Integrating environmental sustainability within national food-based dietary guidelines: a qualitative analysis from five case study countries

Abstract Background The incorporation of environmental sustainability principles into national food-based dietary guidelines (FBDGs) has gained prominence as a strategy to address both human health and environmental concerns. This study aims to identify and explore the processes and considerations to integrate environmental sustainability in food-based dietary guidelines. Methods Countries that have integrated environmental sustainability in FBDGs since 2016 were identified from the UN FAO website. Background documents and interviews with key stakeholders involved in the development of FBDGs from case study countries (The Netherlands, Denmark, Chile, France and Belgium (Flanders)) were thematically analysed using the Framework Method. A coding framework explored the rationale for integration, data sources and analysis methods, stakeholder and expert engagement, synergies and trade-offs, translation into public messaging, and key learnings. Results Eight background documents and six interviews were analysed. Approaches to integrating environmental sustainability varied, from inclusion in dietary modelling optimisation to changes to consumer messaging. Nearly all countries adjusted guidelines to reduce red and processed meat and emphasise the role of plants in diets. However, issues of cultural significance, affordability, and access limited ambitions to reduce overall meat intake. Novel plant-based alternatives remain contentious due to concerns about their ultra-processed nature and potential nutrient inadequacies as substitution foods. Key barriers to integrating environmental sustainability into FBDGs include consumer acceptance, data quality and availability, stakeholder involvement and conflict, timelines, and resource constraints. Conclusions Several countries have successfully integrated environmental sustainability into their dietary guidelines, but there is still variation in the integration and acceptance of FBDGs including environmental sustainability.