Table 2.

The advantages and disadvantages of the six approaches discussed.

	Approach	Advantages	Disadvantages
1	Health first	A lot of experience and science available to develop traditional FBDGs.	Hardly any attention to environmental sustainability.
2	Additional advice	This is the simplest and easiest approach to apply because it adds new rules to existing FBDGs.	It could limit consumer choice.
		This could be both qualitative and sometimes quantitative advice, depending on the scientific evidence available.	It could conflict with health advice and nutritional requirements.
		It builds on scientific evidence and experiences from one’s own or other countries.	Consumers might see it as adding complexity or being of less importance than the health advice.
		Cost-effective to construct.	It is based on measures, not on outcomes.
			It requires additional food literacy from consumers by asking them to interpret ‘seasonal,’ ‘local,’ ‘sustainable’ and other labels.
3	Demonstrating synergies	Provides a more integrated message covering health and environmental impacts.	No attention is paid to conflicts between health and environmental sustainability, such as advice on sugars.
		Supports traditional diets, such as the Mediterranean and Nordic diet, and is adaptive to native cultures.	Difficult to manage trade-offs between environmental indicators or satisfy several constraints simultaneously.
		Quantifying the synergy can help consumers make more informed choices.	This misses additional environmental gains or a food system approach.
		Growing evidence from science and practice.	Mostly focused on nutritional health but not on other health issues such as zoonoses and antimicrobial resistance.
4	Modelling impact	It provides optimised solutions while satisfying several constraints, such as health, environmental sustainability, and costs.	This needs the use of sophisticated tools, experts, and data can be expensive.
		Contrary to scenarios, optimisation tools can calculate solutions that are close to the current diet.	Interpretation of outcomes requires dedicated experts, without guaranteeing satisfying, realistic solutions.
		Less conflicts between health and environmental advice.	This requires significant (national) environmental and consumption data, which are not available for all essential food products or all environmental aspects. Thus, it may be difficult to apply in low to middle income countries.
			Introducing acceptability constraints is recommended, however no study has as yet provided an ultimate solution for calculating acceptability.
5	Combining strategies	This approach could indicate which products are best to consume more frequently or less frequently if you want to eat healthier and more sustainably.	There is a lack of good practices applying optimisation or other multi-criteria techniques to FBDGs.
		This approach is more focused on the metrics of complete diets.	Introducing acceptability constraints is recommended, however no study has as yet provided an ultimate solution for calculating acceptability.
6	Systems first	A food system approach can help prioritise competing demands.	This needs the use of sophisticated tools, experts, and data can be expensive.
		Guarantees achieving multiple planetary boundaries and some SDGs at the same time.	The methods and applications are still under development and need much expertise on indicators and planetary boundaries.
		If well applied, this could also support other sustainability dimensions such as social-economic and animal welfare.	This requires significant (national) environmental and consumption data, which are often not available for all essential food products. Thus, it is difficult to apply to low to middle income countries.
			This approach needs a lot of expertise on environmental indicators and setting ambitious targets.