References: Roles for Dietitians, Nutrition Professionals & Health Care Providers for Implementing Sustainable Diets and Food Systems

Papers highlighting the role of Dietitians/Nutrition Professionals/Healthcare Providers in food system transformation

While these papers specifically address the role of dietitians/health care providers, be sure to take a look at other reference and resource sections which will provide additional/crossover information that health professionals/dietitians can apply to their practice, work setting, communities and educational platforms.  Be sure to look at papers here and in other sections about the dietary guidelines.  There are also papers below regarding consumer behavior and ways to better market and implement sustainable diets with patient population and brands. The papers with the *** are, in my opinion, extremely helpful and relevant.

Please note: These articles have been updated through January 2026.

2023 Sustainability and Food Insights Survey. Food + Planet Website. https://foodandplanet.org/experience/ Published November 2023.  Accessed Feb 2024

  • Survey of 1,161 registered dietitians (RDs) across the US,
  • Results: The vast majority of RDs believe their profession should be involved in advocating for sustainable food systems,
  • Most do not feel confident in providing guidance on sustainable food choices, primarily due to lack of education and resources.

Akers Hanson RA, Campbell CG. Registered Dietitian Nutritionists’ Perceptions of the Relationship Between Food and Peace in the United States Food System: A Qualitative Study. J Acad Nutr Diet. 2023 Jul;123(7):997-1010.e2. doi: 10.1016/j.jand.2023.02.005. Epub 2023 Feb 10. PMID: 36773719.

  • This initial study revealed a gap in RDNs’ current understandings of peacebuilding in the context of food and acknowledged the need for future research. The Food Peace Framework could offer a comprehensive and inclusive model with the potential to initiate conversations that could address root causes of economic despair, social injustices, and political oppression in food systems.

Alberdi G, Begiristain-Zubillaga M. The Promotion of Sustainable Diets in the Healthcare System and Implications for Health Professionals: A Scoping Review. Nutrients. 2021 Feb 26;13(3):747. ***.

  • The healthcare system could be a powerful tool to educate patients by guiding their diets towards sustainability. 
  • This review has identified a framework with key areas where processes need to be developed to guarantee sustainable diet promotion in healthcare services.

Bash, K., & Patel, V. (2023). Health professionals and sustainable diets: Policy and understanding List of Figures. Eating Better.

  • Most healthcare professionals lack a defined position on sustainable diets. When initiatives to support these diets do exist, they generally emphasize increasing plant-based foods rather than reducing animal product consumption. This means that, for the 83.4% of Americans who see a doctor each year (CDC), diet is often not part of the health conversation. Providing physicians with education on the health and preventative benefits of a sustainable diet—and encouraging them to share this knowledge with patients during health-related discussions—could be a powerful approach to promoting healthier dietary choices.

Bastian GE, Buro D, Palmer-Keenan DM. Recommendations for Integrating Evidence-Based, Sustainable Diet Information into Nutrition Education. Nutrients. 2021; 13(11):4170. ***

  • The results of a thorough, narrative review of the literature performed in 2021 suggest there are five well-supported recommendations nutrition educators should consider incorporating in their work.
  •  They are
    • (1) shift towards a plant-based diet
    • (2) mitigate food waste
    • (3) limit consumption of ultra-processed foods (UPF)
    • (4) engage in local food systems
    • (5) choose sustainable seafood. 
  • There have been calls to promote SD to consumers  in part through nutrition education. Nutrition education has been defined as “any combination of educational strategies, accompanied by environmental supports, designed to facilitate voluntary adoption of food choices and other food- and nutrition-related behaviors conducive to health and well-being”, and has been conducted in a broad array of settings, including schools, colleges and universities, community sites, and clinical sites, to both youth and adults . Of note, the counseling done by dietitians with their patients (typically at clinical sites) should also be considered as “nutrition education” for the purposes of this paper, as this work presents an equally viable opportunity for the incorporation of SD messages in such a setting. 

Burke, J. 2012. Bridging the sustainability gap URL:

Carlsson, L., Callaghan, E., & Broman, G. (2019). How Can Dietitians Leverage Change for Sustainable Food Systems in Canada? Canadian Journal of Dietetic Practice and Research, 80(4): p. 164-171.

Campbell CG, Feldpausch G. Teaching nutrition and sustainable food systems: Justification and an applied approach. Frontiers in Nutrition. 2023;10. doi:10.3389/fnut.2023.1167180

  • Education that addresses the interconnectedness of food systems is fundamental in cultivating future generations equipped to mitigate complex problems, such as hunger, nutrition-related chronic disease, and the climate crisis. Connecting the food, agriculture, and nutrition sectors is vitally important for improving human and planetary health and well-being.
  •  Historically, a “triple-bottom-line” approach focusing on economic, environmental, and social perspectives has been used to define sustainability. In contrast, including nutrition and health may provide a more robust view and even greater consideration for the system in its entirety. The sustainable, resilient, healthy food and water system framework, addressing all four pillars, can be used in higher education to help evaluate the sustainability of food and compare methods of production, place, and dietary patterns. 

Chen, P., & Antonelli, M. (2020, December 18). Conceptual models of food choice: Influential factors related to foods, individual differences, and society. Foods, 9(12), 1898.

  • Food choice is shaped by multiple determinants, including internal factors (sensory and perceptual features), external factors (information, social and physical environments), personal-state factors (biological, psychological, and habitual), cognitive factors (knowledge, attitudes, preferences), and sociocultural factors (culture, economics, politics).
  • Understanding these interacting factors is key to transforming the food system for both human health and planetary sustainability.
  • A multidisciplinary, empirically supported approach is essential for improving conceptual models of food choice and fostering collaboration across research fields.

Craig WJ, Mangels AR, Fresán U, et al. The safe and effective use of plant-based diets with guidelines for health professionals. Nutrients. 2021;13(11):4144.

Cohen, N., Fernandes, N., D’Alessandro, M., Fraser, K. T., & Greene, J. (2025). Developing a Healthy and Climate-Friendly Community College Culinary Curriculum. Gastronomy, 3(1), 4–4.

  • The CHEF (Climate-Friendly, Healthy, Efficient Food Service) curriculum was developed at CUNY to address the gap between industry demand for sustainability-trained culinary workers and limited community college education in this area. It includes four core courses on sustainable food service operations, culinary practices, food systems, and nutrition.
  • The program offers two pathways: a 100-hour continuing education credential and an Associate of Applied Science degree concentration. Industry partners support the program through internships and recognize the credential in hiring, improving graduates’ career prospects in the sustainable food service sector.

Cole A, Pethan J, Evans J. The Role of Agricultural Systems in Teaching Kitchens: An Integrative Review and Thoughts for the Future. Nutrients. 2023; 15(18):4045.

  • Operating teaching kitchens in collaboration with local agriculture, including farms, community gardens, vertical farms, and urban agriculture, has the potential to catalyze a movement that emphasizes the role of the food system in promoting human and planetary health, building resilient communities, and encouraging cross-disciplinary collaboration.

Dietary guidelines and sustainability. Food and Agriculture Organization . https://www.fao.org/nutrition/education/food-dietary-guidelines/background/sustainable-dietary-guidelines/en/.

  • In the past decade, more and more countries have started to incorporate sustainability considerations into their food policies and consumer education programms. Given the policy and programmatic implications of FBDGs, the development and integration of recommendations that promote specific food practices and choices have been an obvious strategy for addressing sustainability, mainly in its nutrition and environment dimensions.
  • Such recommendations include for example: having a mostly plant-based diet, focus on seasonal and local foods, reduction of food waste, consumption of fish from sustainable stocks only and reduction of red and processed meat, highly-processed foods and sugar-sweetened beverages.

EAT-Lancet Commission Brief for Healthcare Professionals . EAT.

  • Proteins should primarily be sourced from plants where possible, fish or alternative sources of omega-3 fatty acids several times per week, and with optional modest consumption of poultry and eggs alongside low intakes of red meat, if any, especially processed meat.
  • Foods sourced from animals, especially red meat, have relatively high environmental footprints per serving compared to other food groups. This has an impact on greenhouse gas emissions, land use and biodiversity loss. This is particularly the case for animal source foods from grain fed livestock.
  • Aim to limit to no more than 98 grams of red meat (pork, beef or lamb), 203 grams of poultry and 196 grams of fish per week.

Ebel, R., Ahmed, S., Valley, W., Jordan, N., Grossman, J., Byker Shanks, C., Stein, M., Rogers, M., & Dring, C. (2020). Co-design of Adaptable Learning Outcomes for Sustainable Food Systems Undergraduate Education. Frontiers in Sustainable Food Systems, 4.

  • This paper offers eight co-designed learning outcomes that serve as a pedagogical framework for sustainable food systems education. These outcomes can be adapted for course learning objectives in BC’s program, aligning with community needs and institutional goals.

Eisenberg DM, Pacheco LS, McClure AC, McWhorter JW, Janisch K, Massa J. Perspective: Teaching Kitchens: Conceptual Origins, Applications and Potential for Impact within Food Is Medicine Research.Nutrients. 2023; 15(13):2859. https://doi.org/10.3390/nu15132859

  • There is a need to identify innovative strategies whereby individuals, families, and communities can learn to access and prepare affordable and nutritious foods, in combination with evidence-based guidance about diet and lifestyle. These approaches also need to address issues of equity and sustainability.
  • Teaching Kitchens (TKs) are being created as educational classrooms and translational research laboratories to advance such strategies. Moreover, TKs can be used as revenue-generating research sites in universities and hospitals performing sponsored research, and, potentially, as instruments of cost containment when placed in accountable care settings and self-insured companies.

ENGAGING CONSUMERS ON REGENERATIVE AGRICULTURE How Brands Can Integrate Nutrient Density for Top-line Growth. (2024, March). Nutrient Density Alliance. https://www.nutrientdensityalliance.org/whitepaper

  • This White Paper provides practical guidance to help food companies capture new opportunities presented by their RA commitments and programs.  As consumer interest grows around the connections between farming techniques and food nutrition, brands have a chance to better engage shoppers by quantifying and communicating the measurable health benefit
  • It is designed to support food companies of all sizes in accelerating consumer engagement around the nutritional benefits of regenerative agriculture (RA) programs.
  • Peer-reviewed research clearly demonstrates that regenerative farming methods lead to significant nutritional gains compared to depleted soils under conventional agriculture
  • Translating these proven links between regenerative techniques and measurable nutrition gains into consumer messaging allows brands to meet increasing consumer demand for tangibly healthier and more sustainable products.

Environmental sustainability in national food-based dietary guidelines: a global review Published: December 2022 DOI:https://doi.org/10.1016/S2542-5196(22)00246-7

  • Food systems, environmental health, and the health of human populations are deeply interconnected. Among other factors, supply dynamics and policies within food systems, such as agricultural subsidies, influence the price and availability of different foods, which in turn influences food choice and consumption.
  • Many countries have developed FBDGs specific for their needs, including cultural considerations and dietary preferences. These government-endorsed documents are designed to influence consumer behaviour and population diets by communicating simple context-specific and population-specific messages about what constitutes a healthy diet nationally
  • To achieve the transformation to food systems needed to curb the accelerating environmental decline globally, more countries need to commit to developing FBDGs that explicitly emphasise the crucial link between diet and planetary health and provide specific and practical advice to address these issues.

Fanzo, J., Bellows, A., Spiker, M., Thorne-Lyman, A., & Bloem, M., 2021. The importance of food systems and the environment for nutrition ***

  • Food systems contribute to and are vulnerable to ongoing climate and environmental changes that threaten their sustainability.
  • In this article, we summarize this emerging field and describe what innovative nutrition research is needed in order to bring about food policy changes in the era of climate disruption and environmental degradation

Fiala, V., Freyer, B., Klimek, M., & Fahringer, A. (2018). How do you teach transdisciplinary competences for food and farming systems research? Insights from the course “System Analysis and Scenario Technique.” Open Agriculture, 3(1), 553–566.

  • This article provides instructional strategies for teaching systems analysis and scenario techniques in food systems. Its focus on transdisciplinary learning aligns with the program’s goal to prepare students for diverse roles in food systems careers.

Galt, R., Clark, S., & Parr, D. (2012). Engaging Values in Sustainable Agriculture and Food Systems Education: Toward an Explicitly Values-Based Pedagogical Approach. Journal of Agriculture, Food Systems, and Community Development, 43–54.

  • The authors argue for a values-based pedagogy that directly addresses social, ecological, and economic dimensions of sustainability. This perspective is crucial to shaping curriculum and learning outcomes centered on justice and equity in food systems.

Garnett, T et al  Dietary Guidelines and Sustainability from FAO: Plates, Pyramids and Planets (read “Executive Summary p. 1-7)  2016 ***

  • One important step that governments can take to signal their commitment to a more sustainable and healthy future, is to develop and disseminate food based dietary guidelines (FBDG) that embed health and sustainability objectives. These can then form the basis of policies seeking to foster such patterns
  • “Recommendations include for example: having a mostly plant-based diet, focus on seasonal and local foods, reduction of food waste, consumption of fish from sustainable stocks only and reduction of red and processed meat, highly-processed foods and sugar-sweetened beverages.”

Garnett, T et al: Policies and actions to shift eating patterns: What works?. Food Climate Research Network
Environmental Change Institute & The Oxford Martin Programme on the Future of Food, The University of Oxford 2015 ***

  • There are also striking inequalities in how the economic benefits of food provisioning are distributed: while the top ten food companies collectively generate daily revenues  of more than $1.1bn,3 over a billion people who rely upon agriculture for their livelihoods live below the poverty line of US$1.25 a day 
  • There is also recognition of the need to go beyond a simple emphasis on producing more food to take into account factors such as the nutritional quality and diversity of foods produced as well as non-food environmental and social goods and services that contribute to the livelihoods of producers and local consumers.
  • We need to address systemic inequities that are important determinants of food security -increases in supply do not automatically lead to increases in access nor to improvements in food quality – and to tackle the growth in obesity and diet-related non communicable diseases while continuing to reduce hunger and malnutrition.
  • The lower the meat, fish and dairy content, the lower the environmental impact – and the more important it is that reduced meat intakes are compensated for, nutritionally speaking, with increases in the quantity and diversity of whole grains, fruits and vegetables, and legumes

Garnett, T., Mathewson, S., Angelides, P., & Borthwick, F. (2015). Policies and actions to shift eating patterns: What works? The Food Climate Research Network.

  • The global food system contributes ~30% of greenhouse gas emissions, drives deforestation, biodiversity loss, water pollution, and overfishing, severely impacting ecosystems.
  • Economic and nutritional inequalities persist: over a billion agricultural workers live in poverty, ~800 million are undernourished, while ~2 billion suffer from obesity and diet-related non-communicable diseases.
  • Rapidly growing, urbanizing populations are increasing demand for resource-intensive foods, while ~30% of all food produced is wasted, exacerbating environmental and social challenges.

Geagan, K.  Navigating Sustainability With Confidence. Today’s Dietitian Magazine.  Vol. 25 No. 1 P. 22 Published January 2022.  Accessed January 2022. ***

Gibbs J, Cappuccio FP. Plant-Based Dietary Patterns for Human and Planetary Health. Nutrients. 2022; 14(8):1614.

Gliessman, S. (2025). School cafeterias: can they promote food system sustainability? Agroecology and Sustainable Food Systems, 49(4), 469–470.

  • “A search of “food procurement” on the journal website [Agroecology and Sustainable Food Systems] (https://www.tandfonline.com/journals/wjsa21/) turns up publications of groups in several parts of the world that have documented how local municipalities have helped develop ways for local food to be prioritized by schools, hospitals, and other public facilities. Some even require that the food be produced using agroecological practices. Many of these programs promote Farm to School systems where local growers are ensured a direct market for their efforts on a regular and consistent basis. Such a direct link in the food chain can be called School-Supported Agriculture. By developing partnerships, students are well nourished and farmers’ livelihoods are strengthened.
  • But school food leaders face big challenges in providing food for millions of young eaters every day. Too often schools only have a few dollars or less to spend on each meal, along with administrative and bureaucratic hurdles to contend with. In the US, the National Farm to School Network (https://www.farmtoschool.org/) is doing valuable work connecting educators, policymakers, farmers, funders, and communities in sharing resources and building support for bringing food directly to schools.
  • This is the procuring and preparing food side of the equation. The other side is teaching kids why local, organic, and fresh food is important, where it comes from, and how they can become food system change agents themselves. School garden programs like the Life Lab Science Program based in California (https://www.lifelab.org/) are thriving examples. Through garden-based experiential learning, Life Lab has equipped thousands of educators nation-wide with innovative curriculum that engages students in the science behind growing, harvesting, preparing, and eating good food. When the school gardens are connected to the school cafeterias, especially when the kids themselves help in food preparation, the local food-chain idea is driven home.

Global Alliance for the Future of Food.Creating Better Health for People, Animals, & the Planet: Food Systems Insights for Health Professionals. n.p.: Global Alliance for the Future of Food, 2022.

  • The report showcases 10 food-focused initiatives that have taken action to promote human, ecological, and animal health and well-being.
  • Food is at the heart of human, animal, and ecological health and well-being; however, our present-day food systems put all three at  risk. Industrialized food systems and unhealthy diets significantly  contribute to climate change, undermine the integrity of ecosystems, and are responsible for the escalating rates of disease.  
  • THE IMPACT OF FOOD SYSTEMS ON HUMAN HEALTH Food systems impact our health in a multitude of ways. The World Health Organization estimates that non-communicable diseases (NCDs) such as diabetes, heart attack, stroke, chronic respiratory disease, and cancer are responsible for 41 million deaths each year —  71% of all mortality globally. Diet is a leading risk factor for NCDs. Other hazards associated with our food systems include food-borne disease and exposure to pesticides and toxins among farm workers and eaters alike. The resistance of people and livestock to antibiotics and other antimicrobials is creating an emerging public health crisis. And then there’s zoonoses — pathogens that cross from animals to humans, most recently illustrated by the novel coronavirus, or COVID-19, pandemic. The primary pathways through which food systems impact health were identified in a 2021 WHO report, Food Systems Delivering Better Health.

Goldman M, Vaidyam A, Parupalli S, Rosencranz H, Ramkumar D, Ramkumar J. Food Systems and Planetary Health Nexus Elective: A Novel Approach to A Medical Education Imperative for the 21st Century. Challenges. 2024; 15(1):6.

  • RA prioritizes soil health and involves practices such as crop rotation, the use of organic fertilizers, eliminating/minimizing synthetic chemical inputs in crop farming and animal husbandry (e.g., antibiotics and hormones), the use of cover crops, recycling farm waste (composting), integrating livestock into crop production systems, animal welfare, and minimal to no tilling [13,14]. Evidence is emerging in support of the theory that food produced by RA (plant or animal/animal products used for food) is of better quality than foods produced by IA [15,16,17]. Examples included increased levels of certain vitamins, minerals, micronutrients, antioxidants, and lower levels of pesticide residue. Some of these benefits may be mediated through the effect of RA on the soil/plant microbiome [18].
  • As medical professionals explore the intricate relationship between nutrition, gut microbiomes, and inflammation, the agricultural sector has embarked on a journey into regenerative agriculture, focusing on soil biodiversity, nutrient exchange, and crop nutrient density [28]. It is also important to understand the economic and policy factors that are involved in order to make changes for the betterment of human and planetary health. Having the skills to advocate for reasonable change from the standpoint of healthcare providers is also key to this paradigm shift

Gonzalez Fischer C, Garnett T. Plates, Pyramids, Planet: Developments in National Healthy and Sustainable Dietary Guidelines: A State of Play Assessment. FAO; 2016. https://www.fao.org/documents/card/en?details=d8dfeaf1-f859-4191-954f-e8e1388cd0b7

  • RE: Dietary Guidelines Adopting food-based dietary guidelines that include sustainability criteria is crucial. Food based dietary guidelines that include sustainability criteria are key to changing dietary patterns towards more sustainable, healthier diets.

Hawkes C, Gallagher-Squires C, Spires M, Hawkins N, Neve K, Brock J, Isaacs A, Parrish S, Coleman P. The full picture of people’s realities must be considered to deliver better diets for all.Nature Food. 2024.

  •  People’s daily realities shape their ability to respond to and engage with policies and interventions.
  • People’s realities must be considered as a full picture. Taking action to address one reality – such as the price of food – may be undermined if other realities, such as women’s time and labor, or the meanings of food for young people, are not considered.
  • Considering the full picture of people’s realities is particularly key to addressing household food insecurity and dietary inequalities, given the accumulation of harsh, interdependent realities that shape people’s ability to eat better diets in these contexts.
  • Evidence of lived experience is a robust source of knowledge that is vital to inform more effective policy and practice, including through co-creation and co-design with people who experience the problems.
  • Actions designed to change food systems will also face blockages if they do not engage with the realities that people face when attempting to change what they eat.

Hawkins IW, Mangels AR. Resources used and innovations in teaching vegetarian and vegan nutrition in accredited dietetics programs in the United States. International Journal of Disease Reversal and Prevention 2021;3(2): d

Howard et al. Learning to treat the climate emergency together: social tipping interventions by the health community. The Lancet Planetary Health  PERSONAL VIEW| VOLUME 7, ISSUE 3, E251-E264, MARCH 2023

  • As trusted voices within communities around the world, health professionals and health organisations have enormous potential to influence the social and policy landscape in support of decarbonisation. 
  • An anti-racist, anti-colonial approach that centres human rights and equity is essential…Reducing inequality is essential to sustainability
  • Women show greater pro-environmental behaviour than men,16 and women leaders have been shown to make more pro-environmental and pro-health decisions than men,24,  25 with a higher proportion of legislators who are women correlating with improved health outcomes.
  • Nature prescriptions involve health-care providers writing recommendations for meaningful contact with nature, often in 20 min increments adding up to at least 2 h per week in alignment with evidence that this dose is associated with improved self-reported wellbeing.83
  • It will require the work of every profession that makes up the health sector—eg, pharmacists, administrators, architects, engineers, economists, artists, medical device suppliers, pharmaceutical companies, and decision makers—to achieve optimal outcomes. As outlined in the São Paulo Declaration on Planetary Health, “We invite you to consider yourself a partner in planetary healing.”

Human health and the rio conventions. World Health Organization. https://www.who.int/publications/m/item/human-health-and-the-rio-conventions. Accessed May 7, 2024.

  • There is growing evidence of the impacts of global environmental changes on ecosystems and people, and a renewed consciousness among peoples and nations of the need to act quickly to protect the planet’s ecological and climatic systems. In the last two decades, the Rio Conventions have brought global attention to the impacts of anthropogenic change on the ecosystems of the planet. 
  • Increasingly unsustainable practices are placing pressure on natural resources to meet the demands of our economies and the needs of a rapidly growing global population, resulting in soil, water and air pollution, increased emissions of greenhouse gases, deforestation and land use change, expanded urban areas, introduction of non-native species, and inadequately planned development of water and land resources to meet food and energy needs. These changes are having both direct and indirect impacts on our climate, ecosystems and biological diversity. More than ever, the pursuit of public health, at all levels from local to global

Huval, R. D. (2020, December 8). UC Davis Sustainable Agriculture and Food Systems. Ucdavis.edu.

  • This program overview highlights the interdisciplinary design of UC Davis’s Sustainable Agriculture and Food Systems major, which integrates agroecology, food justice, economics, and policy. The emphasis on flexible career pathways also supports advising and curriculum planning for students pursuing varied roles in the food system.

Jones, R., Vogliano, C., & Burlingame, B. (2018) Sustainable Diets: Linking Nutrition and Food Systems. Sustainable Diets and Food-based Dietary Guidelines, p 158

James-Martin G, Baird DL, Hendrie GA, Bogard J, Anastasiou K, Brooker PG, et al. Environmental sustainability in national food-based dietary guidelines: A global review. The Lancet Planetary Health. 2022;6(12).

  • Food systems, environmental health, and the health of human populations are deeply interconnected. Among other factors, supply dynamics and policies within food systems, such as agricultural subsidies, influence the price and availability of different foods, which in turn influences food choice and consumption.
  • Many countries have developed FBDGs specific for their needs, including cultural considerations and dietary preferences. These government-endorsed documents are designed to influence consumer behavior and population diets by communicating simple context-specific and population-specific messages about what constitutes a healthy diet nationally
  • To achieve the transformation to food systems needed to curb the accelerating environmental decline globally, more countries need to commit to developing FBDGs that explicitly emphasize the crucial link between diet and planetary health and provide specific and practical advice to address these issues.

Kenny,  T, et al. Consumer attitudes and behaviors toward more sustainable diets: a scoping review, Nutrition Reviews, Volume 81, Issue 12, December 2023, Pages 1665–1679, ***

  •  The findings suggest that consumers, insofar as they are interested in sustainability and have the capacity to engage with the concept, primarily approach the concept of sustainable diet from a human health perspective.
  •  This highlights the need for (1) sustained efforts from public health professionals to encourage a realignment of the term sustainable diet…by championing an ecological public health approach in all efforts aimed at promoting more sustainable consumption, from awareness raising to policy development;… (3) the development of multidisciplinary, clear, and evidence-based sustainable-eating messages, including holistic sustainable dietary guidance, to address knowledge gaps, minimize conflicting narratives, and build consumer agency. 

Kowalsky TO, Morilla Romero de la Osa R, Cerrillo I. Sustainable Diets as Tools to Harmonize the Health of Individuals, Communities and the Planet: A Systematic Review.Nutrients. 2022; 14(5):928. ***

  • Healthcare workers, as nutrition counselors, have an essential role in the nutritional education of patients (therapeutic objectives) and communities (preventive objectives), which positions them as a social speaker for the promotion of a healthy and sustainable diet. However, the way of eating not only has an impact on population health but also has an important environmental impact.
  • A calorie-balanced diet mainly based on food of plant origin that would allow the attainment of 60% of daily caloric requirements and a low protein intake from animal foods (focusing in fish and poultry) could significantly reduce global morbi-mortality and the dietary environmental impact maintaining a framework of sustainability conditioned by the consumption of fresh, seasonal, locally produced and minimally packaged products.
  • It is essential to be clear on the environmental impact of foods or diets when establishing consumption recommendations. Different environmental-impact indicators have been used that determine in what sense land, water or the atmosphere are affected. Among them, greenhouse gas emissions (GHGe) have been considered a good proxy for this total environmental load, but this is not the only parameter to have in account.
  • Incorporating the dimension of sustainability is essential in nutritional counseling; however, a successful educational intervention requires prior training and conceptual mastery of the subject.
  • There is increasing evidence of the high exposure to environmental contaminants to which we are exposed from birth, since many of them accumulate in breast milk 33]. In addition, environmental pollution is related to the emerging appearance of different types of diseases such as those that have an autoimmune basis

MacKenzie‐Shalders KL, Barbour L, Charlton K, et al. A pathway to personal, population and planetary health for dietitians and nutrition professionals. Public Health Challenges. 2023;2(4). doi:10.1002/puh2.137

  • Dietitians and nutrition professionals have a critical role in promoting actions that supporting sustainable and resilient food and health systems 
  • This article aims to develop a conceptual framework to support dietitians and nutrition professionals towards personal, population and planetary health, from a perspective of dietitians who are advocates for planetary health. 

National Restaurant Association. (2022, March 3). State of the industry: Sustainability is back on the menu. NRA.

  • This industry report outlines renewed sustainability commitments in foodservice, emphasizing supply chain transparency, waste reduction, and local sourcing.

Pastorino S, Springmann M, Backlund U, Kaljonen M, Singh S, Hunter D, Vargas M, Milani P, Bellanca R, Eustachio PC, et al. (2023) School meals and food systems: Rethinking the consequences for climate, environment, biodiversity, and food sovereignty. Discussion Paper. London School of Hygiene & Tropical Medicine, London.

  • We need to support plant-forward food policy in the school system so we can improve child health, promote agrobiodiversity, increase awareness of food systems, and center cultural community connections, all through local sourced, seasonal ingredients, and sustainable food practices

Plotnikoff  et al. Nutritional Assessment of the Symptomatic Patient on a Plant-Based Diet: Seven Key Questions. Nutrients 2023, 15(6), 1387; 

  • For persons on a poorly-designed plant-based diet, deficiencies are possible in both macronutrients (protein, essential fatty acids) and micronutrients (vitamin B12, iron, calcium, zinc, and vitamin D). Practitioner evaluation of symptomatic patients on a plant-based diet requires special consideration of seven key nutrient concerns for plant-based diets.
  • This article translates these concerns into seven practical questions that all practitioners can introduce into their patient assessments and clinical reasoning. Ideally, persons on plant-based diets should be able to answer these seven questions.

Powell R, Carlsson L, Callaghan E. Nutrition and dietetics professionals sustainable food systems knowledge seeking behaviour.Journal of Hunger & Environmental Nutrition. Published online February 27, 2024:1-17. doi:10.1080/19320248.2024.2321231

  • Secondary data analysis of 231 anonymous self-assessments collected between September 2020 to December 2021 indicate a high proportion (41%) of self-assessed “beginners” in this topic at a mixture of career stages. There was a preference for learning about topics that already have significant public attention globally. More advanced practitioners sought more applied information. These results are informative for updating education and professional development tools for NDP.

Prescott SL, D’Adamo CR, Holton KF, Ortiz S, Overby N, Logan AC. Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet. International Journal of Environmental Research and Public Health. 2023; 20(15):6461. https://doi.org/10.3390/ijerph20156461

  • This effort  [from animal to plant-derived protein sources] has facilitated the emergence of novel ultra-processed “plant-based” commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into “plant-based” foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales—of people, places, and planet.
  • The impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health.

Rifkin ME. Nutrition policy critical to optimize response to climate, public health crises.Front Nutr. 2023;10:1118753. Published 2023 Aug 16. doi:10.3389/fnut.2023.1118753

  • Accordingly, this article proposes four criteria for nutrition policy in the Anthropocene: objective government nutrition recommendations, healthy dietary patterns, adequate nutrition security, and effective nutrition education.
  • Application of such criteria shows strong potential to improve our resiliency despite the climate and public health crises.

Rosier CL, Knecht A, Steinmetz JS, Weckle A, Bloedorn K, Meyer E. From soil to health: advancing regenerative agriculture for improved food quality and nutrition security. Front Nutr. 2025;12:1638507.

  • Observed decadal declines in diet quality driven by industrial farming practices have led to a global health epidemic marked by increased micronutrient deficiency and malnutrition
  • Current research offers promising results regarding regenerative agriculture’s potential to enhance ecosystem services by increasing soil carbon storage, enhancing biodiversity, and improving crop nutrient quality, benefits that also support human health. In contrast, industrialized agriculture prioritizes monoculture production, contributing to the global proliferation of ultra-processed foods (UPFs), the concomitant rise in obesity and NCDs, including diabetes and cardiovascular disease, coinciding with the drastic acceleration of ecosystem decline 
  • healthcare represents an underutilized avenue for advancing regenerative food systems. Integrating regenerative agriculture principles into medical education and public health strategies can enhance healthcare professionals’ understanding of the link between food quality and chronic disease prevention, shifting healthcare models away from prescription-based solutions.

Rossi L, Ferrari M, Ghiselli A. The Alignment of Recommendations of Dietary Guidelines with Sustainability Aspects: Lessons Learned from Italy’s Example and Proposals for Future Development.Nutrients. 2023 Jan 20;15(3):542. doi: 10.3390/nu15030542.

  • The IDGs sustainability recommendations were related to the 16 guiding principles of a sustainable healthy diet and their contribution to the achievement of the Sustainable Developing Goals was provided. The inclusion of sustainability in dietary guidelines requires a multidisciplinary approach to cover the wide range of aspects of a sustainable diet.
  •  The main recommendation of the IDGs’ sustainability chapter was the reduction of consumption of red and processed meat, maximizing the quota of plant foods, and the intake of proteins from vegetable sources (e.g., legumes). This recommendation combines human health promotion and environmental protection.

Sanjeevi, N; Monsivais, P. . Consumption Trends and Eating Context of Lentils and Dried Peas in the United States: A Nationally Representative Study.Nutrients2024, 16(2), 277;

  • Shifting to more plant-focused diets could improve nutrition and also reduce the environmental impact of diets [2], yet such healthy diets are often more costly to consumers [3]. The 2020–2025 Dietary Guidelines for Americans (DGAs) emphasizes plant-based and minimally-processed dietary patterns
  • Legumes have been shown to provide the highest nutritional value per penny compared to other vegetables [9]. Legumes, including lentils and dried peas [10] are an excellent source of folate [11,12,13] and soluble fiber, especially resistant starch, which have important prebiotic functions [14,15]. Although lentils and dried peas are an abundant source of dietary protein and fiber [16], they are not consumed in adequate quantities for health [17] and are among the least-consumed legumes in the United States

Spiker ML, Knoblock-Hahn A, Brown K, Giddens J, Hege AS, Sauer K, Enos DM, Steiber A. Cultivating Sustainable, Resilient, and Healthy Food and Water Systems: A Nutrition-Focused Framework for Action. J Acad Nutr Diet. 2020 Jun;120(6):1057-1067. ***

Spiker et al. Revised 2020 Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Sustainable, Resilient, and Healthy Food and Water Systems, JAND. VOLUME 120, ISSUE 9, P1568-1585.E28, SEPTEMBER 01, 2020

Springmann M, Godfray HCJ, Rayner M, Scarborough P. Analysis and valuation of the health and climate change cobenefits of dietary change. Proceedings of the National Academy of Sciences of the United States of America. 2016;113(15):4146-4151. doi:10.1073/pnas.1523119113

  • The food system is responsible for more than a quarter of all greenhouse gas (GHG) emissions (1), of which up to 80% are associated with livestock production (2, 3). The aggregate dietary decisions we make thus have a large influence on climate change. High consumption of red and processed meat and low consumption of fruits and vegetables are important diet-related risk factors contributing to substantial early mortality in most regions while over a billion people are overweight or obese (4). Without targeted dietary changes, the situation is expected to worsen as a growing and more wealthy global population adopts diets resulting in more GHG emissions (5) and that increase the health burden from chronic, noncommunicable diseases (NCDs) associated with high body weight and unhealthy diets (6).
  • Transitioning towards more plant-based diets in line with WHO and other international dietary guidelines could decrease global mortality, shrink the global food gap and substantially reduce diet-related GHG emissions.

Stiles G, Collins J, Beck KL. Effectiveness of Strategies to Decrease Animal-Sourced Protein and/or Increase Plant-Sourced Protein in Foodservice Settings: A Systematic Literature Review. J Acad Nutr Diet. 2022 May;122(5):1013-1048.

  • Effective population-based strategies are required to move toward healthy sustainable diets that replace a proportion of animal- with plant-based protein. Food service can support this using a variety of strategies across the food supply chain.

Stubbendorff A, Sonestedt E, Ramne S, Drake I, Hallström E, Ericson U. Development of an EAT-Lancet index and its relation to mortality in a Swedish population, The American Journal of Clinical Nutrition, 2022;115(3):705–716

  • In 2019, the EAT-Lancet Commission on healthy diets from sustainable food systems defined the first global reference diet to improve both human health and environmental sustainability.
  • Divided into 5 adherence groups, the highest adherence to the EAT-Lancet diet was associated with lower all-cause mortality cancer mortality  and cardiovascular mortality 

Sustainability Toolkit. March 28, 2024. Accessed April 25, 2024. https://icdasustainability.org/.

  • Nutrition and dietetics professionals around the world work with food at various stages of food systems—from production to product development to procurement through to consumption. In these roles, you have a unique opportunity to influence these systems to be more sustainable, as well as nutritious. While scholars of many disciplines grapple with what must be done to create sustainable food systems (SFS), you can take these understandings of the what and apply it to the how … and be a part of making it happen! 

Tagtow, A.: Next-Generation Solutions to Address Adaptive Challenges in Dietetics Practice: The I+PSE Conceptual Framework for Action, Journal of the Academy of Nutrition and Dietetics, 2021

Taylor, I., Bull, J.W., Ashton, B. et al. Nature-positive goals for an organization’s food consumption. Nat Food4, 96–108 (2023). https://doi.org/10.1038/s43016-022-00660-2

  • Here we propose an approach to achieve nature-positive targets with respect to the embodied biodiversity impacts of an organization’s food consumption.
  • Organizations are committing to strategic biodiversity targets aimed at mitigating negative biodiversity impacts, and increasingly to nature-positive outcomes in line with global policy directions

Thiry, M. 2022. Intersection of human and planet health  Food and Nutrition Magazine. 2022 URL: https://foodandnutrition.org/from-the-magazine/intersection-of-human-and-planet-health/ 

Vogliano, C., Steiber, A., & Brown, K. (2015). Linking agriculture, nutrition, and health: The role of the registered dietitian nutritionist. Journal of the Academy of Nutrition and Dietetics, 115(10): p. 1710-1714.

Wise J, Vennard D. It’s All in a Name: How to Boost the Sales of Plant-Based Menu Items. World Resources Institute. Published February 5, 2019. Accessed Dec 2023 https://www.wri.org/insights/its-all-name-how-boost-sales-plant-based-menu-items

  • If global consumers shifted 30 percent of their expected consumption of ruminant meat in 2050 to plant-based proteins, the change in diets would close half of agriculture’s GHG mitigation gap to hold global warming well below 2 degrees Celsius – even as the population climbs toward 10 billion by mid-century.
  • 1. DON’T USE “MEAT-FREE” “Meat-free” means less of what meat eaters like
  • 2. DON’T USE “VEGAN” – “Vegan” means “different from me”
  • 3. DON’T USE “VEGETARIAN” – “Vegetarian” means “healthy – but unsatisfying – food”
  • 4. DON’T USE “HEALTHY RESTRICTIVE” LANGUAGE – “Healthy restrictive” language like “low fat” has low appeal

World Health Organization: WHO. Healthier diets for our planet: new WHO/Europe data tool to drive innovative country policies. World Health Organzation. Published November 6, 2023.

  • The way we produce and consume food – through our food systems – is tightly interconnected with environment and health. Foods high in salt, added sugars and trans fats can harm our health and lead to early death. At the same time, the production of food products may contribute to soil pollution, greenhouse gas emissions and packaging waste. But there is a way to help understand the impact of food systems on the environment and health: WHO/Europe’s new tool for diet impact assessment (DIA) can help.
  •  The way we produce and consume food worldwide has led us to go beyond what is thought to be a safe limit for Earth’s stability,” 
  • Agriculture is responsible for about a quarter of all greenhouse gas emissions and uses 70% of all freshwater resources. Over-application of fertilizers in some regions has led to the pollution of surface and groundwater, and to dead zones in oceans.
  • If we don’t make changes to how we produce and eat food, like transitioning to healthier and more plant-based diets, we might jeopardize the well-being of our planet and risk not being able to avoid dangerous levels of climate change
  • For each diet scenario, the DIA simultaneously looks at health indicators – such as premature deaths that could be avoided by improving diets; risk factors for cancer, heart disease and diabetes; and bodyweight-related risks – and environmental analyses, such as for greenhouse gas emissions, cropland and freshwater.