TY - JOUR

T1 - Pathways to "5-a-day": modeling the health impacts and environmental footprints of meeting the target for fruit and vegetable intake in the United Kingdom

AU - Eustachio Colombo, Patricia

AU - Milner, James

AU - Scheelbeek, Pauline F D

AU - Taylor, Anna

AU - Parlesak, Alexandr

AU - Kastner, Thomas

AU - Nicholas, Owen

AU - Elinder, Liselotte Schäfer

AU - Dangour, Alan D

AU - Green, Rosemary

N1 - Funding Information: This study forms part of the Sustainable and Healthy Food Systems (SHEFS) project supported by the Wellcome Trust’s Our Planet Our Health program (grant 205200/Z/6/Z; RG, PFDS, ADD, ON, and AT). The contribution by PEC was funded by the Swedish Research Council FORMAS (grant 2016-00353) and KI Foundations and Funds (grants 2019-01721 and 2019-02016). JM was funded by theWellcome Trust project Complex Urban Systems for Sustainability and Health (CUSSH; grant 209387/Z/17/Z). The funders had no role in the study design, data analysis or writing, or the decision to submit for publication. All authors are independent from the funders and had full access to all data. All authors take responsibility for data integrity and accuracy of the analysis. Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

PY - 2021

Y1 - 2021

N2 - Background: Fruit and vegetable consumption in the United Kingdom is currently well below recommended levels, with a significant associated public health burden. The United Kingdom has committed to reducing its carbon emissions to net zero by 2050, and this transition will require shifts towards plant-based diets. Objective: The aim was to quantify the health effects, environmental footprints, and cost associated with 4 different pathways to meeting the United Kingdom's "5-a-day"recommendation for fruit and vegetable consumption. Methods: Dietary data based on 18,006 food diaries from 4528 individuals participating in the UK National Diet and Nutrition Survey (2012/13-2016/17) constituted the baseline diet. Linear programming was used to model the hypothetical adoption of the 5-a-day (400 g) recommendation, which was assessed according to 4 pathways differing in their prioritization of fruits versus vegetables and UK-produced versus imported varieties. Increases in fruit and vegetable consumption were substituted for consumption of sweet snacks and meat, respectively. Changes in life expectancy were assessed using the IOMLIFET life table model. Greenhouse gas emissions (GHGEs), blue water footprint (WF), and total diet cost were quantified for each 5-a-day diet. Results: Achieving the 5-a-day target in the United Kingdom could increase average life expectancy at birth by 7-8 mo and reduce diet-related GHGEs by 6.1 to 12.2 Mt carbon dioxide equivalents/y; blue WFs would change by -0.14 to +0.07 km3/y. Greater reductions in GHGEs were achieved by prioritizing increased vegetable consumption over fruit, whereas the greatest reduction in WF was obtained by prioritizing vegetable varieties produced in the United Kingdom. All consumption pathways increased diet cost (£0.34-£0.46/d). Conclusions: Benefits to both population and environmental health could be expected from consumption pathways that meet the United Kingdom's 5-a-day target for fruit and vegetables. Our analysis identifies cross-sectoral trade-offs and opportunities for national policy to promote fruit and vegetable consumption in the United Kingdom.

AB - Background: Fruit and vegetable consumption in the United Kingdom is currently well below recommended levels, with a significant associated public health burden. The United Kingdom has committed to reducing its carbon emissions to net zero by 2050, and this transition will require shifts towards plant-based diets. Objective: The aim was to quantify the health effects, environmental footprints, and cost associated with 4 different pathways to meeting the United Kingdom's "5-a-day"recommendation for fruit and vegetable consumption. Methods: Dietary data based on 18,006 food diaries from 4528 individuals participating in the UK National Diet and Nutrition Survey (2012/13-2016/17) constituted the baseline diet. Linear programming was used to model the hypothetical adoption of the 5-a-day (400 g) recommendation, which was assessed according to 4 pathways differing in their prioritization of fruits versus vegetables and UK-produced versus imported varieties. Increases in fruit and vegetable consumption were substituted for consumption of sweet snacks and meat, respectively. Changes in life expectancy were assessed using the IOMLIFET life table model. Greenhouse gas emissions (GHGEs), blue water footprint (WF), and total diet cost were quantified for each 5-a-day diet. Results: Achieving the 5-a-day target in the United Kingdom could increase average life expectancy at birth by 7-8 mo and reduce diet-related GHGEs by 6.1 to 12.2 Mt carbon dioxide equivalents/y; blue WFs would change by -0.14 to +0.07 km3/y. Greater reductions in GHGEs were achieved by prioritizing increased vegetable consumption over fruit, whereas the greatest reduction in WF was obtained by prioritizing vegetable varieties produced in the United Kingdom. All consumption pathways increased diet cost (£0.34-£0.46/d). Conclusions: Benefits to both population and environmental health could be expected from consumption pathways that meet the United Kingdom's 5-a-day target for fruit and vegetables. Our analysis identifies cross-sectoral trade-offs and opportunities for national policy to promote fruit and vegetable consumption in the United Kingdom.

KW - Diet cost

KW - Dietary patterns

KW - Health impact assessment

KW - Health promotion

KW - Nutrition

KW - Planetary health

U2 - 10.1093/ajcn/nqab076

DO - 10.1093/ajcn/nqab076

M3 - Journal article

C2 - 33871601

AN - SCOPUS:85112245912

VL - 114

SP - 530

EP - 539

JO - American Journal of Clinical Nutrition

JF - American Journal of Clinical Nutrition

SN - 0002-9165

IS - 2

ER -