Generational differences in healthy and sustainable eating: the Doetinchem Cohort Study

Abstract Dutch dietary patterns are high in animal-based foods, contributing to non-communicable diseases and environmental pressures, but may vary across generations due to social and cultural factors. Therefore, this cross-sectional analysis examines generational differences in diet quality and environmental impacts among 2348 adults from the Doetinchem Cohort Study (2018–2023). Diet quality was assessed with the Dutch Healthy Diet (DHD15) index and the animal-to-plant protein ratio, and life-cycle analysis linked foods to greenhouse gas emissions (GHGE) and blue water consumption. Analyses were stratified by generation (Generation X, Baby Boomers and the Silent Generation) and sex and adjusted for relevant confounders. Adjusted mean DHD15-index scores were higher in older female generations, ranging from 81 to 84 ( P -trend = 0·06). Generation X males obtained a larger share of protein from plant sources than older generations (+4 % in Generation X, P -trend = 0·02). Absolute GHGE were lower in older generations (males: −18 % in the Silent Generation, P < 0·001; females: −11 %, P = 0·005), with differences attenuating per 1000 kcal among males. Older generations also had lower absolute blue water consumption among males (–11 % in the Silent Generation, P = 0·05), with differences attenuating per 4184 kJ (1000 kcal). Generation X had higher impacts from certain meats, processed foods and rice, whereas older generations had relatively higher impacts from dairy products, tea and fruit. These modest generational differences suggest that generation-specific dietary strategies could support healthier and more sustainable diets.