Do sustainable diets take food processing into account? A scoping review

OBJECTIVE: This study aimed to examine how food processing is addressed within indices/tools used to assess healthy and sustainable diets. DESIGN: A scoping review was conducted following the PRISMA-ScR protocol. Peer-reviewed studies developing or applying indices/tools for assessing sustainable diets were included. Two independent reviewers performed the selection, with disagreements resolved by discussion, and, when necessary, a third reviewer was consulted to reach a consensus. SETTING: The review included studies published in English, Portuguese or Spanish, without time restrictions and indexed in PubMed, Scopus, Web of Science and SciELO databases. PARTICIPANTS: A total of fifty-seven studies about sustainable diets were analysed. RESULTS: Most studies showed significant gaps in addressing food processing and other food system components when assessing sustainable diets. The majority of studies were conducted in recent years and primarily in high-income countries, and while environmental and health dimensions of sustainability are widely explored, economic and sociocultural dimensions remain underrepresented. CONCLUSIONS: The assessment of diet sustainability remains incomplete without accounting for the role of food processing and the broader food system. There is a need for comprehensive methodologies that integrate all sustainability dimensions while also considering local contexts, particularly in low- and middle-income countries.