Inadequate nutrition, with its resulting malnutrition, is the leading cause of health problems worldwide. Today, over 820 million people suffer from hunger, and 2 billion adults and more than 40 million children are overweight. Malnutrition, obesity, and climate change simultaneously attack, producing serious effects on a region or family. It is urgent to have a strategy that addresses these three epidemics simultaneously, intervening in food systems to improve social equity, responsible production and consumption, human and ecosystem health, and economic development.
Sustainable healthy eating should:
– At the planetary level, have a low environmental impact, preserve biodiversity and the health of ecosystems, and to this end, modify production, technology, distribution and marketing in food systems, creating legislation and labeling mechanisms aligned between different government sectors;
– At the human level, promote physical, mental and social health and well-being; guarantee food accessibility and security; respect the acceptability, culture, cuisine, gastronomy, and traditional forms of production and consumption of each region; and have an appropriate cost (in a study of approximately 2000 children in Porto, we showed that eating more Mediterranean-style food can be more expensive than the opposite).
Key characteristics of a sustainable healthy diet include:
– Exclusive breastfeeding for the first 6 months of life;
– Encouraging a nutritionally adequate plant-based diet, even though knowledge about the precise impact of each dietary pattern on health and sustainability is far from complete;
– Preserving food biodiversity, avoiding the overexploitation of resources;
– Ensuring the absence, or minimizing the presence, of pathogens, toxins, contaminants, antibiotics, hormones, and plastics (or their derivatives) in food or its production;
– When making food choices, consider the type of processing , favoring whole foods (the edible parts of plants and animals – with the unique benefit of preserving the original matrix of the food – and its cooking), and minimally processed foods (procedures to increase the shelf life of whole foods, such as pasteurization, or to facilitate culinary use, such as grinding, or to change the flavor, such as fermentation), over ultra-processed foods (often industrial formulations, typically with 5 or more ingredients, with additives and substances such as sugars, oils, fats, salt, antioxidants, stabilizers and preservatives);
– Have clean and safe water as the drink of choice;
– Avoid gender inequalities, particularly regarding the allocation of time to buy and prepare food; and
– Drastically reduce food loss and waste .
A plant-based diet can vary greatly (it doesn't necessarily mean being vegetarian, a healthy pattern that can include eggs and dairy), and encompasses traditional models in many cultures around the world that include: reduced amounts of animal products (particularly red meat); high amounts of plant-based foods such as vegetables, fruits, whole grains, legumes, nuts, and seeds; adequate energy intake; and tea and coffee. By recommending the consumption of these foods in patterns, we obtain synergistic effects between foods consumed simultaneously, either at mealtimes or throughout the day, with health benefits far superior to those that would result from a fragmented intake of these foods.
In flexitarian (similar to pescatarian, but with animal products in moderation), pescatarian (similar to vegetarian, but with fish), vegetarian, and vegan (without animal products) dietary patterns, the consumption of animal-based foods decreases and plant-based foods increases, respectively. Plant-based dietary patterns that converge with sustainability, such as the Mediterranean, Nordic, and DASH diets, are extensively associated with better health and longevity, lower mortality, and reduced risk of non-communicable diseases (NCDs). The Planetary Health Diet , although criticized for potentially reducing mortality unevenly depending on the socio-demographic level of countries, has the merit of proposing to reduce NCDs by improving sustainability (Table 1).
It is important to remember that a plant-based diet is not necessarily healthy, as is the case when one overindulges in refined grains, fried potatoes, salt, oils, drinks, or sugary products. Therefore, the food choices we make can be healthy and sustainable, unhealthy and sustainable, or healthy but not sustainable. For this reason, it is important to seek the help of a nutritionist to avoid concerns about potential nutritional deficiencies (for example, of vitamins B12 or D, calcium, iron, or zinc), particularly in more vulnerable groups of individuals.
* Text previously published in the journal Cadernos de Economia of the Order of Economists.
