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Sustainability analysis of French dietary guidelines using multiple criteria


Sustainability is now accounted for in certain food-based dietary guidelines (FBDG). In 2017, the French FBDG were updated to incorporate environmental preservation. We conducted a multi-indicator evaluation of the 2001 and 2017 FBDG, based on data from 28,340 participants in the NutriNet-Santé cohort who completed an organic food frequency questionnaire. Indicators related to nutrition, environment (three indicators and the synthetic partial ReCiPe (pReCiPe) score) and economy were used, to distinguish organic and conventional farming systems. To estimate compliance with the 2001 and 2017 FBDG, we used two validated adherence scores (PNNS-GS1 and PNNS-GS2, respectively). We estimated numbers of averted deaths by adhering to the FBDG using a competing risk assessment model. Higher adherence to the 2017 guidelines was related to higher plant-based diet, cost and deaths averted and lower energy intake, synthetic environmental score and exposure to certain pesticides. Overall, larger differences between lowest and highest PNNS-GS2 were observed than between lowest and highest PNNS-GS1. Our results suggest that the 2017 guidelines are in line overall with the multiple dimensions of diet sustainability, including health, although at a slight cost increase. If adopted by a large part of the population, these dietary guidelines might contribute to the prevention of chronic diseases while reducing food-related environmental pressures.

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Fig. 1: Relative differences for sustainable indicators between high and low adherence to PNNS-GS1 and PNNS-GS2.
Fig. 2: Relative differences for dietary exposure to pesticides between high and low adherence to PNNS-GS1 and PNNS-GS2.
Fig. 3: Estimated number of deaths averted or delayed (for year 2014) through use of the EpiDiet comparing high and low adherence to the 2017 FBDG.
Fig. 4: Estimated number of deaths averted or delayed (for year 2014) through use of the EpiDiet comparing high adherence to 2017 dietary guidelines and high adherence to 2001 dietary guidelines.

Data availability

Data are available from the corresponding author upon reasonable request.

Code availability

Code and programmes are available from the corresponding author upon reasonable request.


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We thank O. Hamza, C. Boizot-Santai, L.-G. Soler and Bioconsom’acteurs’ members for price collection and data management, CVUA for the pesticide residue database and N. Soton for her contribution to data management of the CVUA database. We also thank C. Agaesse (dietitian); T. H. Van Duong, Y. Esseddik (IT manager), R. Gatibelza, D. Lamri, J. Mohinder and A. Timera (computer scientists); J. Allegre, N. Arnault, L. Bourhis and F. Szabo de Edelenyi (supervision and data/statistics management) for their technical contribution to the NutriNet-Santé study; and N. Druesne-Pecollo (operational coordination). We thank all volunteers of the NutriNet-Santé cohort. The NutriNet-Santé study is funded by French Ministry of Health and Social Affairs, Santé Publique France, Institut National de la Santé et de la Recherche Médicale, Institut National de la Recherche Agronomique, Conservatoire National des Arts et Métiers and Paris 13 University. The BioNutriNet project was supported by the French National Research Agency (Agence Nationale de la Recherche) in the context of the 2013 Programme de Recherche Systèmes Alimentaires Durables (no. ANR-13-ALID-0001). The funders had no role in study design, data collection, analysis, interpretation of data, preparation of the manuscript or decision to submit the paper.

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E.K.-G., B.A., M.T., C.J. and S.H. conducted the study. E.K.-G., P.P., B.L., R.V., D.L. and J.B. conducted the research and implemented databases. J.W. and F.M. conducted the EPIDiet simulation. E.K.-G. performed statistical analyses and drafted the manuscript. All authors critically helped in the interpretation of results, revised the manuscript and provided relevant intellectual input. They all read and approved the final manuscript.

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Correspondence to Emmanuelle Kesse-Guyot.

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Transparency statement E.K.-G. (the guarantor) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.

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Kesse-Guyot, E., Chaltiel, D., Wang, J. et al. Sustainability analysis of French dietary guidelines using multiple criteria. Nat Sustain 3, 377–385 (2020).

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