Korean Journal of Community Nutrition (대한지역사회영양학회지)

The Korean Society of Community Nutrition (대한지역사회영양학회)
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Sustainable diets: a scoping review and descriptive study of concept, measurement, and suggested methods for the development of Korean version

지속가능한 식이의 개념과 측정방법 및 한국형 식이 지수 개발을 위한 방안 모색: 주제범위 문헌고찰과 기술 연구

  • Sukyoung Jung (Biomedical Research Institute, Chungnam National University Hospital)
  • 정수경 (충남대학교병원 의생명연구원)
  • Received : 2023.12.26
  • Accepted : 2024.02.02
  • Published : 2024.02.29
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Abstract

Objectives: Transformation through a sustainable food system to provide healthy diets is essential for enhancing both human and planetary health. This study aimed to explain about sustainable diets and illustrate appropriate measurement of adherence to sustainable diets using a pre-existing index. Methods: For literature review, we used PubMed and Google Scholar databases by combining the search terms "development," "validation," "sustainable diet," "sustainable diet index," "planetary healthy diet," "EAT-Lancet diet," and "EAT-Lancet reference diet." For data presentation, we used data from National Health and Nutrition Examination Survey, 2017-2018, among adults aged 20 years and older (n = 3,920). Sustainable Diet Index-US (SDI-US), comprising four sub-indices corresponding to four dimensions of sustainable diets (nutritional quality, environmental impacts, affordability, and sociocultural practices), was calculated using data from 24-hour dietary recall interview, food expenditures, and food choices. A higher SDI-US score indicated greater adherence to sustainable diets (range: 4-20). This study also presented SDI-US scores according to the sociodemographic status. All analyses accounted for a complex survey design. Results: Of 148 papers, 16 were reviewed. Adherence to sustainable diets fell into 3 categories: EAT-Lancet reference diet-based (n = 8), Food and Agriculture Organization (FAO) definition-based (n = 4), and no specific guidelines but including the sustainability concept (n = 4). Importantly, FAO definition emphasizes on equal importance of four dimensions of diet (nutrition and health, economic, social and cultural, and environmental). The mean SDI-US score was 13 out of 20 points, and was higher in older, female, and highly educated adults than in their counterparts. Conclusions: This study highlighted that sustainable diets should be assessed using a multidimensional approach because of their complex nature. Currently, SDI can be a good option for operationalizing multidimensional sustainable diets. It is necessary to develop a Korean version of SDI through additional data collection, including environmental impact of food, food price, food budget, and use of ready-made products.

Keywords

Acknowledgement

I thank Dr. Cynthia L. Ogden (Adjunct Professor, The George Washington University Milken Institute School of Public Health and Branch Chief, National Center for Health Statistics, Centers for Disease Control and Prevention) for her in-depth guidance of the methodological accuracy of this paper.

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