Background Dietary patterns significantly impact climate change and morbidity, making transitions to sustainable diets urgent. Few studies explore repeated dietary measures collected over several years or variations across distinct consumer profiles characterized by sociodemographic and dietary patterns. Objective Our study aims to identify dietary trajectory profiles in French adults (2014–2022), assessing environmental, nutritional, and health outcomes. Methods Consumption data from 17,187 NutriNet-Santé cohort participants (52% women, average age 48y, SD = 16) were collected via food frequency questionnaires in 2014 (weighted to the French Census), 2018, and 2022. Dietary trajectory profiles were modeled using Group-based multi-trajectory modeling based on principal component analysis of energy-adjusted consumption data. Associations with environmental (greenhouse gas (GHG) emissions) and nutritional (adherence to French dietary guidelines, diet quality index) dimensions were assessed via multivariable mixed models. Health impacts were evaluated as Disability-Adjusted Life Years (DALYs)avoided, using the Comparative Risk Assessment approach. Results Six dietary trajectory profiles (P) with distinct starting diets and evolutions were identified. P0 had average intakes, while P1 and P5 were meat-focused, with P5 showing the highest animal consumption. P3 and P4 leaned plant-based, with P4 maintaining high fish and plant intakes, and P3 increasing ruminant meat. P2 initially high in salty or sweet fatty foods, shifted significantly toward plant-based diets. Over time, GHG emissions decreased (− 5% to − 14%), diet quality (PNNS-GS2 score) improved (+ 12% to + 174%), and health risks declined in four profiles due to reduced red meat and higher whole grains/fruits but increased for P4 and P5 due to processed meat. Conclusion These profiles reflect diverse population segments with distinct dietary profiles and degrees of sustainability improvements. However, significant advancements remain limited, highlighting the need for further research on economic, psychological, and cultural factors to guide sustainable changes. Trial Registration Trial registration number: NCT03335644. URL of registration: https://clinicaltrials.gov/study/NCT03335644?id=NCT03335644&rank=1
There is a current trend towards plant-based diets in Western countries. These diets have been associated with long-term health benefits but could limit the adequacy of some indispensable nutrients. Here, we estimated the nutritional risks and health benefits of consuming more plant-based diets. Based on the latest French representative survey (INCA3), we defined a subgroup of adults (representing 12% of the population) with more plant-based diets (“MORE-PB”), defined as having plant protein and plant energy intakes above the 80th percentile. In the MORE-PB and the rest of the population, we estimated prevalences of nutrient inadequacy and deficiency risk. We also assessed the nutrient quality of the diet using the PANDiet and SecDiet scoring systems. Finally, we evaluated the hypothetical burden of disease if the entire population were shifting to the MORE-PB, using a comparative risk assessment framework (EpiDiet). In MORE-PB, we found a lower prevalence of inadequacy for fiber (both sexes), vitamin C (male), vitamin B9 and potassium (female) and a higher prevalence for vitamins B2 and B12 (both sexes), vitamin B6 (male), and protein (female). No differences were found concerning the prevalences of deficiency risk. No significant differences were observed in the PANDiet and SECDiet scores in MORE-PB compared to the rest of the population. Regarding nutrient intakes related to long-term health, MORE-PB were less prone to exceeding upper limits for SFA but more prone to exceeding those for sugars and sodium. Shifting to a MORE-PB would benefit population health, with ~132,700 [~125,400–~140,000, 95% UI] Disability-Adjusted Life Years (DALYs) averted. The gain would be higher for males than females (~92,000 vs. ~40,700 DALYs averted) but related to the same main diseases (ischemic heart diseases, diabetes and colorectal cancer). The decreases in processed meat and SFA in the plant-based diet were among the main contributors to its benefits. Other significant contributors were higher nuts consumption and mediation by lower blood cholesterol in females and higher fruit consumption and fiber intake in males. Overall, although diet quality was suboptimal in MORE-PB, significant nutritional risks were limited, particularly concerning deficiency risk. In contrast, such diets would benefit the population’s long-term health.
#dataviz Leading causes of morbidity and mortality - visualized using packed circles. Circle size (area) corresponds to #DALYs.
Data: @ourworldindata @ourworldindata.org
Code: https://tinyurl.com/gbd-2021
Tools: Inspired from Yan Holtz's R Graph Gallery; {packcircles} #rstats