Co-benefits and trade-offs between environmental impact and diet quality: insights from observational dietary data in a Swedish population

PURPOSE: This study characterises food and nutrient intake in self-reported diets with varying environmental impacts and evaluates their adherence to dietary guidelines and nutritional adequacy, exploring co-benefits and trade-offs between environmental impact and diet quality. METHODS: Dietary data were from two population-based cohorts (n = 30 000) of Swedish adults aged 56–70 years. Environmental impact was assessed using an aggregated score based on six environmental indicators. Adherence to dietary guidelines and nutritional adequacy was evaluated against the Nordic Nutrition Recommendations 2023. RESULTS: In line with the dietary guidelines, diets with a lower environmental impact had lower intake of red meat, processed meat, sugar-sweetened beverages, high-fat dairy products, saturated fat, sodium and alcohol, alongside higher intake of whole grains, fibre and polyunsaturated fat. Contrary to the dietary guidelines, lower-impact diets had higher intake of sweets and snacks and lower intake of vegetables, fruits and berries, nuts and seeds, and seafood. While lower-impact diets had a lower intake of protein and most vitamins and minerals, adherence to macronutrient recommendations was generally higher, and micronutrient intake was adequate, except for selenium and vitamin D. CONCLUSIONS: This study highlights both co-benefits and trade-offs between environmental and health goals. To prevent negative health effects from diets with lower environmental impact, it is essential to limit foods with low nutritional value (e.g., sweets and snacks) and promote healthy plant-based foods. Potential risks associated with a lower micronutrient intake should be considered, particularly for groups with special requirements, such as children, adolescents, fertile and pregnant women, and the elderly.