Harmonised assessment of environmental impacts from diets and dietary scenarios: sustainability and protein intake in eleven European countries

Abstract

Introduction

Improving human and planetary health is one of the most important challenges of the current century. Demand-side food policy strategies can be implemented to achieve this dual objective. To develop and implement policy measures effectively, it is essential to conduct upfront analyses that demonstrate their potential impact.

Objective

To explore the harmonised assessment of environmental impacts of national representative food consumption surveys using the MCRA software, and to demonstrate the framework by assessing the potential environmental impact of food policy strategies that aim to simultaneously improve human and planetary health.

Methods

Individual-level food consumption data from 11 European countries were used to evaluate current diets and the potential impact of demand-side food policy scenarios designed to reflect health and sustainability objectives. Dutch life-cycle assessment data were used to estimate six environmental impact indicators. Food composition data were applied to estimate protein intake. Food consumption, dietary environmental impacts, and protein intake were estimated and modelled using the MCRA (Monte-Carlo Risk Assessment) software for baseline and alternative scenarios.

Results

In the baseline scenarios, daily average GHG emissions ranged from 4.01 kg CO₂-eq per person in Cyprus to 6.30 kg CO₂-eq in France. Blue water consumption averaged between 104 L per person per day in the Czech Republic and 256 L in Italy. Across all countries, the environmental impact of diets specific to each country demonstrated potential reductions up to 55% in GHG emissions, land use, blue water consumption, and animal protein, and reductions up to 70% in freshwater and marine eutrophication, acidification, when meat intake was reduced and/or replaced by legumes or meat substitutes. Strategies such as replacing dairy with dairy substitutes, soft drinks with water, and limiting confectionery foods demonstrated less pronounced effects on environmental indicators, with reductions ranging from 1 to 11%. Strategies aimed at increasing fruit and vegetable consumption had adverse environmental effects, increasing environment impacts by up to 7% and blue water consumption by up to 14%.

Conclusion

Using the MCRA framework, this study demonstrates that harmonised assessment of current diets and the potential impacts of dietary scenarios can effectively inform policy development. Policies reducing animal food consumption and increasing plant-based intake offer the greatest environmental benefits, particularly when meat is substituted with plant-based alternatives. Implementation of coherent, multi-level policy instruments and tailored country-specific approaches will be essential for achieving both human and planetary health objectives.

Introduction

Improving human and planetary health is one of the most important challenges of the current century. The rise in non-communicable diseases (NCDs), including cardiovascular diseases, type 2 diabetes, and cancer, is the leading cause of morbidity and mortality in the WHO European Region [1, 2]. Almost 60% of adults and one in three children are overweight or obese [3, 4]. The growing burden of obesity, which is both an NCD and a risk factor for other NCDs, poses a continued public health challenge in Europe. However, not only human health is at risk. The average temperature has continued to increase, with visible consequences of climate change [5]. Food production and consumption account for 26% of global greenhouse gas (GHG) emissions, 70% of freshwater withdrawals, and 78% of marine and freshwater eutrophication. Additionally, agriculture contributes to soil acidification, biodiversity loss, and air pollution [6–8].

Dietary change is needed in order to improve human and planetary health. A large body of evidence shows that limiting animal-based food consumption reduces the impact on the environment [9]. High red and processed meat consumption (100–120 g and 50 g per day, respectively) are associated with a 10–20% greater likelihood of developing cancer, type 2 diabetes, stroke, coronary heart disease, and heart failure, substantially contributing to the foodborne burden of disease [10–12]. Shifting from more animal-based diets to more plant-based diet supports human health while being more sustainable through the reduction of animal-based foods. Plant-based diets are inversely associated with risks of chronic diseases and mortality [13]. Furthermore, reducing the intake of sugar-sweetened beverages has demonstrated health [14] and environmental [15] benefits.

There is an urgent need for action, as evidenced by key agendas set at the global, international, and national levels, which focus on healthy and sustainable diets. In the 2023 UN Sustainable Development Goals (SDGs), including zero hunger (SDG2), good health and well-being (SDG3), clean water and sanitation (SDG6), responsible consumption and production (SGD12), climate action (SDG13), life below water (SDG14), life on land (SDG15), as well as the 2015 Paris Agreement, the European Green Deal, including the Farm-to-Fork strategy, diet, nutrition and the environment are key issues.

To simultaneously improve diet quality and reduce environmental impact, various strategies have been proposed or implemented, at both the individual country level and the EU level. Many EU member states have revised their national dietary guidelines to emphasise sustainability outcomes [16]. For example, these guidelines recommend consuming more plant-based foods, purchasing locally produced food, and reducing food waste. In the Netherlands, the focus is on shifting protein intake towards more plant-based proteins, with a goal of achieving a 50/50 balance by 2030 [17]. Meanwhile, some EU member states have introduced taxes on unhealthy foods, such as sugar-sweetened beverages (e.g., the UK, France, and Norway), discretionary foods (e.g., Finland and Hungary: sweets, ice cream, snacks, condiments, confectionery). Others have started to investigate fiscal measures to discourage consumption of harmful foods for the environment [18]. Initiatives at EU level, such as the Green Deal and Farm-to-Fork strategy, aim to reduce the consumption of animal-based foods and promote healthy and sustainable dietary patterns. Despite these efforts, increasing fruit and vegetable intake remains a challenge in many countries [19].

While urgent action towards more healthy sustainable diets and food systems is needed, robust monitoring remains critical for tracking progress, identifying synergies and trade-offs and unintended effects and risks. Such monitoring is essential to support evidence-informed policy making, and requires harmonised methods, standardised data and integrated sustainability assessments covering all sustainability dimensions. Effective development and implementation of policy measures also depend on upfront analyses that can demonstrate the potential impact of these interventions. Although several European countries have reported on the environmental impacts of their populations’ diets, the availability of uniform, comparable data, especially beyond greenhouse gas (GHG) emissions, remains limited. Integrated assessments using harmonised methodologies and comprehensive environmental impact indicators are needed to monitor the environmental footprint of European diets and to support the transition towards diets with reduced impact. In the field of chemical risk assessment, the Monte Carlo Risk Assessment (MCRA) platform is widely used across the EU for harmonised analyses (/mcra/#/). Building on this, we investigated whether MCRA could also be applied to environmental impact assessments, thereby supporting the harmonisation of methods in this domain.

The aim of this study is to explore the feasibility of using the MCRA platform for harmonised assessment of environmental impacts based on nationally representative food consumption surveys, and to demonstrate the framework by evaluating the potential environmental impact of food policy scenarios that target simultaneous improvements in human and planetary health. The scenarios analysed range from moderate dietary changes to more extreme interventions, allowing for illustration of the full spectrum of potential impacts. The assessment includes key indicators: GHG emissions, land use, blue water consumption, acidification, eutrophication, protein intake, and the distribution between plant and animal protein.

Materials and methods

Food consumption data

Individual-level food consumption data from eleven nationally representative dietary surveys hosted by EFSA, stored in the Comprehensive European Food Consumption Database, developed and maintained since 2011 by the European Food Safety Authority (EFSA) [20] were used. The food consumption surveys used in this study covered Austria, Croatia, Cyprus, the Czech Republic, Denmark, France, Italy, the Netherlands, Portugal, Sweden, and Slovenia. These surveys were accessible through the FNS Cloud (https://www.fns-cloud.eu/), which is a follow-up of EUROMIX (https://cordis.europa.eu/project/id/633172). For each survey, the adult population (18–64 years) was included in the current study. See Appendix Table 1 for a description of the food consumption data used.

Development and description of scenarios

In order to estimate the potential impact of EU-wide food policy strategies, scenarios were developed based on observed diets. A total of eight scenarios were developed, each aiming to study the potential effects on dietary environmental impact and protein intake (Table 1). The scenarios in this study were based on common themes in European and national policies, focusing on dietary shifts toward improved health and sustainability. The selected scenarios included: reducing meat consumption by 50% and 100%, replacing 100% of meat with meat substitutes or legumes, replacing 100% of dairy milk with plant-based milk, increasing fruit and vegetable intake by 50 g each, which represents approximately one portion or serving, replacing 100% of soft drinks with water, and limiting the consumption of confectionery foods by 50%. These scenarios reflect varying degrees of dietary change, providing a framework to assess the potential health and environmental impacts of policy-relevant dietary transitions. For each scenario, FoodEx2 codes eligible for reduction, substitution, or addition to the diets were selected based on the description of the FoodEx2 “Exposure Hierarchy” [21]. For example, in scenarios in which meat consumption quantities were adjusted, all relevant FoodEx2 codes and corresponding consumption quantities from Hierarchy Level 1 ‘Meat and meat products’, were considered.

Table 1.

Scenarios reflecting EU-wide health and sustainability objectives to simultaneously improve human and planetary health

Name	Scenario	Level of exposure Hierarchy
Baseline	–	–
MEAT50	Reduce the consumption of meat by 50%	Meat and meat products
MEAT100	Reduce the consumption of meat by 100%	Meat and meat products
MEAT100REP	Replace 100% of meat with meat substitutes	Meat and meat products; Meat imitates
MEAT100LEG	Replace 100% of meat with legumes	Meat and meat products; Legumes
DAIREP	Replace 100% of dairy milk with plant-based milk	Buttermilk; Milk; Dairy imitated
FRUIVEG	Add 50 g extra fruit and 50 g extra vegetables	Fruit and fruit products; Vegetable and vegetable products
CONF	Limit the consumption of confectionery foods by 50%	Fine bakery wares; Confectionery including chocolate
SOFT	Replace 100% of soft drinks by water	Soft drinks; Drinking water; Unbottled water

The scenarios studied in this study were designed to explore the potential environmental impacts of dietary shifts, ranging from moderate reductions to more extreme dietary changes. While some scenarios, particularly those involving 100% reductions or replacements, are not intended to reflect near-term realistic dietary changes, they serve as boundary cases to highlight the full spectrum of potential impacts and provide useful benchmarks for assessing the effectiveness of dietary strategies.

Linkage between food consumption data and indicators

FoodEx2-coded food consumption data from EFSA were linked to environmental impact data using the Dutch Life Cycle Assessment (LCA) Food database [22], and food composition and corresponding nutritional information, using the Dutch Food Composition Database, version 2016 (NEVO online version 2016/5.0) [23]. Firstly, the linkage was initiated using the Dutch Food Consumption Survey (2012–2016) [24], where the foods consumed were coded according to both NEVO codes and FoodEx2 codes. Mertens et al. extended this classification to additional FoodEx2 codes available in the EFSA database by using NEVO codes that most closely resembled the level-six descriptions of the FoodEx2 “Exposure Hierarchy” [25, 26]. For the current study, the classification was further extended to include foods from the food consumption data of EFSA that had not been previously linked. Remaining food items were matched to NEVO codes that most closely corresponded to the level-six descriptions of the FoodEx2 “Exposure Hierarchy” following the methodology outlined by Mertens et al. [25, 26]. In order to ensure the reliability of this matching process, two nutritional scientists independently reviewed a random sample of the matches. This review involved verifying the accuracy and appropriateness of the assigned NEVO codes, ensuring the integrity of the overall linkages. The constructed linkage between FoodEx2 and NEVO codes allowed for the estimation of environmental impacts and protein intake.

Assessment of environmental impact and protein intake

For each country, the average environmental impact was estimated using life-cycle assessment (LCA) data from the Dutch LCA Food database, which has been previously described elsewhere [22, 27, 28]. In short, environmental impacts were calculated based on LCA methodology, which quantifies the environmental impact throughout the foods’ entire life cycle. The LCAs had an attributional approach and a hierarchical perspective and were performed following the ISO 14040 and 14044 guidelines [29]. A time horizon of 100 years was used, and GHG emissions were recalculated following Intergovernmental Panel on Climate Change (IPCC) guidelines (2006) [30]. Economic allocation was applied when production processes led to more than one food product, except for milk, for which bio-physical allocation was used. The functional unit used was 1 kg of prepared food or drink as it would appear on the plate. Remaining foods were matched to food codes by experts, whose judgements were based on similarities in types of food, production systems, and ingredient composition. For composite dishes, standardised recipes from the Dutch Food composition table (NEVO-online version 2016/5.0) were used where available, and if recipes were not available, they were based on food label information (e.g. ingredients and nutritional content). The environmental impact was estimated for six mid-point indicators, which can be linked to planetary boundaries [6]. The mid-point indicators were: GHG emissions (kg CO₂-equivalents (eq)), land use (m²/year), blue (irrigation) water consumption (L), acidification (g SO₂-eq) and fresh and marine water eutrophication (g P-eq and N-eq, respectively). The Dutch Food Composition Database (NEVO online version 2016/5.0) was used to estimate protein intake [23].

Software and data analysis

MCRA (Monte Carlo Risk Assessment) is a web-based software platform used to assess health risks from exposure to multiple chemicals (https://mcra.rivm.nl/mcra). It allows researchers to estimate risks for specific populations by simulating different exposure scenarios, considering food intake, inhalation, and skin contact. MCRA includes over 50 modules covering all main steps of risk assessment, such as hazard identification, exposure assessment, and risk characterization, using both established regulatory methods (from the European Commission and EFSA) and innovative scientific models. This makes MCRA a comprehensive tool for evaluating complex chemical mixtures and their potential health effects. This study evaluates the applicability of the MCRA platform for assessing the environmental impacts of dietary patterns.

All analyses were executed separately for each county included. The dietary environmental impacts and protein intakes for the observed diet (baseline) and the scenarios were assessed using the statistical software MCRA, version 10. An observed individual means (OIM) model was applied to estimate the chronic, long-term dietary environmental impact and protein intake under the assumption that positive intake and exposure distributions were normally distributed [31]. For the daily exposure distribution, a logarithmic transformation was used, and the correlation between intake frequency and amount was assumed to be zero. Consumed quantities were used to estimate the environmental impact. Descriptive statistics were used to determine differences in intake and environmental impacts between the observed diet and the modelled diet following the different scenarios.

Results

In the baseline scenarios, daily average GHG emissions ranged between 4.01 kg CO₂-eq per person per day (pppd) in Cyprus and 6.30 kg CO₂-eq pppd in France (Fig. 1). The average land use, acidification, and fresh and marine water eutrophication per person per day were all lowest in Cyprus. On average, blue water consumption ranged between 104 L pppd in the Czech Republic and 256 L pppd in Italy. Total average protein intake varied between 71 g pppd in Slovenia and 99 g pppd in Portugal. The share of plant-based protein was highest in the Netherlands (40%) and lowest in Portugal (25%).

Fig. 1.

The mean environmental impact indicators and protein intake per person per day per country

Across the countries, reducing meat consumption by 50% could potentially reduce GHG emissions by 16–27% (Fig. 2). Further reductions of up to 55% could be achieved in the 100% meat reduction scenario. Replacing meat with meat substitutes (100%) or legumes (100%) could potentially reduce emissions by 22–39% and 28–47%, respectively. The most pronounced potential reductions in daily GHG emissions due to meat reduction and replacements were observed in Slovenia, Croatia, and Portugal. Substituting dairy milk with milk substitutes (100%) could potentially reduce GHG emissions by a maximum of 8%. The largest potential reductions were seen in Denmark (8%) and Cyprus (6%). The scenario in which 50 g of fruit and 50 g of vegetables were added to the diets showed that the environmental impact slightly increased compared to the baseline scenarios in each country. GHG emissions increased by a maximum of 5% in Slovenia and Austria. Limiting the consumption of confectionery foods by 50% or replacing soft drinks with water each reduced GHG emissions by 1–3%.

Fig. 2.

Potential reductions or increases in greenhouse gas emissions (in %) per person per day for the different scenarios compared to baseline diets

Across the countries, compared to the baseline scenario, reducing meat consumption by 50% could potentially reduce blue water consumption by 4-12% (Fig. 3). Further potential reductions of up to 24% could be achieved in the 100% meat reduction scenario. Replacing meat withmeat substitutes (100%) or legumes (100%) could potentially reduce blue water consumption by 2–7% and 4–13%, respectively. The Czech Republic, Croatia, and Slovenia showed the largest potential in lowering blue water consumption due to limiting or replacing meat. Blue water consumption could potentially increase by a maximum of 3–4% in Croatia and Denmark due to replacing dairy milk with milk substitutes. The scenario in which 50 g of fruit and 50 g of vegetables were added to the diets showed that blue water consumption could potentially increase by 4% in Portugal up to 15% in Croatia. Replacing soft drinks with water did not result in significant reductions in blue water consumption. Limiting confectionery food consumption by 50% or replacing soft drinks with water had no pronounced effect on blue water consumption.

Fig. 3.

Potential reductions or increases in land use (in %) per person per day for the different scenarios compared to baseline diets

In contrast to blue water consumption, the direction and magnitude of changes for land use, acidification, and freshwater and marine eutrophication were similar to those observed for GHG emissions (Figs. 4, 5, 6 and 7).

Fig. 4.

Potential reductions or increases in blue water consumption (in %) per person per day for the different scenarios compared to baseline diets

Fig. 5.

Potential reductions or increases in freshwater eutrophication (in %) per person per day for the different scenarios compared to baseline diets

Fig. 6.

Potential reductions or increases in marine water eutrophication (in %) per person per day for the different scenarios compared to baseline diets

Fig. 7.

Potential reductions or increases in acidification (in %) per person per day for the different scenarios compared to baseline diets

Reducing meat consumption by 50% or 100% could potentially lower protein intakes by 12–21% and 25–41%, respectively (Fig. 8). The smallest reduction was observed in the Netherlands, while Slovenia showed the most pronounced decrease in protein intake. Replacing meat with legumes could potentially result in a greater reduction in protein intake compared to replacing it with meat substitutes. Substituting dairy milk with milk substitutes has the potential to reduce protein intake by a maximum of 9% in Denmark. Adding 50 g of fruit and 50 g of vegetables to the diets increased protein intakes by a maximum of 2%.

Fig. 8.

Potential reductions or increases in protein intake (in %) per person per day for the different scenarios compared to baseline diets

In all countries, diets shifted towards a higher share of plant-based proteins when meat consumption was reduced by 50%, although animal-based proteins still dominated (Fig. 9). With a 100% reduction of meat, diets in all countries had a higher proportion of plant-based proteins, except in France, Italy, Portugal, and Sweden. When meat was replaced by legumes or meat substitutes, diets in all countries had a higher proportion of plant-based proteins. In all other scenarios, the share of animal-based proteins remained higher than that of plant-based proteins in all countries.

Fig. 9.

Potential ratio between animal-based and plant-based protein per person per day for the different scenarios

Discussion

Achieving sustainable diets is a major challenge of the twenty-first century, as reflected in global and national agendas and strategies. In this paper, we explored the harmonised assessment of environmental impacts of national representative food consumption surveys using the MCRA software, and demonstrated the framework by assessing the potential environmental impact of food policy strategies that aim to simultaneously improve human and planetary health across eleven European countries. Our findings demonstrate the potential population-level environmental impact of observed diets and of dietary changes. Limiting meat intake and/or replacing it with legumes or meat substitutes could reduce GHG emissions, land use, blue water, and (animal) protein by up to 55%, and freshwater and marine eutrophication and acidification by up to 70%. In contrast, strategies such as replacing milk with plant-based alternatives, substituting soft drinks with water, and reducing confectionery foods had more limited potential, achieving reductions between 1 and 11%. Strategies to increase fruit and vegetable intake were associated with potential increases in overall environmental impacts (up to 7%) and blue water consumption (up to 14%).

Action towards sustainable food systems and diets is urgently needed. To track progress and support evidence-informed policy making, harmonised methods, robust data, and integrated sustainability assessments covering all sustainability dimensions are required. In this context, our study evaluated the applicability of the Monte Carlo Risk Assessment (MCRA) platform for assessing the environmental impacts of dietary patterns across European food consumption surveys. The baseline scenarios revealed that daily average GHG emissions ranged from 4.01 kg CO₂-eq per person in Cyprus to 6.30 kg CO₂-eq per person in France. Although direct comparisons with other environmental impact data and methods are limited — such as differences between food basket approaches and individual-level consumption data — the ranking of countries in our analysis broadly aligns with the JRC monitoring dashboard, with France among the top three and Cyprus among the lowest three [32]. However, the use of nationally representative food consumption surveys presents challenges, as these data are self-reported, time-consuming, and costly to collect. In contrast, market-based sales data and food basket information may offer a more efficient means of assessment but lack the granularity to identify individual consumption patterns. Market-based sales data could complement food consumption surveys, providing a more frequent, albeit higher-level, perspective on dietary trends [33]. Integrating these diverse data sources and approaches will be essential to advance harmonised and comprehensive sustainability assessments of food systems.

In line with previous studies, our findings emphasise that reducing meat consumption offers the greatest potential for mitigating environmental impacts [34–39]. Diets with lower meat intake were associated with a substantial decrease in protein intake and a shift towards plant-based proteins. Although the reduction in protein intake, it may not pose an immediate risk in countries where dietary protein levels are already excessive [24]. Replacing milk with plant-based alternatives showed smaller environmental benefits, likely due to the relatively low environmental impact of milk (~ 1.8 to 2.0 kg CO₂eq/kg) compared to other animal-based foods such as meat and cheese. The magnitude of the environmental reduction observed, ranging between 30 and 55% in scenarios with 100% meat reduction, underscores the substantial contribution dietary adjustments can make towards Europe’s environmental sustainability goals. The majority of previous modelling studies also report significant reductions in environmental impacts from reducing or substituting animal-based foods, especially ruminant meat, with plant-based alternatives [34–39]. For instance, Perignon et al. [39] found that dietary change can reduce GHG emissions and land use by up to 50%, depending on the type (e.g. beef versus chicken) and quantity of meat consumed. Our results align with these findings across GHG emissions, land use, acidification, and freshwater and marine eutrophication, though less pronounced reductions were observed for blue water consumption. This is likely due to the significant role of other foods (e.g., nuts, fruits, vegetables, non-alcoholic beverages) in contributing to blue water consumption [28].

We observed that the inclusion of fruits and vegetables led to an increase in blue water consumption. Similar findings have been reported in other studies, which show that diets rich in plant-based foods tend to have a higher blue water consumption compared to baseline diets [34, 40–42]. This highlights the complexity of balancing environmental sustainability with nutritional recommendations. It is important to note that increasing food consumption, even when plant-based, contributes to overall environmental impact due to its correlation with energy intake [43]. Nonetheless, while the increases in GHG emissions, land use, acidification, and eutrophication associated with adding fruits and vegetables were relatively modest, the rise in blue water was more pronounced. This raises the question of whether the health and nutritional benefits of adding these foods outweigh their increased environmental impact, particularly for blue water. Higher water consumption for plant-based foods is often overlooked. Yet, it warrants greater attention as 30% of Europe currently experiences water stress [44]. With water stress likely to worsen due to climate change and droughts, it becomes essential to adapt. Adaptation may include regional tailoring of dietary guidelines and promoting the consumption of fruits, vegetables, and nuts that are more water-efficient.

Strategies to reduce the consumption of soft drinks and energy-dense foods have the potential to improve both health and the environmental impacts of dietary choices. Our study specifically focused on reducing confectionery foods, as these calorie-dense yet nutrient-poor options are often overconsumed. Although not examined in the current study, substituting confectionery foods with healthier alternatives may increase both environmental burdens and costs [27, 45]. As shown in our figures, individual interventions targeting sugar-sweetened beverages and confectionery foods have a relatively modest environmental impact compared to reducing meat consumption. It should be noted that consumption patterns for soft drinks and confectionery foods vary by age group [46–49], whereas our study focused exclusively on adults. For example, data from the Netherlands indicate that children under 18 consume significantly more unhealthy foods, especially sugar-sweetened beverages (approximately 50% higher), compared to adults and elderly [27]. Furthermore, the availability and consumption of these foods may have increased over time [50]. Therefore, replacing these foods in current diets could potentially yield greater environmental benefits than those reflect in our study.

Our findings reveal consistent trends across countries, while also highlighting variations in the magnitude of differences from the observed situation. These differences may be influenced by regional factors and cultural preferences in dietary choices. For instance, Croatia, the Czech Republic, Portugal, and Slovenia consume higher amounts of meat, whereas Italy, France, and Denmark exhibit greater consumption of plant-based foods such as vegetables, fruits, and legumes [51]. The largest reductions in GHG emissions were observed in Croatia, the Czech Republic, and Slovenia. However, countries with the highest baseline GHG emissions, such as France and Portugal, did not show the most substantial reductions. This discrepancy can be attributed to a significant portion of their emissions originating from non-meat sources. For instance, France and Portugal are characterized by higher fish intake [51], which also explains their higher animal protein intake. Countries with relatively smaller reductions in GHG emissions include Austria, Cyprus, Denmark, and Sweden. In Cyprus, although meat intake was relatively high, the potential reduction in GHG emissions was smaller than expected due to the type of meat consumed [51] and its associated environmental impact. Denmark, despite lower meat consumption, showed a high overall environmental impact due to higher dairy consumption [51]. Variations were also observed in plant-based foods consumption. Italy stands out for its high intake of vegetables, fruits, and fruit and vegetable juices [51], corresponding to a higher consumption of blue water. Adding 50 g of fruit and 50 g of vegetables to the diets further highlighted differences among countries. For example, Austria and Slovenia experienced the most substantial increases in water consumption, likely due to higher consumption of high-impact fruits, such as citrus fruits, compared to other countries.

The transition to healthier and more sustainable diets is a key 21st-century challenge, yet it remains insufficiently addressed by policymakers and decision-makers in public and environmental health. The results of our study demonstrates the potential impact of policy implementation on health and the environment, with strategies focusing on meat reduction showing the greatest benefits. To date, most efforts to address meat consumption have relied on informational measures, such as awareness campaigns [52, 53], which have shown limited effectiveness [54, 55]. Stronger measures have yet to be implemented, partly due to complex structural and political challenges, including economic considerations and the influence of specific sectors [56, 57]. Compared to policies targeting other sectors, such as fossil fuels, or issues like public health, measures to reduce meat consumption remain less stringent. If reducing meat consumption is essential for improving health and environmental outcomes, more impactful policies may need to be considered. These could include public awareness campaigns, fiscal incentives, and regulatory measures aimed at promoting plant-based diets and discouraging meat consumption. Previous studies have demonstrated the promising effects of economic interventions [58]. For example, a randomized controlled trial showed that combining fiscal measures with informational components reduced meat consumption by 36% [58]. Alongside strategies to reduce meat consumption, increasing the intake of whole grains, fruits, vegetables, and unsalted nuts is recommended to improve public health. However, attention must be paid to the related rise in environmental impact, as increasing the consumption of any food, including healthier options, adds to the overall environmental burden. Finally, our study highlights the need for tailored approaches to account for the diverse circumstances of European countries. Regional factors, cultural preferences, and existing policies play a significant role in shaping the effectiveness of dietary changes. As such, informed decision-making should reflect these nuances to develop policies that effectively promote sustainable and healthy diets.

The study provides a thorough analysis of environmental factors beyond GHG emissions, including land use, acidification, eutrophication, and blue water consumption, offering a broad perspective on the environmental impact of observed diets and dietary changes. Several important limitations should be considered when interpreting these findings. First, the analysis relies on self-reported dietary intake data, which are subject to recall bias and reporting inaccuracies, a well-known limitation in nutritional epidemiology. However, these data provide valuable insights and can complement market-based sales analyses [33]. Second, the use of generic Dutch LCA data to estimate environmental impacts may result in over- or underestimation, especially when applied to the diets in other European countries. Harmonised, country-specific LCA datasets would enhance the accuracy and comparability of results across regions. Third, although the study includes key environmental indicators, it does not address other critical aspects such as biodiversity loss, soil degradation, or broader nutritional, social, and economic outcomes. Future assessments should adopt a more integrative framework covering these dimensions to support comprehensive policy development. Fourth, the study explores specific scenarios, including meat reduction and substitution, dairy replacement, and increased fruit and vegetable intake. These focused scenarios provide valuable insights into practical policy interventions and their potential impacts on environmental sustainability across Europe. However, it is important to acknowledge the simplifications, assumptions, and limitations inherent in the research. While the scenarios model high-level dietary changes, they do not fully account for real-world complexities such as individual preferences and behavioural dynamics. Despite this, the scenarios provide a useful framework for guiding policy decisions by highlighting relative environmental differences compared to observed diets. Fifth, while the study explores the immediate environmental implications of dietary scenarios, it provides limited discussion on the long-term sustainability and health effects, such as micronutrient adequacy and the evolution of dietary patterns over time [59]. Finally, translating these findings into effective policy will require further research into more realistic scenarios, implementation feasibility, stakeholder engagement, and adaptation to local contexts. Despite these limitations, the study demonstrates the potential of the MCRA platform for harmonised assessment of dietary environmental impacts and provides a first step towards a useful framework for monitoring and guiding policy decisions towards healthier and more sustainable food systems.

This study demonstrates the feasibility of using the MCRA framework for harmonised assessment of the environmental impacts of current diets and upfront assessment of dietary scenarios aimed at improving health and sustainability. By applying integrated methods and comparable data, we show that policy strategies promoting reduced animal food consumption, increased plant-based intake, and limiting unhealthy food options have substantial potential to simultaneously improve human and planetary health. The most significant environmental benefits are achieved by reducing meat consumption and substituting it with plant-based alternatives. Achieving these dual objectives will require a coherent set of effective policy instruments, combining both forceful and soft strategies, implemented at the food system level. Our findings also highlight the importance of country-specific approaches to account for regional differences in dietary patterns and environmental impacts.

Appendix

See Table 2.

Table 2.

Description of the food consumption data of 11 different European countries included in the study

Country	Food consumption survey						Data included in study
	Methoda	Yearsc	Named	Populatione (y)	N totalg	Consumption daysh	Populationi (y)	Nj
Austria (AT)	24-h dietary recall	2016	NATIONAL-2016	18–64	2250	2	18–64	2250
Croatia (HR)	24-h and 48-h dietary recall	2011–2012	NIPNOP-HAH-2011–2012	18–64	2002	3	18–64	2002
Cyprus (CY)	24-h dietary recall	2014–2017	2014–2017-LOT2	10–76	1016	3	18–64	478
Czech Republic (CZ)	24-h dietary recall	2004–2008	SISP04	4–64	2353	2	18–64	1666
Denmark (DK)	Food record	2005–2008	DANSDA 2005–08	4–75	2700	7	18–64	1739
France (FR)	FPQb and 24 h dietary recall	2014–2015	INCA3	General populationf	4874	3	adults	1980
Italy (IT)	Food record	2005–2006	INRAN SCAI 2005–06	0–97	3323	3	18–64	2313
Netherlands (NL)	Food record, 24 h dietary recall	2012–2016	FCS2016_Core	1–80	4313	2	18–64	2849
Portugal (PT)	Food record, 24 h dietary recall	2015–2016	IAN-AF-2015–2016	0–84	6429	2	18–64	3434
Slovenia (SI)	24 h dietary recall	2018	SI.MENU-2018	0–75	1981	2	18–64	1047
Sweden (SE)	Food record	2010	RIKSMATEN 2010	18–75	1797	4	18–64	1430

^aMethod of food consumption survey

^bFPQ–Food propensity questionnaire

^cYear(s) in which the food consumption survey was conducted

^dName of the food consumption survey

^eThe population addressed, the population included males and females

^fTo respect French RGPD law, only age group were available instead of individual age for the French food consumption data

^gThe total number of individuals included in the food consumption survey

^hThe number of consumptions days included in the study

^IThe age of the subpopulation group (adults) included in the assessment

^jThe number of individuals included in the assessment

Funding

The authors reported no funding received for this study.

Data availability

Data are available upon request.