Skip to main content
×
×
Home

The Mediterranean diet, an environmentally friendly option: evidence from the Seguimiento Universidad de Navarra (SUN) cohort

  • Ujué Fresán (a1), Miguel-Angel Martínez-Gonzalez (a1) (a2) (a3), Joan Sabaté (a4) and Maira Bes-Rastrollo (a1) (a2) (a3)
Abstract
Objective

How food is produced and consumed has consequences for ecosystems, such as resource use and greenhouse gas (GHG) emission among others. The Mediterranean diet (MedDiet) was proposed as a sustainable dietary model, due to its nutritional, environmental, economic and sociocultural dimensions. However, further evidence is needed. Thus, our objective was to evaluate the impact on resource (land, water and energy) use and GHG emission of better adherence to the MedDiet in a Mediterranean Spanish cohort.

Design

We analysed the dietary pattern of participants through a validated FFQ. The outcomes were land use, water and energy consumption and GHG emission according to MedDiet adherence. The specific environmental footprints of food item production and processing were obtained from different available life-cycle assessments.

Setting

Spanish university graduates.

Subjects

Participants (n 20 363) in the Seguimiento Universidad de Navarra (SUN) cohort.

Results

Better adherence to the MedDiet was associated with lower land use (−0·71 (95 % CI −0·76, −0·66) m2/d), water consumption (−58·88 (95 % CI −90·12, −27·64) litres/d), energy consumption (−0·86 (95 % CI −1·01, −0·70) MJ/d) and GHG emission (−0·73 (95 % CI −0·78, −0·69) kg CO2e/d). A statistically significant linear trend (P<0·05) was observed in all these analyses.

Conclusions

In this Mediterranean cohort, better adherence to the MedDiet was an eco-friendly option according to resource consumption and GHG emission.

Copyright
Corresponding author
* Corresponding author: Email ujuefresan@gmail.com
References
Hide All
1. Bach-Faig, A, Berry, EM, Lairon, D et al. (2011) Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 14, 22742284.
2. Trichopoulou, A & Lagiou, P (1997) Healthy traditional Mediterranean diet: an expression of culture, history, and lifestyle. Nutr Rev 55, 383389.
3. Willett, WC, Sacks, F, Trichopoulou, A et al. (1995) Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 61, 6 Suppl., 1402S1406S.
4. Sanchez-Tainta, A, Zazpe, I, Bes-Rastrollo, M et al. (2016) Nutritional adequacy according to carbohydrates and fat quality. Eur J Nutr 55, 93106.
5. Serra-Majem, L, Bes-Rastrollo, M, Roman-Vinas, B et al. (2009) Dietary patterns and nutritional adequacy in a Mediterranean country. Br J Nutr 101, Suppl. 2, S21S28.
6. Bosetti, C, Pelucchi, C & La Vecchia, C (2009) Diet and cancer in Mediterranean countries: carbohydrates and fats. Public Health Nutr 12, 15951600.
7. Buckland, G, Bach, A & Serra-Majem, L (2008) Obesity and the Mediterranean diet: a systematic review of observational and intervention studies. Obes Rev 9, 582593.
8. Estruch, R, Ros, E, Salas-Salvado, J et al. (2013) Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 368, 12791290.
9. Martinez-Gonzalez, MA, Bes-Rastrollo, M, Serra-Majem, L et al. (2009) Mediterranean food pattern and the primary prevention of chronic disease: recent developments. Nutr Rev 67, Suppl. 1, S111S116.
10. Martinez-Gonzalez, MA & Martin-Calvo, N (2016) Mediterranean diet and life expectancy; beyond olive oil, fruits, and vegetables. Curr Opin Clin Nutr Metab Care 19, 401407.
11. Serra-Majem, L, Roman, B & Estruch, R (2006) Scientific evidence of interventions using the Mediterranean diet: a systematic review. Nutr Rev 64, 2 Pt 2, S27S47.
12. Sofi, F, Cesari, F, Abbate, R et al. (2008) Adherence to Mediterranean diet and health status: meta-analysis. BMJ 337, a1344.
13. Trichopoulou, A, Martinez-Gonzalez, MA, Tong, TY et al. (2014) Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med 12, 112.
14. United Nations Educational, Scientific and Cultural Organization (2013) Representative List of the Intangible Cultural Heritage of Humanity. http://www.unesco.org/culture/ich/en/lists (accessed September 2016).
15. Donini, LM, Dernini, S, Lairon, D et al. (2016) A consensus proposal for nutritional indicators to assess the sustainability of a healthy diet: the Mediterranean diet as a case study. Front Nutr 3, 37.
16. Gussow, JD & Clancy, KL (1986) Dietary guidelines for sustainability. J Nutr Educ 18, 15.
17. Carlsson-Kanyama, A & Gonzalez, AD (2009) Potential contributions of food consumption patterns to climate change. Am J Clin Nutr 89, issue 5, 1704S1709S.
18. Baroni, L, Cenci, L, Tettamanti, M et al. (2007) Evaluating the environmental impact of various dietary patterns combined with different food production systems. Eur J Clin Nutr 61, 279286.
19. Pimentel, D & Pimentel, M (2003) Sustainability of meat-based and plant-based diets and the environment. Am J Clin Nutr 78, 3 Suppl., 660S663S.
20. Reijnders, L & Soret, S (2003) Quantification of the environmental impact of different dietary protein choices. Am J Clin Nutr 78, 3 Suppl., 664S668S.
21. Burlingame, B & Dernini, S (2012) Sustainable Diets and Biodiversity: Directions and Solutions for Policy, Research and Action. Proceedings of the International Scientific Symposium ‘Biodiversity and Sustainable Diets United Against Hunger’, 3–5 November 2010, FAO Headquarters, Rome. http://www.fao.org/docrep/016/i3004e/i3004e.pdf (accessed September 2016).
22. Gussow, JD (1995) Mediterranean diets: are they environmentally responsible? Am J Clin Nutr 61, issue 6, 1383S1389S.
23. Burlingame, B & Dernini, S (2011) Sustainable diets: the Mediterranean diet as an example. Public Health Nutr 14, 22852287.
24. Dernini, S, Berry, EM, Serra-Majem, L et al. (2017) Med Diet 4.0: the Mediterranean diet with four sustainable benefits. Public Health Nutr 20, 13221330.
25. Germani, A, Vitiello, V, Giusti, AM et al. (2014) Environmental and economic sustainability of the Mediterranean diet. Int J Food Sci Nutr 65, 10081012.
26. Leon-Munoz, LM, Guallar-Castillon, P, Graciani, A et al. (2012) Adherence to the Mediterranean diet pattern has declined in Spanish adults. J Nutr 142, 18431850.
27. Vareiro, D, Bach-Faig, A, Raido Quintana, B et al. (2009) Availability of Mediterranean and non-Mediterranean foods during the last four decades: comparison of several geographical areas. Public Health Nutr 12, 16671675.
28. Varela-Moreiras, G, Avila, JM, Cuadrado, C et al. (2010) Evaluation of food consumption and dietary patterns in Spain by the Food Consumption Survey: updated information. Eur J Clin Nutr 64, Suppl. 3, S37S43.
29. Trichopoulou, A, Costacou, T, Bamia, C et al. (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348, 25992608.
30. Martinez-Gonzalez, MA, Sanchez-Villegas, A, De Irala, J et al. (2002) Mediterranean diet and stroke: objectives and design of the SUN project. Seguimiento Universidad de Navarra. Nutr Neurosci 5, 6573.
31. Martinez-Gonzalez, MA (2006) The SUN cohort study (Seguimiento University of Navarra). Public Health Nutr 9, 127131.
32. Segui-Gomez, M, de la Fuente, C, Vazquez, Z et al. (2006) Cohort profile: the ‘Seguimiento Universidad de Navarra’ (SUN) study. Int J Epidemiol 35, 14171422.
33. Willett, WC (2013) Nutritional Epidemiology, 3rd ed. New York: Oxford University Press.
34. Martin-Moreno, JM, Boyle, P, Gorgojo, L et al. (1993) Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol 22, 512519.
35. de la Fuente-Arrillaga, C, Ruiz, ZV, Bes-Rastrollo, M et al. (2010) Reproducibility of an FFQ validated in Spain. Public Health Nutr 13, 13641372.
36. Fernandez-Ballart, JD, Pinol, JL, Zazpe, I et al. (2010) Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain. Br J Nutr 103, 18081816.
37. Bustos, A (1999) 777 Recetas de Cocina Inteligente, 4th ed. Spain: Ediciones Internacionales Universitarias.
38 Pretty, J (2008) Agricultural sustainability: concepts, principles and evidence. Philos Trans R Soc Lond B Biol Sci 363, 447465.
39. Food and Agriculture Organization of the United Nations (2009) How to Feed the World in 2050. http://www.fao.org/fileadmin/templates/wsfs/docs/expert_paper/How_to_Feed_the_World_in_2050.pdf (accessed September 2016).
40. Johnston, JL, Fanzo, JC & Cogill, B (2014) Understanding sustainable diets: a descriptive analysis of the determinants and processes that influence diets and their impact on health, food security, and environmental sustainability. Adv Nutr 5, 418429.
41. Galli, A, Iha, K, Halle, M et al. (2017) Mediterranean countries’ food consumption and sourcing patterns: an ecological footprint viewpoint. Sci Total Environ 578, 383391.
42. Rockstrom, J, Steffen, W, Noone, K et al. (2009) A safe operating space for humanity. Nature 461, 472475.
43. Heller, MC, Keoleian, GA & Willett, WC (2013) Toward a life cycle-based, diet-level framework for food environmental impact and nutritional quality assessment: a critical review. Environ Sci Technol 47, 1263212647.
44. Sabate, J, Harwatt, H & Soret, S (2016) Environmental nutrition: a new frontier for public health. Am J Public Health 106, 815821.
45. Dutilh, CE & Krammer, KJ (2000) Energy consumption in the food chain: comparing alternative options in food production and consumption. AMBIO 29, 98101.
46. Pereira, HM, Leadley, PW, Proenca, V et al. (2010) Scenarios for global biodiversity in the 21st century. Science 330, 14961501.
47. Edenhofer, O, Pichs-Madruga, R, Sokona, Y et al. (2014) Climate Change 2014: Mitigation of Climate Change. Working Group III Contribution to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. New York: Cambridge University Press; available at http://www.ipcc.ch/pdf/assessment-report/ar5/wg3/ipcc_wg3_ar5_full.pdf
48. Johnson, JA, Runge, CF, Senauer, B et al. (2014) Global agriculture and carbon trade-offs. Proc Natl Acad Sci U S A 111, 1234212347.
49. Gerber, PJ, Steinfeld, H, Henderson, B et al. (2013) Tackling Climate Change Through Livestock: A Global Assessment of Emissions and Mitigation Opportunities. Rome: FAO.
50. Sabate, J & Soret, S (2014) Sustainability of plant-based diets: back to the future. Am J Clin Nutr 100, Suppl. 1, 476S482S.
51. US Department of Health and Human Services & US Department of Agriculture (2015) 2015–2020 Dietary Guidelines for Americans, 8th ed. Washington, DC: DHHS and USDA; available at http://www.health.gov/dietaryguidelines/2015/guidelines/
52. Saez-Almendros, S, Obrador, B, Bach-Faig, A et al. (2013) Environmental footprints of Mediterranean versus Western dietary patterns: beyond the health benefits of the Mediterranean diet. Environ Health 12, 118.
53. Bach, A, Serra-Majem, L, Carrasco, JL et al. (2006) The use of indexes evaluating the adherence to the Mediterranean diet in epidemiological studies: a review. Public Health Nutr 9, 132146.
54. Mila-Villarroel, R, Bach-Faig, A, Puig, J et al. (2011) Comparison and evaluation of the reliability of indexes of adherence to the Mediterranean diet. Public Health Nutr 14, 23382345.
55. Marlow, HJ, Harwatt, H, Soret, S et al. (2015) Comparing the water, energy, pesticide and fertilizer usage for the production of foods consumed by different dietary types in California. Public Health Nutr 18, 24252432.
56. Tilman, D & Clark, M (2014) Global diets link environmental sustainability and human health. Nature 515, 518522.
57. Martinez-Gonzalez, MA, Sanchez-Tainta, A, Corella, D et al. (2014) A provegetarian food pattern and reduction in total mortality in the Prevencion con Dieta Mediterranea (PREDIMED) study. Am J Clin Nutr 100, Suppl. 1, 320S328S.
58. Sranacharoenpong, K, Soret, S, Harwatt, H et al. (2015) The environmental cost of protein food choices. Public Health Nutr 18, 20672073.
59. Gerbens-Leenes, PW & Nonhebel, S (2002) Consumption patterns and their effects on land required for food. Ecol Econom 42, 185199.
60. Le, LT & Sabate, J (2014) Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts. Nutrients 6, 21312147.
61. Orlich, MJ, Singh, PN, Sabate, J et al. (2013) Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med 173, 12301238.
62. Satija, A, Bhupathiraju, SN, Rimm, EB et al. (2016) Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies. PLoS Med 13, e1002039.
63. Springmann, M, Godfray, HC, Rayner, M et al. (2016) Analysis and valuation of the health and climate change cobenefits of dietary change. Proc Natl Acad Sci U S A 113, 41464151.
64. van Dooren, C, Marinussen, M, Blonk, H et al. (2014) Exploring dietary guidelines based on ecological and nutritional values: a comparison of six dietary patterns. Food Policy 44, 3646.
65. Becerra-Tomas, N, Babio, N, Martinez-Gonzalez, MA et al. (2016) Replacing red meat and processed red meat for white meat, fish, legumes or eggs is associated with lower risk of incidence of metabolic syndrome. Clin Nutr 35, 14421449.
66. Calder, PC (2006) n-3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 83, 6 Suppl., 1505S1519S.
67. Sanchez-Villegas, A, Henriquez, P, Figueiras, A et al. (2007) Long chain omega-3 fatty acids intake, fish consumption and mental disorders in the SUN cohort study. Eur J Nutr 46, 337346.
68. Sociedad Española de Nutrición Comunitaria (2015) Pirámide de la Alimentación Saludable 2015. http://www.nutricioncomunitaria.org/es/noticia/piramide-de-la-alimentacion-saludable-senc-2015 (accessed September 2016).
69. Duchin, F (2005) Sustainable consumption of food: a framework for analyzing scenarios about changes in diets. J Ind Ecol 9, 99114.
70. Nelson, ME, Hamm, MW, Hu, FB et al. (2016) Alignment of healthy dietary patterns and environmental sustainability: a systematic review. Adv Nutr 7, 10051025.
71. Ruini, LF, Ciati, R, Pratesi, CA et al. (2015) Working toward healthy and sustainable diets: the ‘Double Pyramid Model’ developed by the Barilla Center for Food and Nutrition to raise awareness about the environmental and nutritional impact of foods. Front Nutr 2, 9.
72. Gonzalez, C & Garnett, T (2016) Plates, pyramids, planet. Developments in national healthy and sustainable dietary guidelines: a state of play assessment. http://www.fao.org/3/a-i5640e.pdf (accessed November 2016).
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Fresán et al. supplementary material
Fresán et al. supplementary material 1

 Word (20 KB)
20 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed