Table_1_Advancing an Integrative Framework to Evaluate Sustainability in National Dietary Guidelines.DOCX

The food system is responsible for some of society's most pressing sustainability challenges. Dietary guidelines are one policy tool to help address the multiple sustainability challenges associated with food systems through dietary recommendations that better support environmental and human well-being. This article develops and applies a sustainability framework scoring tool comprised of four key dimensions (environmental, economic, human health, and sociocultural and political) and 32 sub-dimensions of sustainable food systems for the analysis and modification of national dietary guidelines. Two coders pilot tested the framework to quantify the occurrence of sustainability dimensions and sub-dimensions in national and regional dietary guidelines of 12 randomly selected high-income and upper-middle income countries including Albania, Australia, Brazil, the Grenadines, Grenada, Qatar, Netherlands, Nordic Countries, St. Vincent, Sweden, Thailand, the United Kingdom, and the United States. Sustainability Dimension Scores (SDS) were calculated as a percentage of the occurrence of the eight sub-dimensions comprising each sustainability dimension and Total Sustainability Scores (TSS) were calculated as a percentage of the occurrence of the 32 sub-dimensions in each guideline. Inter-rater reliability of TSS and SDS indicated high validity of applying the sustainability framework for dietary guidelines. SDS varied between the four sustainability dimensions with human health being the most represented in the dietary guidelines examined, as hypothesized (average SDS score of 83%; range from 50 to 100%). Significant differences (p < 0.0001) were found in mean SDS between the four sustainability dimensions. Overall, results indicate that the ecological (average SDS score of 31%; range from 0 to 100%) economic (average SDS score of 29%; range from 0 to 100%), and socio-cultural and political (average SDS score of 44%; range of 0–100%) dimensions of sustainability are underrepresented in the examined national dietary guidelines with significant differences in SDS between guidelines (p < 0.0001). TSS varied by country between 12 and 74% with a mean score of 36% (± 20%). Brazil had the highest TSS (74%) followed by Australia (69%). The sustainability framework presented here can be applied by policy makers, researchers, and practitioners to identify gaps and opportunities to modify national dietary guidelines and associated programs for transforming food systems through diets that support planetary health.

食品系统是引发社会诸多紧迫可持续发展挑战的重要诱因之一。膳食指南（dietary guidelines）是一类政策工具，通过制定更有利于生态环境与人类健康福祉的膳食建议，助力应对食品系统关联的各类可持续发展挑战。本文构建并应用了一套可持续性框架评分工具，该工具包含四大核心维度（环境、经济、人类健康、社会文化与政治）以及可持续食品系统的32个子维度，用于分析和修订国家膳食指南。两名编码员对该框架进行了预测试，以量化12个随机选取的高收入及中高收入国家（包括阿尔巴尼亚、澳大利亚、巴西、格林纳丁斯、格林纳达、卡塔尔、荷兰、北欧国家、圣文森特、瑞典、泰国、英国以及美国）的国家和区域膳食指南中，可持续性维度与子维度的覆盖情况。可持续性维度得分（Sustainability Dimension Scores, SDS）以各可持续性维度所包含的8个子维度的覆盖占比计算得出；总可持续性得分（Total Sustainability Scores, TSS）则以每份指南中32个子维度的覆盖占比计算得出。TSS与SDS的评分者间信度结果表明，将该可持续性框架应用于膳食指南分析具有较高的有效性。如研究假设所示，四大可持续性维度的SDS存在显著差异，其中人类健康维度在被分析的膳食指南中覆盖度最高，其平均SDS得分为83%，分值区间为50%至100%。四大可持续性维度的平均SDS存在极显著差异（p < 0.0001）。整体结果显示，在所分析的国家膳食指南中，生态（对应环境维度，平均SDS得分为31%，分值区间为0至100%）、经济（平均SDS得分为29%，分值区间为0至100%）以及社会文化与政治（平均SDS得分为44%，分值区间为0至100%）维度的覆盖度不足，且不同指南间的SDS存在极显著差异（p < 0.0001）。各国的TSS分值区间为12%至74%，平均得分为36%（±20%）。巴西的TSS得分最高，为74%，其次为澳大利亚（69%）。本文提出的可持续性框架可供政策制定者、研究人员与从业者使用，以识别当前国家膳食指南及相关项目的不足与优化空间，助力通过支持行星健康的膳食模式转型食品系统。