Multiple environmental and nutritional effects of changing food consumption in urban and rural China

Driven by urbanization and increasing income, dietary changes are dramatic in China. Food consumption directly links environmental and human health, and an in-depth understanding on environment-health nexus is necessary to achieve their co-benefits. Previous studies mostly examine health outcomes through disease risks and premature deaths, overlooking the hidden hunger resulting from inadequate nutrients intakes. Here, we evaluated multiple dietary environmental and nutritional impacts as well as their linkages in urban and rural China for the period 1990-2020. The results showed that daily per capita water, land and carbon footprints are 1.25-1.61 m3, 1.67-2.23 g2, and 1.47-1.84 kg CO2eq. Fat, fiber and Ca were key nutrients influencing dietary nutritional quality. Dietary changes in China increased environmental effects, and increased intakes of both beneficial and restricted-intake nutrients. More importantly, adoption of Chinese Dietary Guidelines, Mediterranean diet, EAT-Lancet, WHO recommendations, and DASH dietary scenarios would increase environmental footprints by 33% and 48% on average compared with current urban and rural diets. It would improve nutritional quality, but increase intakes of restricted-intake nutrients. The complex trade-offs between dietary environmental and nutritional effects emphasize the need for formulating comprehensive dietary guidelines, and food waste reduction is a possible strategy for addressing the environment-health dilemma effectively.