Determining ecological sustainability of individual diets and plant-based diet patterns in childhood and adolescence, and their prospective associations with metabolic health in young adulthood: analyses in the DONALD Study (SusDietDONALD)

饮食对环境和健康的影响在当前关于地球健康的辩论中发挥着重要作用。基于植物的饮食模式由于其对温室气体排放（GHGE）和土地使用（LU）的影响较低以及其对慢性病预防的有利影响而变得越来越具有社会相关性。然而，人口中以植物为基础的饮食有很大的差异，这就要求探索个人饮食习惯的环境和健康联系，以支持为所需的社会转型而改变行为。 2019年初，EAT-Lancet委员会批准了一项根据环境目标制定的推荐饮食。食物摄入走廊的目的是提供所需的适应区域习惯。其他基于植物的饮食指数已经建立，区分健康和不健康的模式，侧重于人类健康方面。营养流行病学研究探索植物性饮食的变化及其与健康和环境影响的联系。关于后者，近年来将个人食物摄入量与GHGE和LU生态指标联系起来已变得可行。除了植物性饮食的总体模式之外，植物性肉类和牛奶替代品的使用也越来越受欢迎，尽管这种食品替代品的环境和健康效益尚不清楚。目前的项目将着手全面调查DONALD研究中以植物为基础的可持续饮食模式的变化。DONALD研究是一项正在进行的开放队列研究，包括儿童和青少年，随访至成年。本项目的分析将使用从2000年至今每年收集的约850名儿童和青少年的3天饮食记录。我们将分析报告的习惯饮食的可持续饮食指标GHGE和LU的变化，决定因素，性别差异，年龄和时间趋势。随后，我们将得出一个分化的食物模式最大化的变化，在GHGE和LU使用的方法减少秩回归。我们将通过调查与年轻人（心脏）代谢健康指标（例如脂质和炎症生物标志物，脂肪肝指数）的关联来分析这种模式与人类健康的相关性。我们将通过采用EAT-Lancet参考饮食以及“健康”和“不健康的植物性饮食”来比较环境影响和营养质量，从而补充这一探索性工作。最后，我们将调查在这种情况下，在研究参与者的饮食中使用乳制品和肉类替代食品。在唐纳德研究中，我们将重点关注儿童和青少年，这是建立营养行为和特定脆弱性的特别关注时期。凭借其独特的设计在德国，唐纳德研究提供了一个深入的探索研究问题。

Environmental and health impacts of diets play a significant role in the current debate about planetary health. Plant-based dietary patterns have become increasingly societally relevant due to their lower impact on greenhouse-gas emissions (GHGE) and land use (LU) as well as their favourable effects with respect to chronic disease prevention. However, there is considerable variation in plant-based diets in populations, which calls for exploration of environmental and health associations of individual dietary practices to support behaviour change for the societal transformation needed. Early in 2019 the EAT-Lancet commission endorsed a recommended diet which was developed drawing on environmental targets. The corridors of food intake were meant to offer the required adaptation to regional habits. Other plant-based dietary indices have been constructed differentiating healthful and unhealthful patterns focusing on the human health aspect. Nutritional epidemiological studies offer the exploration of variations in plant-based diets and their linkage to health and environmental impacts. With respect to the latter, linking individual food intakes with the ecological indicators GHGE and LU has become feasible in recent years. Next to the overall patterns of plant-based diets, the use of plant-based meat and milk alternatives is becoming increasingly popular, though the environmental and health benefits of such food alternatives as yet are unclear. The current project will set out to comprehensively investigate variation in plant-based, sustainable dietary patterns in the DONALD Study. The DONALD Study is an ongoing, open cohort study including children and adolescents with follow-up into adulthood. The analyses for the current project will use annually collected 3-day dietary records of about 850 children and adolescents from the year 2000 until today. We will analyse variation, determinants, sex differences, age and time trends of the sustainable diet indicators GHGE and LU of the habitual diets reported. Subsequently, we will derive a differentiated food pattern maximising variation in GHGE and LU using the method of reduced rank regression. We will analyse the human health relevance of this pattern by investigating associations with indicators of (cardio)metabolic health (e.g. lipid and inflammatory biomarkers, fatty liver indices) in young adulthood. We will complement this exploratory work by adopting the EAT-Lancet reference diet, and ‘healthful’ and ‘unhealthful plant-based diets’ to compare environmental impacts and nutritional quality. Finally, we will investigate the use of dairy and meat alternative food products in the study participants’ diets in this context. With the DONALD Study we will focus on childhood and adolescence, time periods of particular interest for establishing nutritional behaviour and with specific vulnerability. With its unique design in Germany, the DONALD Study offers an in depth exploration of the research questions.