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Review: Can diets be healthy, sustainable, and equitable?

Image: National Institutes of Health, Fruit, Vegetables and Grain, Wikimedia Commons, Public domain
Image: National Institutes of Health, Fruit, Vegetables and Grain, Wikimedia Commons, Public domain

This paper reviews current dietary patterns and trends, examines their links with health, the environment and equity, and suggests how governments, industry and consumers can help to shift diets towards patterns that are beneficial to both people and the environment.

The paper finds that some of the leading causes of diet-related illness are diets high in sodium and diets low in whole grains, fruits, nuts and seeds, vegetables and seafood omega-3 fatty acids. It finds that, based on current trends, diets high in refined sugars, fats, oils, and meats are likely to contribute to large increases in greenhouse gas emissions and land clearance by 2050.

Regarding dietary equity - defined as “when everyone has access to a nutritious, affordable, and culturally acceptable diet” - the paper says that in high-income countries, poorer people are more likely to have diets that are “high in energy and low in nutrients”, leading to a greater risk of obesity and diet-related diseases. In low-income countries, poorer people are more likely to experience multiple forms of malnourishment, and richer people are more likely to be obese.

To make diets more equitable, healthy and sustainable, the paper suggests that many different interventions at different points in the food system are necessary, including changes to food environments that promote unhealthy diets, industry approaches, trade and subsidy policies that align better with healthy, sustainable diets, and consumer education. The authors stress that consumer choice should not be seen as the only way of changing diets, given the strong influence of systemic and social factors.




The purpose of this study was to review the evidence on global dietary intake and trends in dietary patterns over time and to examine associations between diets and health, environment, and equity.

Recent Findings

Diets now serve as a significant risk factor for the global burden of disease and death. Diet-related non-communicable disease and rising obesity are increasingly prevalent, affecting much of the global population. At the same time, the food system is producing food in ways that are not aligned with planetary health. Inequity restricts access to healthy diets and is associated with broad social determinants.


Current dietary patterns are increasingly unhealthy, unsustainable, and inequitable for many populations. Multi-pronged interventions are needed to address the impacts of diets in order to improve human and planetary well-being.



Fanzo, J. and Davis, C., 2019. Can Diets Be Healthy, Sustainable, and Equitable? Current obesity reports, pp.1-9.

Read the full paper here. See also the Foodsource building block What is the nutrition transition? and the article Affordability of the EAT–Lancet reference diet: a global analysis.

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