ArticlePublic health nutrition2019
Are our diets getting healthier and more sustainable? Insights from the European Prospective Investigation into Cancer and Nutrition - Netherlands (EPIC-NL) cohort.
Article in Public health nutrition, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Environmental Impact of Current Diets and Alternative Dietary Scenarios Worldwide: A Systematic Review.Nutrition reviews · 2025Pooled it
- Aligning Environmental Sustainability, Health Outcomes, and Affordability in Diet Quality: A Systematic Review.Advances in nutrition (Bethesda, Md.) · 2023Pooled it
- Greater readiness to reduce meat consumption is associated with lower greenhouse gas emissions.Nature food · 2026Article
- Differences in plant- and animal-based protein sources consumed across socioeconomic groups in The Netherlands and their associated environmental impact.European journal of nutrition · 2026Article
- Exploring eight-year trajectories of diet-related environmental pressures in the NutriNet-Santé cohort.Scientific reports · 2025Article
- Dietary consumption trajectory profiles over time of French adults from the NutriNet-Santé cohort (2014-2022): multicriteria analysis of sustainability.The international journal of behavioral nutrition and physical activity · 2025Observational
- Non-communicable disease burden through adhering to Dutch dietary guidelines: a modeling study to estimate future reductions.EClinicalMedicine · 2025Article
- Adherence to the EAT-Lancet Healthy Reference Diet in Relation to Risk of Cardiovascular Events and Environmental Impact: Results From the EPIC-NL Cohort.Journal of the American Heart Association · 2023Article
- Are recent dietary changes observed in the NutriNet-Santé participants healthier and more sustainable?European journal of nutrition · 2022Article
- Future-proof and sustainable healthy diets based on current eating patterns in the Netherlands.The American journal of clinical nutrition · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify differences in dietary quality, dietary greenhouse gas (GHG) emissions and food consumption over 20 years in a Dutch cohort.
designParticipants (n 8932) filled out an FFQ in 1993-1997 and in 2015. The Dutch Healthy Diet index 2015 (DHD15-index) score, GHG emissions and consumption of food groups (g/4184 kJ (1000 kcal)) were compared between the time points with paired t tests.
settingThe Netherlands.
participantsEuropean Prospective Investigation into Cancer and Nutrition - Netherlands (EPIC-NL) cohort, aged 18-65 years at baseline.
resultsTotal energy intake decreased by -678 (95 % CI -4908, 3377) kJ/d (-162 (95 % CI -1173, 807) kcal/d) for men and -372 (95 % CI -3820, 3130) kJ/d (-89 (95 % CI -913, 748) kcal/d) for women. DHD15-index scores increased by 11 % (from 64·8 to 71·9 points) and 13 % (from 65·2 to 73·6 points) in men and women, respectively (P < 0·0001), mainly due to an increased (shell)fish and nuts/seeds/nut paste consumption. After energy intake adjustment, dietary-related GHG emissions increased by 5 % in men (2·48-2·61 kg CO2-eq/4184 kJ (1000 kcal), P < 0·0001) and were similar in women (0·4 %, 2·70-2·71 kg CO2-eq/4184 kJ (1000 kcal), P = 0·3930) due to the increased consumption of (shell)fish, nuts/seeds/nut paste, poultry and higher GHG-intensive red meats such as beef.
conclusionsThis Dutch cohort analyses showed more healthy diets without mitigated GHG emissions over a 20-year period, at similar energy intakes. Higher consumption of (shell)fish and poultry was not yet at the expense of red and processed meat. Lower consumption of animal-based foods is needed to achieve healthier as well as environmentally friendly diets.
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