| Summary: | Objective To evaluate the sustainability of the dietary
patterns, according to their effects on health and
environment and their affordability.
Design Prospective, ongoing cohort study of university
graduates.
Settings The Spanish SUN project (Seguimiento
Universidad de Navarra, University of Navarra Follow-up),
starting from 1999.
Participants A total of 18 429 participants.
Methods Information from participants is collected every
2 years by validated questionnaires. We assessed three
dietary patterns (the Mediterranean, the Western and the
Provegetarian dietary patterns). The rate advancement
period (RAP) was used to assess the healthiness of each
pattern (considering the composite endpoint of all-cause
mortality, cardiovascular disease, breast cancer or type 2
diabetes). We also assessed environmental footprints and
monetary costs of each dietary pattern.
Results After a median follow-up of 10.1 years, we
identified 469 incident cases of the composite endpoint.
The Mediterranean dietary pattern exhibited the best
RAP (3.10 years gained [95% CI 4.35 to 1.85] for the
highest vs the lowest quartile), while the Western pattern
was the unhealthiest pattern (1.33 years lost when
comparing extreme quartiles). In a scale between 4 and
16 of harmful environmental effects (the lower, the more
environmentally friendly), the Provegetarian pattern
scored best (8.82 [95% CI 8.75 to 8.88] when comparing
extreme quartiles), whereas the Western pattern was the
most detrimental pattern (10.80 [95% CI 10.72 to 10.87]).
Regarding monetary costs, the Western pattern was the
most affordable pattern (€5.87/day [95%CI 5.82 to 5.93],
for the upper quartile), while the Mediterranean pattern
was the most expensive pattern (€7.52/day [95%CI
7.47 to 7.56]). The Mediterranean dietary pattern was the
most overall sustainable option, closely followed by the
Provegetarian pattern. The least overall sustainable pattern
was the Western dietary pattern.
Conclusion Following plant-based diets, like the
Mediterranean or Provegetarian dietary patterns, could be
a good option in order to achieve an overall sustainable
diet.
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