Dietary shifts are needed to align the global food systems with the planetary boundaries and contribute to Sustainable Development Goals. We employed a Life Cycle Assessment (LCA) framework, extended with indicators on human health and animal welfare, to assess 2020 food consumption data (N=189) collected through an online survey in the Rhine-Ruhr Metropolis (Germany). Feasible optimisation scenarios representing alternative sustainable choices towards overarching environmental, societal and policy goals were explored. Meat and meat products contributed most to overall environmental impacts (e.g., climate change, terrestrial acidification), and fish and seafood to animal welfare loss (e.g., animal lives lost, animal life years suffered). Sodium intake was the most contributing risk factor for life minutes lost. The combined optimisation scenario reduces 55% of greenhouse gas emissions, improves human health indicators by 25% and reduces animal welfare loss substantially (by 52-97%). This is possible with a shift towards flexitarian and vegetarian dietary scenarios. Although the sample is not representative of the entire population, optimisations deliver sustainability improvements with few changes in dietary scenarios. The extended LCA framework can assess the implications of food consumption towards One Health, provided that further indicators on animal health are developed.