The complementarity of nutrient density and disease burden for Nutritional Life Cycle Assessment

The triple burden of obesity, undernutrition and climate change calls for systemic action to find solutions that co-benefit human and planetary health. A Nutritional Life Cycle Assessment (nLCA) can be used as a tool to assess the health- and environmental impact of foods and guide a transition to healthy and sustainable diets. Thus far, nLCAs have used the nutrient content of foods to represent their health impact, whereas the disease risk linked to under- or overconsuming certain nutrients, foods or food groups has been largely underutilized. This study explored, for the Dutch diet, the correlation between an indicator for essential nutrient density and for the disease burden of individual food items, i.e., a Nutrient Rich Food index with 24 essential nutrients (NRF24) and the HEalth Nutritional Index (HENI), respectively. NRF24 and HENI scores were calculated for food items contained in the Dutch Food Composition database. A very weak correlation between NRF24 and HENI values confirmed that nutrient density and disease burden should be considered as complementary and thus, that a high nutrient density does not directly imply a low disease burden, and vice versa. Moreover, the direction and strength of the correlation was food group-dependent, with negative correlations between NRF24 and HENI mainly observed for animal-based products, with the exception of dairy. In addition, the correlations between the nutrition-based indicators and indicators for greenhouse gas emissions, land use and water use were mostly weak, which stresses the need to include health impact in traditional LCAs because foods with a high nutrient density and low disease burden can imply trade-offs due to high environmental impacts. We therefore conclude that multiple indicators for health and environmental impact should be considered side-by-side in nLCA to avoid the risk of missing important information and trade-offs when assessing the performance of individual food items for healthy and sustainable diets.