4 What is a Healthy and Sustainable Dietary Pattern?
A healthy and sustainable dietary pattern looks different for different people and communities around the world. There is no one dietary pattern that is best for all. In the Glossary, we use the following definition from Food and Agriculture Organisation of the United Nations (FAO):
“Sustainable Diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimising natural and human resources.”
Sustainable dietary patterns focus on the consumption component of the food system. They contribute to and are supported by food system sustainability.
Learning Activities
4.1. Watch
Start by watching the two short videos below to explore what Healthy and Sustainable dietary patterns are (~5 minutes):
Transcript – Food and Health: A sustainable and balanced diet is good also for your health[PDF]
Interactive Video – Food & Health: a sustainable and balanced diet is good also for your health [1]
Healthy food choices that make balanced meals are often also Planet-friendly choices. But how to eat healthy and sustainably? Watch the video and discover the five top tips for a tasty, healthy, and Sustainable diet. This video is most relevant to individuals and families in industrialised, wealthy nations.
Note: This video makes generalisations about plants and animals. While it is true that the balance of plants and animals in our diets contributes to sustainable systems (or not), it is also the source of the food that determines if it is sustainable or not. We need to consider how foods were raised, processed, packaged, transported, and sold. One banana (or egg) can be sustainable, while another banana (or egg) is not sustainable. In the section below you will read about guiding principles for sustainable healthy dietary patterns that consider both People & the Planet.
Healthy Diets from Sustainable Food Systems for Children and All [2]
This video describes sustainable dietary patterns generally and talks about some global, population-level efforts for more sustainable dietary patterns. You can also read more in this Toolkit about the Coalition of Action on Healthy Diets from Sustainable Food Systems for Children and All (HDSFS), available online.
Transcript – Healthy Diets from Sustainable Food Systems for Children and All [PDF]
4.2. Read
The Food and Agriculture Organisation of the United Nations (FAO) has published a set of guiding principles that are helpful in understanding how to actualise sustainable dietary patterns, as described below. These were informed by experts representing nations of diverse income levels and cultural backgrounds. The full, 44-page report is included in the ‘Extend your learning’ section below. Read the summarised version below (~10 minutes).
In 2019, the FAO and the World Health Organisation (WHO) jointly organised an international expert consultation on sustainable healthy dietary patterns. Thirty-three experts representing low, middle, and high-income countries participated in the consultation. The objective of the meeting was to develop guiding principles around what constitutes sustainable, healthy dietary patterns. The guiding principles are food-based and take into account nutrient recommendations while considering environmental, social/cultural and economic sustainability.
Guiding principles of sustainable healthy dietary patterns.
… Regarding Human Health …
- Start early in life with early initiation of breastfeeding, exclusive breastfeeding until six months of age, and continued breastfeeding until two years and beyond, combined with appropriate complementary feeding.
- Are based on a great variety of unprocessed or minimally processed foods, balanced across food groups, while restricting highly processed food and drink products.
- Include wholegrains, legumes, nuts and an abundance and variety of fruits and vegetables.
- Can include moderate amounts of eggs, dairy, poultry, and fish; and small amounts of red meat.
- Include safe and clean drinking water as the fluid of choice.
- Are adequate (i.e. reaching but not exceeding needs) in energy and nutrients for growth and development, and to meet the needs for an active and healthy life across the lifecycle.
- Are consistent with WHO guidelines to reduce the risk of diet-related Non-Communicable Diseases (NCDs), and ensure health and wellbeing for the general population.
… Regarding Environmental Impact …
- Contain minimal levels, or none if possible, of pathogens, toxins and other agents that can cause foodborne disease.
- Maintain Greenhouse Gas (GHG) emissions, water and land use, nitrogen and phosphorus application, and chemical pollution within set targets.
- Preserve biodiversity, including that of crops, livestock, forest-derived foods and aquatic genetic resources, and avoid overfishing and overhunting.
- Minimise the use of antibiotics and hormones in food production.
- Minimise the use of plastics and derivatives in food packaging.
- Reduce food loss and waste.
… Regarding Socio-Cultural Aspects …
- Are built on and respect local culture, culinary practices, knowledge and consumption patterns, and values on how food is sourced, produced and consumed.
- Are accessible and desirable.
- Avoid adverse gender-related impacts, especially with regard to time allocation (e.g. for buying and preparing food, water and fuel acquisition).
The guiding principles are meant to be further translated into clear, non-technical information and messaging to be used by governments and other actors in policymaking and communications.
The guidelines take a holistic approach to diets; they consider international nutrition recommendations, the environmental cost of food production and consumption, and the adaptability to local social, cultural and economic contexts.
Countries should decide on the trade-offs according to their situations and goals.
4.3. Reflect
After reading this chapter and coming to the end of Part 1, reflect on the following questions (~15 minutes).
- Describe two to three important principles, or qualities, of a healthy and sustainable dietary pattern.*
- Provide some examples of healthy and sustainable dietary patterns that are relevant to your community. Explain using some examples of foods.*
- Can a healthy diet be a sustainable dietary pattern? Provide some examples of food patterns that are beneficial for both.*
- In what ways do you think a healthy and sustainable dietary pattern may differ across various communities and cultures around the world? Can you provide examples?*
- How do you balance your personal nutritional needs with the environmental and social considerations of a sustainable dietary pattern?*
4.4. Extend your Learning
If you wish to deepen your understanding, explore the following:
- Talk to colleagues about what they think sustainable dietary patterns would look like in your community.
- FAO’s Learning Academy offers a “Nutrition and Food Systems: Pathways to sustainable and healthy diets” course available online.
- For a more in-depth understanding of the guiding principles of a sustainable and healthy dietary patterns, please refer to the WHO and FAO report: Sustainable Healthy Diets: Guiding Principles, available online (44 pages).
- Check out the resources Food is Our Medicine — Nourish available online. This free course was designed to introduce Canadian healthcare professionals and leaders to new ways of understanding the complex relationships between Indigenous foodways, reconciliation, healing, and healthcare. It includes five learning modules, a recorded webinar series, and a digital resource library. The learning course is organised into seasonal learning modules: introductory, fall, winter, spring, and summer. The course is self-paced and typically takes 15 to 30 hours to complete.
- Read this document by the Food Climate Research Network (FCRN), Foodsource (now TABLE): What is a Healthy Sustainable Eating Pattern? available online (30 pages).
Congratulations on finishing Chapter 4!
Media Attributions
- Sustainable healthy diets title page & Guiding Principles for Sustainable Healthy Diets © World Health Organization, Food and Agriculture Organization of the United Nations is licensed under a CC BY-NC-SA (Attribution NonCommercial ShareAlike) license
- Fondazione Barilla. Food & Health: a sustainable and balanced diet is good also for your health. [Internet]. YouTube. 2021 [cited 2025 Jun 19]. Available from: https://www.youtube.com/watch?v=4n8bXqnXWq8 ↵
- EAT. Healthy Diets from Sustainable Food Systems for Children and All [Internet]. YouTube. 2021 [cited 2025 Jun 19]. Available from: https://www.youtube.com/watch?v=I_euV2ii1SE ↵
A term used in this report, and by Health Canada to describe processed or prepared foods and beverages that contribute to excess sodium, free sugars, or saturated fat, including foods such as processed meat, deep-fried foods, sugary breakfast cereals, biscuits and cake, confectioneries, sugary drinks, and many ready-to-heat packaged dishes (39). The term “Ultra Processed Foods” is similarly used by the FAO and WHO; these foods are generally made to be convenient, attractive (hyperpalatable), highly profitable (using cheap ingredients), and to displace other food groups; they are also marketed intensively. A Canadian study found that Ultra Processed Foods make up almost half of Canadians’ daily energy intake across all socio-economic groups, and almost 60% of energy intake among children aged 9 and over, and that the more ultra-processed foods are contained in diets, the poorer the overall nutritional quality. This shift in consumption patterns has been linked to the global rise in obesity rate. Most health professionals contend that they should be minimized or avoided in a healthy and sustainable diet. — Dietitians of Canada, 2020
There is not one clear definition of processed food. Processing can reference any kind change from its original form, such as cutting or mincing, or a particular type of preservation, such as canning or freezing. Some forms of processing can make very little difference to the nutritional content of a food, while others can fundamentally change the nutritional value, including by adding sugar, salt, fat or other additives. Some additives, such as vitamins and minerals, can have a positive impact (such as fortified flour used to produce bread).
Often, processing is described as a spectrum, with different levels of processing fitting into different categories. The NOVA classification from Monteiro and colleagues1 provides four broad groupings, with the advice to prioritise less processed foods and to avoid “Ultra-processed” foods (see groups 1-4 below). — BDA, 2018
This is only one possible means of defining processed foods and there are a number of alternatives. For much more on the issue of defining “Ultra-processed foods”, including some criticisms of this model, read the FRCN’s building block2 on this topic.
Group 1: Unprocessed or Minimally processed foods
Unprocessed foods are edible parts of plants or of animals and also fungi, algae and water, after separation from nature. Minimally processed foods are natural foods altered by processes such as removal of inedible or unwanted parts, drying, crushing, filtering, boiling, pasteurization, refrigeration, freezing or non-alcoholic fermentation.
Ex: Fresh, frozen, dried or squeezed fruit and vegetables; grains such as rice, corn, wheat or oats; meat, fish, eggs, milk, plain yoghurt; nuts, legumes, mushrooms; herbs and spices; tea, coffee, drinking water.
Group 2: Processed culinary ingredients
These are substances obtained directly from Group 1 foods or from nature by processes such as pressing, refining, grinding, milling, and spray drying. Group 2 items are rarely consumed in the absence of Group 1 foods.
Ex: Salt, refined sugar, vegetable or plant oils, honey, maple syrup, butter, lard, vinegar.
Group 3: Processed Foods
These are relatively simple products made by adding sugar, oil, salt or other Group 2 substances to Group 1 foods. Most processed foods have two or three ingredients. Processes include various preservation or cooking methods, and, in the case of breads and cheese, non-alcoholic fermentation.
Ex: Canned or bottled vegetables, fruits and legumes. Salted, cured or smoked meat, canned fish, cheeses and fresh made bread.
Group 4: Ultra- processed food and drink products
These are industrial formulations typically with five or more and usually many ingredients. Such ingredients often include those also used in processed foods, such as sugar, oils, fats, salt, anti-oxidants, stabilisers, and preservatives.
Ex: Carbonated drinks, confectionary, pre- packaged cakes, breads and biscuits, ice-cream, sausages etc. produced from “reconstituted” meat. Instant soups, slimming products etc.
“Climate change is caused [in large part] by the increase in concentrations of greenhouse gases in the atmosphere. These increases are primarily due to human activities such as the use of fossil fuels or agriculture…. Anthropogenic (human-made) greenhouse gas (GHG) emissions… include emissions for 7 greenhouse gases (carbon dioxide, methane, nitrous oxide, sulphur hexafluoride, perfluorocarbons, hydrofluorocarbons and nitrogen trifluoride).” — Dietitians of Canada, 2020
“Food loss refers to food that is intended for human consumption but, through poor functioning of the food production and supply system, is reduced in quantity or quality.” “Food waste refers to food for human consumption that is discarded (both edible and inedible parts) due to intentional behaviors. Food waste often refers to what occurs along the food chain from the retail store through to the point of intended consumption (p.2).” — Dietitians of Canada, 2020
