更健康的饮食是否更具可持续性？对8种饮食质量指数和7种可持续性指标的横断面评估。

Are healthier diets more sustainable? A cross-sectional assessment of 8 diet quality indexes and 7 sustainability metrics.

作者信息

Conrad Zach, Thorne-Lyman Andrew L, Wu Songze, DiStaso Chloe, Korol Madison, Love David C

机构信息

Department of Kinesiology, William & Mary, Williamsburg, United States; Global Research Institute, William & Mary, Williamsburg, United States.

Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States; Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.

出版信息

Am J Clin Nutr. 2025 Feb;121(2):315-323. doi: 10.1016/j.ajcnut.2024.11.027. Epub 2024 Dec 9.

DOI:10.1016/j.ajcnut.2024.11.027

PMID:39662595

Abstract

BACKGROUND

A comparison of commonly used diet quality indexes (DQIs) and their association with multiple indicators of sustainability has not been performed, which limits policy action.

OBJECTIVES

To evaluate the associations between 8 DQIs and 7 sustainability indicators in a nationally representative sample in the United States.

METHODS

In this cross-sectional analysis, dietary data from the National Health and Nutrition Examination Survey (2011-2018, n = 18,522 ≥20 y) were merged with data on greenhouse gas emissions (GHGE), cumulative energy demand (CED), water scarcity footprint (WSF), land, fertilizer nutrients, pesticides, and food prices from multiple publicly available databases. Diet quality was measured using the Healthy Eating Index-2020 (HEI-2020), Alternate Healthy Eating Index-2010 (aHEI-2010), Mediterranean Diet Score (Med), Alternate Mediterranean Diet Score (aMed), Healthful Plant-Based Diet Index (hPDI), Planetary Health Diet Index (PHDI) for the United States, Dietary Approaches to Stop Hypertension Index (DASH), and Nutrient-Rich Foods Index 9.3 (NRF9.3). The relationship between each DQI and sustainability indicator was assessed using linear regression.

RESULTS

Greater scores on most or all DQIs were associated with lower daily per capita GHGE (β = -0.908 to -0.250 carbon dioxide equivalents per 1 unit increment in diet quality z-score), CED (β = -2.699 to 0.202 MJ), land (β = -0.002 to <-0.001 ha), and fertilizer nutrients (β= -0.026 to 0.007 kg). By contrast, greater scores on most or all DQIs were associated with greater WSF (β = 343-649 L equivalents) and diet cost (β = 0.037-1.125 US$), and had mixed associations with pesticide use (β = -0.001 to <-0.001 kg). Greater scores on aHEI-2010 and hPDI were associated with the greatest ratio of favorable-to-unfavorable sustainability outcomes (5:2 each), followed by PHDI (4:1), Med and aMed (4:2 each), HEI-2020 and DASH (3:2 each), and NRF9.3 (3:4).

CONCLUSIONS

All DQIs had sustainability trade-offs, but those that emphasized plant-based foods, rather than nutrients or animal-based foods, were associated with more favorable sustainability outcomes.

摘要

背景

尚未对常用饮食质量指数（DQIs）进行比较，也未探讨其与多种可持续性指标之间的关联，这限制了政策行动。

目的

在美国具有全国代表性的样本中，评估8种饮食质量指数与7种可持续性指标之间的关联。

方法

在这项横断面分析中，将来自国家健康与营养检查调查（2011 - 2018年，n = 18,522，年龄≥20岁）的饮食数据与来自多个公开可用数据库的温室气体排放（GHGE）、累积能源需求（CED）、水资源稀缺足迹（WSF）、土地、肥料养分、农药和食品价格数据相结合。饮食质量采用健康饮食指数 - 2020（HEI - 2020）、替代健康饮食指数 - 2010（aHEI - 2010）、地中海饮食评分（Med）、替代地中海饮食评分（aMed）、健康植物性饮食指数（hPDI）、美国行星健康饮食指数（PHDI）、饮食预防高血压指数（DASH）和营养丰富食物指数9.3（NRF9.3）进行衡量。使用线性回归评估每个饮食质量指数与可持续性指标之间的关系。

结果

大多数或所有饮食质量指数得分越高，人均每日温室气体排放越低（饮食质量z分数每增加1个单位，β = -0.908至 -0.250二氧化碳当量）、累积能源需求越低（β = -2.699至0.202兆焦耳）、土地使用越低（β = -0.002至< -0.001公顷）以及肥料养分使用越低（β = -0.026至0.007千克）。相比之下，大多数或所有饮食质量指数得分越高，水资源稀缺足迹越大（β = 343 - 649升当量）和饮食成本越高（β = 0.037至1.125美元），并且与农药使用的关联不一（β = -0.001至< -0.001千克）。aHEI - 2010和hPDI得分越高，有利与不利可持续性结果的比例最大（均为5:2），其次是PHDI（4:1）、Med和aMed（均为4:2）、HEI - 2020和DASH（均为3:2）以及NRF9.3（3:4）。