Association between sustainable dietary patterns and body weight, overweight, and obesity risk in the NutriNet-Santé prospective cohort

Abstract

Background Improving the sustainability of current food systems may prevent future public health, environmental, and social concerns. Objective Our objective was to investigate the associations between sustainable dietary patterns, assessed using the Sustainable Diet Index (SDI), and the risk of obesity, overweight, and weight gain in French adults, with a prospective design. Methods In 2014, the SDI was computed among 15,626 participants of the NutriNet-Santé study (of whom 76% were women) using data collected within the BioNutriNet project. The SDI ranges from 4 (lowest sustainability) to 20 points and includes 4 subindexes representing the 4 pillars of a sustainable diet. Longitudinal data of weight and height were collected yearly from 2014 to 2018. We used mixed models to estimate the associations between sex-specific quintiles (Qs) of the SDI and weight change and Cox proportional hazard models with different levels of adjustments to assess the association between sex-specific Qs of the SDI and risk of obesity and overweight (mean follow-up time: 2.8 y). Results At baseline, a higher percentage of participants with overweight was observed in the first SDI Q, reflecting the lowest sustainable dietary patterns (Q1), than in Q5 (29.83% compared with 12.71%). Compared with Q5, a slight increase (at the population level) of almost 160 g/y was observed in Q1, whereas weight remained relatively stable among participants in other Qs. In total, 281 incident cases of obesity and 777 cases of overweight were identified during the follow-up. Participants in Q1 had a higher risk of obesity and overweight than participants in Q5 (HR comparing Q1 with Q5: 4.03; 95% CI: 2.42, 6.10; P-trend < 0.001; and HR comparing Q1 with Q5: 1.49; 95% CI: 1.13, 1.95; P-trend < 0.001, respectively). Conclusions The findings support a potential protective role for more sustainable diets to prevent the risk of weight gain, overweight, and obesity. This trial was registered at clinicaltrials.gov as NCT03335644.

Nutritional quality and carbon footprint of university students’ diets: results from the EHU12/24 study

“…On the other hand, our results suggest that students with excessive BF, in addition to showing lower dietary quality, also have higher GHGE associated with their diets. These results are consistent with those of Seconda et al (99) who observed that a sustainable diet, from environmental, nutritional, economic and sociocultural perspectives, exerts a potential protective role against weight gain, being overweight and obesity. Moreover, Vieux et al (55) found that when energy intake was reduced to meet individual energetic needs, diet-associated GHGE was reduced by up to 10 %.…”

“…In any case, the method used for determining GHGE is a feasible alternative that has been applied in previous studies quantifying GHGE (54,55,116) . Third, the university students' diets were assessed by focusing on two sustainability dimensions, and further investigation should consider the use of indices such as Sustainable Diet Index which include other dimensions of sustainability such as economic and sociocultural aspects (99) . Moreover, only one of the relevant environmental indicators associated with food consumption was used; it would be convenient to consider multiple measures of sustainability.…”

Adherence to the Planetary Health Diet Index and Obesity Indicators in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

“…The SDI is an index that features four sub-indices (nutritional, environmental, economic, and food practices), which are scored from 1 to 5 points, resulting in an overall SDI score of 4 to 20 points. As a result, the authors observed that lower SDI scores were associated with a higher risk of obesity and being overweight, when compared to individuals with higher SDI scores [27].…”

“…In addition to the aforementioned studies, which evaluated the relationship between obesity indicators and EAT-Lancet-based indices, there was a population-based study, carried out by Seconda et al [27], which assessed the relationship between the Sustainable Diet Index (SDI) and excess weight and obesity in French adults participating in the NutriNet-Santé study. The SDI is an index that features four sub-indices (nutritional, environmental, economic, and food practices), which are scored from 1 to 5 points, resulting in an overall SDI score of 4 to 20 points.…”

Advances in dietary pattern analysis in nutritional epidemiology

“…Lately, DP very recently started to take effects beyond health outcomes into account and implications in relation to sustainability and environmental impact have come into focus. Yet, only very few studies have addressed sustainability aspects in exploring DP to-date [14,15,[125][126][127][128]. Thus, there is a strong need to investigate the broader impact of diets on the environment and link these to disease prevention, for which DP analysis has the means to respectively expand its scope and close the gap of analyses of sustainable DPs with chronic disease risk.…”