Development and validation of a multicriteria measure to assess the sustainability characteristics of diets: the Diet Sustainability Score (original) (raw)
Willett W, Rockström J, Loken B, Springmann M, Lang T, Vermeulen S et al (2019) Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems. Lancet 393(10170):447–492 ArticlePubMed Google Scholar
WHO, FAO (2019) Sustainable healthy diets: guiding principles. World Health Organization, Geneva, Switzerland Google Scholar
Aleksandrowicz L, Green R, Joy EJ, Smith P, Haines A (2016) The impacts of dietary change on greenhouse gas emissions, land use, water use, and health: a systematic review. PLoS ONE 11(11):e0165797 ArticlePubMedPubMed Central Google Scholar
Godfray HC, Beddington JR, Crute IR, Haddad L, Lawrence D, Muir JF et al (2010) Food security: the challenge of feeding 9 billion people. Science 327(5967):812–818 ArticleCASPubMed Google Scholar
Brouwer ID, McDermott J, Ruben R (2020) Food systems everywhere: improving relevance in practice. Glob Food Secur 26:100398 Article Google Scholar
van Dijk M, Morley T, Rau ML, Saghai Y (2021) A meta-analysis of projected global food demand and population at risk of hunger for the period 2010–2050. Nat Food 2(7):494–501 ArticlePubMed Google Scholar
FAO (2010) Sustainable diets and biodiversity: directions and solutions for policy, research and action. Rome, Italy: FAO Nutrition and Consumer Protection Division
Gussow JD, Clancy KL (1986) Dietary guidelines for sustainability. J Nutr Educ 18(1):1–5 Article Google Scholar
Lang T (2021) The sustainable diet question: reasserting societal dynamics into the debate about a good diet. Int J Sociol Agric Food 27(1):12–34 Google Scholar
Rei M, Costa A, Sosa S, da Costa S, Torres D, Sage C et al (2024) Multicriteria measures to assess the sustainability of diets: a systematic review. Nutr Rev 83(3):e980–e990 Article Google Scholar
Seconda L, Baudry J, Pointereau P, Lacour C, Langevin B, Hercberg S et al (2019) Development and validation of an individual sustainable diet index in the NutriNet-Santé study cohort. Br J Nutr 121(10):1166–1177 ArticleCASPubMed Google Scholar
Fresán U, Martínez-González MA, Sabaté J, Bes-Rastrollo M (2019) Global sustainability (health, environment and monetary costs) of three dietary patterns: results from a Spanish cohort (the SUN project). BMJ Open 9(2):e021541 ArticlePubMedPubMed Central Google Scholar
Fresán U, Martínez-González MA, Segovia-Siapco G, Sabaté J, Bes-Rastrollo M (2020) A three-dimensional dietary index (nutritional quality, environment and price) and reduced mortality: The “Seguimiento Universidad de Navarra” cohort. Prev Med 137:106124 ArticlePubMed Google Scholar
UN (2015) Transforming our world: the 2030 Agenda for Sustainable Development: United Nations [Available from: https://sdgs.un.org/2030agenda
Grosso G, Mateo A, Rangelov N, Buzeti T, Birt C (2020) Nutrition in the context of the sustainable development goals. Eur J Public Health 30(Suppl_1):i19–i23 ArticlePubMedPubMed Central Google Scholar
Lopes C, Torres D, Oliveira A, Severo M, Guiomar S, Alarcão V et al (2018) National food, nutrition, and physical activity survey of the Portuguese general population (2015–2016): protocol for design and development. JMIR Res Protoc 7(2):e42 ArticlePubMedPubMed Central Google Scholar
Lopes C, Torres D, Oliveira A, Severo M, Guiomar S, Alarcão V et al (2017) National food, nutrition and physical activity survey of the Portuguese general population. EFSA Support Publ 14(12):1341E Google Scholar
Sjostrom M, Ainsworth BE, Bauman A, Bull FC, Hamilton-Craig CR, Sallis JF, editors (2005) Guidelines for data processing analysis of the International Physical Activity Questionnaire (IPAQ) - Short and long forms
Goios AC, Severo M, Lloyd AJ, Magalhães VP, Lopes C, Torres DP (2020) Validation of a new software eAT24 used to assess dietary intake in the adult Portuguese population. Public Health Nutr 23(17):3093–3103 ArticlePubMedPubMed Central Google Scholar
Moshfegh AJ, Rhodes DG, Baer DJ, Murayi T, Clemens JC, Rumpler WV et al (2008) The US Department of Agriculture automated multiple-pass method reduces bias in the collection of energy intakes. Am J Clin Nutr 88(2):324–332 ArticleCASPubMed Google Scholar
EFSA (2011) The food classification and description system FoodEx 2 (draft-revision 1). EFSA Supporting Publications 8(12):215E
EFSA (2015) The food classification and description system FoodEx 2 (revision 2). EFSA Supporting Publications 12(5):804E
EFSA (2014) Guidance on the EU Menu methodology. EFSA Journal 12(12):3944
Van Kernebeek HRJ, Oosting SJ, Feskens EJM, Gerber PJ, De Boer IJM (2014) The effect of nutritional quality on comparing environmental impacts of human diets. J Clean Prod 73:88–99 Article Google Scholar
Fulgoni VL 3rd, Keast DR, Drewnowski A (2009) Development and validation of the nutrient-rich foods index: a tool to measure nutritional quality of foods. J Nutr 139(8):1549–1554 ArticlePubMed Google Scholar
WHO (2015) Guideline: Sugars intake for adults and children. Switzerland, Geneva Google Scholar
WHO (2023) Saturated fatty acid and trans-fatty acid intake for adults and children: WHO guideline
Monteiro CA, Cannon G, Levy RB, Moubarac JC, Louzada ML, Rauber F et al (2019) Ultra-processed foods: what they are and how to identify them. Public Health Nutr 22(5):936–941 ArticlePubMedPubMed Central Google Scholar
Mertens E, Kaptijn G, Kuijsten A, van Zanten H, Geleijnse JM, van ’t Veer P (2019) Sharp-indicators database towards a public database for environmental sustainability. Data Brief 27:104617 ArticlePubMedPubMed Central Google Scholar
Carvalho C, Correia D, Costa SA, Lopes C, Torres D (2023) Assessing the environmental impact of diet – influence of using different databases of foods’ environmental footprints. J Clean Prod 416:137973 Article Google Scholar
Rei M, Carvalho C, Torres D, Sage C, Rodrigues S (2025) Identifying sustainable foods from among those culturally acceptable by Portuguese adults (18–84 years old): a multicriteria analysis. Eur J ClinNutr. Manuscript submitted.
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J et al (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60(1):34–42 ArticlePubMed Google Scholar
Streiner DL, Norman GR, Cairney J (2015) Health Measurement Scales: A practical guide to their development and use. Oxford University Press, Oxford Google Scholar
Rodrigues S, Franchini B, Graça P, de Almeida MD (2006) A new food guide for the Portuguese population: development and technical considerations. J Nutr Educ Behav 38(3):189–195 ArticleCASPubMed Google Scholar
Rodrigues S, Franchini B, Pinho I, Graça P (2022) The Portuguese mediterranean diet wheel: development considerations. Br J Nutr 128(7):1315–1321 ArticleCASPubMed Google Scholar
Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA et al (1991) Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 45(12):569–581 CASPubMed Google Scholar
Black AE (2000) Critical evaluation of energy intake using the Goldberg cut-off for energy intake:basal metabolic rate. A practical guide to its calculation, use and limitations. Int J Obes Relat Metab Disord 24(9):1119–1130 ArticleCASPubMed Google Scholar
Schofield WN (1985) Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 39(Suppl 1):5–41 PubMed Google Scholar
FAO (2001) Human energy requirements. Report of a Joint FAO/WHO/UNU Expert Consultation. Rome, Italy.
Magalhães V, Severo M, Torres D, Ramos E, Lopes C (2020) Characterizing energy intake misreporting and its effects on intake estimations, in the Portuguese adult population. Public Health Nutr 23(6):1031–1040 ArticlePubMed Google Scholar
Jung S, Young HA, Braffett BH, Simmens SJ, Ogden CL (2024) Development of a sustainable diet index in US adults. Nutr J 23(1):46 ArticlePubMedPubMed Central Google Scholar
Baudry J, Allès B, Langevin B, Reuzé A, Brunin J, Touvier M et al (2023) Associations between measures of socio-economic position and sustainable dietary patterns in the NutriNet-Santé study. Public Health Nutr 26(5):965–975 ArticlePubMed Google Scholar
Baudry J, Pointereau P, Seconda L, Vidal R, Taupier-Letage B, Langevin B et al (2019) Improvement of diet sustainability with increased level of organic food in the diet: findings from the BioNutriNet cohort. Am J Clin Nutr 109(4):1173–1188 ArticlePubMed Google Scholar
Rei MCC, Correia DM, Torres DPM, Lopes CMM, Costa AIA, Rodrigues SSP (2025) Patterns of food preparation in children and adult diets and their associations with demographic and socio-economic characteristics, health and nutritional status, physical activity, and diet quality. J Nutr Sci 14:e10 ArticlePubMedPubMed Central Google Scholar
Rei M, Correia D, Torres D, Lopes C, Costa AIA, Rodrigues SS (2025) Dietary intake according to different patterns of food preparation in children and adults: results from the Portuguese National Food, Nutrition and Physical Activity Survey (IAN-AF 2015/2016). Public Health Nutr 28(1):e122 ArticlePubMedPubMed Central Google Scholar
Silva M, Rodrigues SSP, Correia DM, Rei MCC, Severo M, Costa AIA et al (2024) Eating out of home in Portugal: characterisation and effects on dietary intake. Br J Nutr 132(2):169–181 ArticleCASPubMed Google Scholar
Dai T, Yang Y, Lee R, Fleischer AS, Wemhoff AP (2020) Life cycle environmental impacts of food away from home and mitigation strategies—a review. J Environ Manage 265:110471 ArticleCASPubMed Google Scholar
Bôto JM, Neto B, Miguéis V, Rocha A (2024) Development of the dietary pattern sustainability index (DIPASI): a novel multidimensional approach for assessing the sustainability of an individual’s diet. Sustain Prod Consum 50:139–154 Article Google Scholar
Poore J, Nemecek T (2018) Reducing food’s environmental impacts through producers and consumers. Science 360(6392):987–992 ArticleCASPubMed Google Scholar
Petersson T, Secondi L, Magnani A, Antonelli M, Dembska K, Valentini R et al (2021) A multilevel carbon and water footprint dataset of food commodities. Sci Data 8(1):127 ArticleCASPubMedPubMed Central Google Scholar
Drewnowski A, Fulgoni VL 3rd (2014) Nutrient density: principles and evaluation tools. Am J Clin Nutr 99(5 Suppl):1223s-s1228 ArticleCASPubMed Google Scholar
Drewnowski A, Maillot M, Darmon N (2009) Should nutrient profiles be based on 100 g, 100 kcal or serving size? Eur J Clin Nutr 63(7):898–904 ArticleCASPubMed Google Scholar
Lopes C, Torres D, Oliveira A, Severo M, Alarcão V, Guiomar S et al (2018) National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population, IAN-AF 2015–2016: Summary of Results. University of Porto, Portugal, Porto Google Scholar
EFSA Panel on Nutrition NFaFA, Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch-Ernst KI, et al (2022) Scientific advice related to nutrient profiling for the development of harmonised mandatory front-of-pack nutrition labelling and the setting of nutrient profiles for restricting nutrition and health claims on foods. EFSA J 20(4):e07259
Keding GB, Schneider K, Jordan I (2013) Production and processing of foods as core aspects of nutrition-sensitive agriculture and sustainable diets. Food Secur 5(6):825–846 Article Google Scholar
Knorr D, Augustin MA (2021) Food processing needs, advantages and misconceptions. Trends Food Sci Technol 108:103–110 ArticleCAS Google Scholar
Chen X, Zhang Z, Yang H, Qiu P, Wang H, Wang F et al (2020) Consumption of ultra-processed foods and health outcomes: a systematic review of epidemiological studies. Nutr J 19(1):86 ArticlePubMedPubMed Central Google Scholar
Lane MM, Gamage E, Du S, Ashtree DN, McGuinness AJ, Gauci S et al (2024) Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ 384:e077310 ArticlePubMedPubMed Central Google Scholar
Moubarac JC, Parra DC, Cannon G, Monteiro CA (2014) Food classification systems based on food processing: significance and implications for policies and actions: a systematic literature review and assessment. Curr Obes Rep 3(2):256–272 ArticlePubMed Google Scholar
Crino M, Barakat T, Trevena H, Neal B (2017) Systematic review and comparison of classification frameworks describing the degree of food processing. Nutr Food Technol 3(1):138 Google Scholar
Morais TG, Teixeira RFM, Domingos T (2016) Regionalization of agri-food life cycle assessment: a review of studies in Portugal and recommendations for the future. Int J Life Cycle Assess 21(6):875–884 Article Google Scholar
INE (2017) Inquérito às Despesas das Famílias: 2015–2016. Lisboa, Portugal Google Scholar
Drewnowski A (2017) Measures and metrics of sustainable diets with a focus on milk, yogurt, and dairy products. Nutr Rev 76(1):21–28 ArticlePubMed Central Google Scholar
Maillot M, Darmon N, Drewnowski A (2010) Are the lowest-cost healthful food plans culturally and socially acceptable? Public Health Nutr 13(8):1178–1185 ArticlePubMed Google Scholar
House J, Brons A, Wertheim-Heck S, van der Horst H (2024) What is culturally appropriate food consumption? A systematic literature review exploring six conceptual themes and their implications for sustainable food system transformation. Agric Hum Values 41(2):863–882 Article Google Scholar