. These impacts could belessened by choosing fewer overcon-sumed animal products, particularlyfood from ruminant animals, includ-ing more plant-based foods, andreducing excess calorie consumptionand wasted food.20,32,37�42

Taken together, the science onenvironmental impacts of foodchoices and diet has several implica-tions for policy, practice, and futureresearch. First, federal dietary guide-lines should include environmentalsustainability considerations. Second,nutrition advisors and educators canconvey both the health and environ-mental benefits of dietary choices.Finally, more research is needed onchanging consumer behavior regard-ing sustainable diets and on varioustopics related to the LCA of foods,including studies on a wider variety offoods with a greater number of envi-ronmental impacts and on more foodsproduced in the US.

ACKNOWLEDGMENTS

This work was supported by the Well-come Trust (Grant No. 106854/Z/15/Z). The authors also acknowledge theexcellent research assistance of Brit-tany Kovacs, especially for her tremen-dous help with the references andwith the Table. Amelia Willits-Smithhelped with the Figure and Kelly Bondhelped with the initial work on theTable. Thank you to the following forreviewing this paper: Marilyn Briggs,PhD, RD, SNS; Ardyth H. Gillespie,PhD; Lora Suzanne Goodell, PhD, RD;Mary A. Harris, PhD, RD; Laura H.McArthur, PhD; and Rickelle Richards,PhD, MPH, RDN.

Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019 Rose et al 11

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Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019 Rose et al 15

CONFLICTS OF INTEREST

All authors have received researchfunding from the Wellcome Trust’sOur Planet, Our Health program. M.C. Heller has been a consultant tothe United Nations Environment

Programme and the Oregon Depart-ment of Environmental Quality;and has received honoraria fromthe Culinary Institute of America/Harvard School of Public Health,the California Dairy Research

Foundation, the Dairy Farmers ofCanada, the Almond Board of Cali-fornia, and the Global Dairy Plat-form. The rest of the authorsdeclare that they have no relevantconflicts of interest.

15.e1 Rose et al Journal of Nutrition Education and Behavior � Volume 51, Number 1, 2019