Estimating the nutrition- and environment-attributable human health burden of the Spanish food consumption vs. Spanish dietary guidelines

Abstract

Current dietary patterns in Spain contribute significantly to both chronic health burden and environmental degradation, which in turn has a health impact. Using disability-adjusted life years (DALYs) as a common metric, this study aimed to quantify and compare the dietary health burden among Spanish adults (referred to as nutDALYs) and the human health burden associated with the environmental impacts of food consumption (referred to as envDALYs). We analyzed current food consumption in Spain in 2022 and compared it with scenarios reflecting adherence to the 2022 Spanish Dietary Guidelines, and alternative, more plant-forward dietary guidelines. Their effects on morbidity and mortality were quantified through dietary comparative risk assessment (for nutDALY) and life cycle assessment (for envDALY). In 2022, Spanish adult diets were associated with 945,351 nutDALYs and 331,797 envDALYs, primarily driven by low intake of whole grains, fruits and legumes, and high consumption of red meat and ultra-processed foods. Adherence to the Spanish Dietary Guidelines could reduce nutDALYs by 78–96%, with further reductions under alternative, more plant-forward guidelines. These shifts would also improve nutritional adequacy, aligning intake with WHO recommendations—except for calcium and vitamin B12 in certain plant-based scenarios. Environmentally mediated health impacts showed more nuanced changes: compared to current diets, Spanish Dietary Guidelines adoption would reduce envDALYs by 3% to 27%, while alternative, more plant-forward guidelines would reduce envDALYs by up to 33%. This study underscores the dual potential of dietary transitions through sustainable dietary guidelines to improve direct and indirect human health, offering a realistic and inclusive pathway toward sustainable food systems.