Greater accordance with the Dietary Approaches to Stop Hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom

Abstract

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs).Objective: The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance.Design: In this cross-sectional study of adults aged 39–79 y from the European Prospective Investigation into Cancer and Nutrition–Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom–based supermarket comparison website.Results: Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P < 0.0001). Among the DASH food groups, GHGs were most strongly and positively associated with meat consumption and negatively with whole-grain consumption. In addition, higher accordance with the DASH diet was associated with higher dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001).Conclusions: Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet-related GHGs. However, to make the DASH diet more accessible, food affordability, particularly for lower income groups, will have to be addressed.

The effectiveness of Dietary Approaches to Stop Hypertension (DASH) counselling on estimated 10-year cardiovascular risk among patients with newly diagnosed grade 1 hypertension: A randomised clinical trial

“…Moreover, both the UK and US studies have argued that greater accordance with the DASH food 270 group targets could be associated with higher dietary costs indeed [40,41]. This may suggest a 271 reconsideration of the DASH diet given the cultural acceptability and structural barriers to modifying 272 eating habits, despite that we were unable to account for the cost-effectiveness in the present trial.…”

How low can dietary greenhouse gas emissions be reduced without impairing nutritional adequacy, affordability and acceptability of the diet? A modelling study to guide sustainable food choices

“…Healthy diets are known to be generally more expensive than unhealthy diets (16,17) , as recently confirmed in studies investigating affordability, healthy dietary pattern and GHGE (12) . Diet optimization by linear programming has been used in human nutrition to assess the compatibility between nutritional adequacy and affordability of diets, or the gaps in consumption between observed and recommended dietary patterns at population and individual levels (18)(19)(20)(21) .…”

“…The MAR was calculated for each diet as the mean percentage of daily recommended intakes for twenty key nutrients (proteins, fibre, Ca, K, Fe, Mg, Zn, Cu, iodine, Se, vitamin A, vitamin C, vitamin D, vitamin E, thiamin, riboflavin, niacin, vitamin B 6 , folic acid and vitamin B 12 ) by:…”

“…Hence it has been suggested that dietary changes aimed at reducing diet-related GHGE may also promote health (8,9) . Some studies investigating dietary scenarios (10,11) or self-selected diets (12) with reduced meat consumption in the UK have strengthened the message of a compatibility between health and environmental dimensions. However, in a Dutch cohort, the GHGE of usual diets were not associated with mortality, indicating that an environmentally friendlier diet is not necessarily a healthier diet (13) .…”

Sustainable diets within sustainable food systems

“…Gill et al (32) , focusing on the effects of the nutrition transition in emerging economies note that the impact on environment are significant and deserve proper consideration. Other studies (33,34) analyse the environmental consequences of switching to more healthy diets or the consequences on health of switching to more environmentally friendly diets (35) . Some studies analyse the environmental impacts of adopting diets respecting national dietary guidelines (36,37) .…”