A cross-cultural study of sustainable nutrition and its environmental impact in Asia and Europe: A comparison of China and Germany

doi:10.1016/j.regsus.2024.100136

Abstract

Abstract:

Global challenges such as climate change, biodiversity loss, and health crises necessitate a shift towards sustainable diets. Incorporating sustainability into food-based dietary guidelines (FBDGs) is essential for this shift, and cultural considerations also play a vital role, as food culture significantly influences dietary habits. Considering that Asia and Europe exhibit distinct food cultures, tailored approaches are necessary. Additionally, countries face diverse nutritional challenges, ranging from malnutrition to diet-related diseases, and regional variation in environmental impact necessitates context-specific strategies. Achieving sustainable nutrition depends on understanding cultural influences and regional dynamics. This paper compares China’s and Germany’s dietary guidelines and dietary patterns and their impact on sustainability. It shows that Chinese and German FBDGs only slightly differ, despite the different eating cultures and habits of each country. Alone the recommended amounts for eggs and fish are considerably higher in China than in Germany. However, in both China and Germany, actual dietary patterns deviate from the dietary guidelines. In China, concomitant with economic growth and urbanization, a dietary shift towards increased consumption of animal products and decreased consumption of vegetables and cereals has been observed in the last decades, which has led to a decline in nutritional deficiencies but an increase in obesity and overweight. Obesity and overweight are also on the rise in Germany. A dietary shift could therefore also be beneficial for public health. While following the respective national guidelines would benefit the environment, alternative diets such as a plant-based diet offer even lower environmental footprint. Revising guidelines to prioritize sustainability in addition to health aspects while considering regional contexts and cultural preferences is recommended to foster sustainable eating habits globally. This approach is pivotal for promoting dietary shift towards sustainability on a global scale.

Key words: Food-based dietary guidelines(FBDGs), Dietary shift, Planetary health diet, Dietary patterns, Sustainable nutrition, Greenhouse gas(GHG) emission

Birgit Anika RUMPOLD, SUN Lingxiao, Nina LANGEN, YU Ruide. A cross-cultural study of sustainable nutrition and its environmental impact in Asia and Europe: A comparison of China and Germany[J]. Regional Sustainability, 2024, 5(2): 100136.

Figures/Tables 1

Table 1

Dietary guidelines for adults in global regions, China, and Germany."

Country/region	Dietary guideline	Key points and recommendations	Reference
Global	World Health Organization (WHO)	A healthy diet includes fruits, vegetables, legumes, nuts, and whole grains.	WHO (2020)
		Fresh fruits and vegetables in season: at least 400 g/d (5 portions).
		Maximum 50 g free sugar per day (10.0% of the total energy uptake).
		Less than 30.0% of the total energy from fat, less than 10.0% of the total energy from saturated fat, and less than 1.0% of total energy from trans fats.
		Less than 5 g of salt; salt should be iodized.
		Energy intake (calories) should be balanced with energy expenditure.
	EAT-Lancet Commission’s planetary health diet in 2019	Whole grains: 232 g/d.	Willett et al. (2019)
		Tubers and starchy vegetables: 50 g/d (0-100 g/d).
		Vegetables: 300 g/d (200-600 g/d).
		Fruits: 200 g/d (100-300 g/d).
		Dairy foods: 250 g milk equivalents per day (a unit used to convert cheese and other dairy products into the equivalent quantity of milk) (0-500 g/d).
		Beef and lamb: 7 g/d (0-14 g/d).
		Pork: 7 g/d (0-14 g/d).
		Poultry: 29 g/d (0-58 g/d).
		Eggs: 13 g/d (0-25 g/d).
		Fish: 28 g/d (0-100 g/d).
		Legumes (dry beans, lentils, and peas): 50 g/d (0-100 g/d).
		Soybean foods: 25 g/d (0-50 g/d).
		Peanuts: 25 g/d (0-75 g/d).
		Tree nuts: 25 g/d.
		Unsaturated oils: 40 g/d (20-80 g/d).
		Palm oil maximum: 7 g/d and no dairy fats.
		Lard and tallow maximum: 5 g/d.
		Added sugars maximum: 31 g/d.
		Overconsumption is considered a waste of food with both health and environmental costs.
China	Dietary Guidelines for Chinese Residents in 2016	1. Eating a variety of foods in a cereal-based diet (cereals and tubers 250-400 g/d, including 50-150 g/d of whole grains and legumes, and 50-100 g/d of tubers).	Chinese Center for Disease Control and Prevention (2022)
		2. Be active to maintain a healthy body weight (6000 steps/d and 150 min of moderate-level physical activities per week).
		3. Consuming plenty of vegetables, milk and dairy products, and soybeans (300-500 g/d of vegetables, 200-350 g/d of fruits, and milk and dairy products: 300 g milk equivalents per day, 25 g/d of soybean, and nuts in moderate quantities).
		4. Eating moderate amounts of fish, poultry, eggs, and lean meat (40-75 g/d of fish and seafood, 40-50 g/d of eggs, and 40-75 g/d of meat and poultry).
		5. Limiting salt, cooking oil, added sugar, and alcohol (daily maximum amounts: 6 g of salt, 25-30 g of cooking oil, 25-50 g of added sugar, 2 g of trans fatty acids, 7-8 cups of fluids, 1600-1800 mL/d of water, and alcohol 15 g for women and 25 g for men).
		6. Developing healthy dietary habits and avoiding food waste (avoiding waste at each stage from harvest and transport to the storage, preparation, and consumption of food; and learning to read food labels to make healthy and informed food choices).
Country/region	Dietary guideline	Key points and recommendations	Reference
China	Dietary Guidelines for Chinese Residents in 2022	1. Eating diversified and balanced meals (a total daily intake 200-300 g of cereals, including 50-150 g/d of grains and legumes and 50-100 g/d of tubers).	Chinese Center for Disease Control and Prevention (2022)
		2. Balancing eating and exercise to maintain a healthy body weight (6000 steps/d and 150 min of moderate-level physical activities per week).
		3. Eating plenty of vegetables, fruits, dairy products, whole grains, and soybeans (300-500 g/d of vegetables, 200-350 g/d of fresh fruits, 300 g/d of milk equivalent, and soy and grain products daily).
		4. Enjoying fish, poultry, eggs, and lean meat (120-200 g/d: 300-500 g/week of fish, 300-350 g/week of eggs, and 300-500 g/week of poultry and meat).
		5. Limiting intake of table salt, cooking oil, added sugar, and alcohol (maximum amounts: 5 g/d of salt, 25-30 g/d of cooking oil, 25 g/d of sugar, 2 g/d of trans fatty acids, and 15 g/d of alcohol).
		6. Keeping a regular diet and drink enough water (water: 1700 mL/d for men and 1500 mL/d for women) and drinking tea or water instead of sugary drinks.
		7. Learning to read food labels and choosing food wisely.
		8. Developing healthy dietary habits and avoiding food waste.
Germany	Ten guidelines of German Nutrition Society (DGE) for a wholesome diet in 2017	1. Enjoying food diversity.	Jungvogel et al. (2016); DGE (2017a, b)
		2. Vegetables and fruits: 5 portions/d (3 portions/d (400 g/d) of vegetables and 2 portions/d (250 g/d) of fruits).
		3. Favoring whole-grain foods (30 g/d of fibers, 200-300 g/d or 150-250 g/d of bread, 50-60 g/d of cereal flakes, 200-250 g/d of cooked potatoes or noodles, and 150-180 g/d of cooked rice).
		4. Completing the choice with animal-based foods (200-250 g/d of milk and dairy products and 2 slices/d (50-60 g/d) of cheese, 150-220 g/week of fish, 300-600 g/week of meat, and maximum of 3 eggs per week).
		5. Choosing health-promoting fats (prefer vegetable oils: 10-15 g/d of oil and 15-30 g/d of butter or margarine).
		6. Reducing sugar and salt intake (salt less than 6 g/d).
		7. Water is the best choice (water of 1500 mL/d, zero sugar-sweetened and alcoholic beverages, and maximum 10 g/d of alcohol for women and 20 g/d of alcohol for men).
		8. Preparing carefully cooked dishes (cook as long as necessary and as short as possible to preserve nutrients and taste).
		9. Mindful eating and enjoying (eating slowly since the feeling of satiety sets in 15-20 min after the start of the meal).
		10. Watching weight and staying active (30-60 min/d of moderate-level physical activities).

Table 1

References 56

[1]	Amilien V., Notaker H., 2018. Health and nutritional perspectives on nordic food traditions—An approach through food culture and history. In: AndersenV., BarE., WirtanenG., (eds.). Nutritional and Health Aspects of Food in Nordic Countries. Salt Lake City: Academic Press, 1-31.
[2]	Breidenassel C., Schäfer A.C., Melanie M., et al., 2022. The Planetary Health Diet in contrast to the food-based dietary guidelines of the German Nutrition Society (DGE). A DGE statement. Nutr. Rev. 69(5), 56-72.
[3]	Chinese Center for Disease Control and Prevention, 2022. Eight key recommendations from Dietary Guidelines for Chinese Residents (2022). [2023-12-08]. https://en.chinacdc.cn/health_topics/nutrition_health/202206/t20220616_259702.html.
[4]	Davis K.F., Gephart J.A., Emery K.A., et al., 2016. Meeting future food demand with current agricultural resources. Glob. Environ. Change. 39, 125-132.
[5]	Dawczynski C., Weidauer T., Richert C., et al., 2022. Nutrient intake and nutrition status in vegetarians and vegans in comparison to omnivores-the Nutritional Evaluation (NuEva) study. Front. Nutr. 9, 819106, doi: 10.3389/fnut.2022.819106.
[6]	European Commission, 2023a. Food-Based Dietary Guidelines-Guidance on Sustainability. [2023-12-08]. https://knowledge4policy.ec.europa.eu/health-promotion-knowledge-gateway/food-based-dietary-guidelines-europe-table-19_en.
[7]	European Commission, 2023b. Towards Sustainable Food Consumption-Promoting Healthy, Affordable and Sustainable Food Consumption Choices. Brussels: Publications Office of the European Union, 1-84.
[8]	FAO (Food and Agricultural Organization of the United Nations), 2013.Food Wastage Footprint: Impacts on Natural Resources. Rome: FAO, 6.
[9]	FAOSTAT(World Food and Agriculture Organization Statistical Database), 2023. Food and Agriculture Data. [2023-12-29]. https://www.fao.org/faostat/en/#data.
[10]	Fischer C.G., Garnett T., 2016. Plates, Pyramids, and Planets: Developments in National Healthy and Sustainable Dietary Guidelines: A State of Play Assessment. Rome: FAO, 2-3, 15.
[11]	Gao C., Xu J., Liu Y., et al., 2021. Nutrition Policy and Healthy China 2030 Building. Eur. J. Clin. Nutr. 75(2), 238-246. doi: 10.1038/s41430-020-00765-6 pmid: 33219269
[12]	DGE(German Nutrition Society), 2016. 13^th DGE-Nutrition Report:Summary. [2023-12-29]. https://www.dge.de/fileadmin/dok/english/DGE-Nutrition-Report-summary-2016.pdf.
[13]	DGE, 2017a. 10 Guidelines of the German Nutrition Society (DGE) for a Wholesome Diet. [2023-11-07]. https://www.dge.de/fileadmin/dok/english/10-guidelines/10-guidelines-wholesome-diet-dge.pdf.
[14]	DGE, 2017b. Eatin and Drinking Wholesomely according to the 10 Rules of the DGE. [2023-12-16]. https://www.dge.de/gesunde-ernaehrung/dgeernaehrungsempfehlungen/10-regeln/.
[15]	DGE, 2023. Food-Related Dietary Recommendations of the DGE (FBDG)-Revision and Further Development. [2023-12-12]. https://www.dge.de/wissenschaft/fbdg/.
[16]	Halpern B.S., Frazier M., Verstaen J., et al., 2022. The environmental footprint of global food production. Nat. Sustain. 5(12), 1027-1039.
[17]	He P., Baiocchi G., Feng K., et al., 2019. Environmental impacts of dietary quality improvement in China. J. Environ. Manage. 240, 518-526. doi: S0301-4797(19)30415-3 pmid: 30999146
[18]	Hedegaard L., 2016. Food culture in obesity prevention Europe. European Journal of Public Health. 26(4), 536-537. doi: 10.1093/eurpub/ckw048 pmid: 27060595
[19]	Heuer T., Krems C., Moon K., et al., 2015. Food consumption of adults in Germany: results of the German National Nutrition Survey II based on diet history interviews. The British Journal of Nutrition. 113(10), 1603-1614. doi: 10.1017/S0007114515000744 pmid: 25866161
[20]	Huang L.N., Wang Z.H., Wang H.J., et al., 2021. Nutrition transition and related health challenges over decades in China. Eur. J. Clin. Nutr. 75(2), 247-252.
[21]	IPCC (Intergovernmental Panel on Climate Change), 2019. Climate Change and Land: An IPCC Special Report on Climate Change, Desertification, Land Degradation, Sustainable Land Management, Food Security, and Greenhouse Gas Fluxes in Terrestrial Ecosystems. [2024-02-16]. https://www.ipcc.ch/srccl/.
[22]	Jiang Q.Q., You Q.Q., Lou Y.L., et al., 2022. Adherence to the Chinese Food Pagoda in the high-risk population of non-communicable diseases aged 35-59 in central China. Front. Nutr. 9, 781963, doi: 10.3389/fnut.2022.781963.
[23]	Jungvogel A., Michel M., Bechtholdt A., et al., 2016. The food-related nutritional recommendations of the DGE. Nutr. Rev. 8, 474-481.
[24]	Kabisch S., Wenschuh S., Buccellato P., et al., 2021. Affordability of different isocaloric healthy diets in Germany-An assessment of food prices for seven distinct food patterns. Nutrients. 13(9), doi: 10.3390/nu13093037.
[25]	Klapp A.-L., Feil N., Risius A., 2022. A global analysis of National Dietary Guidelines on plant-based diets and substitutions for animal-based foods. Curr. Dev. Nutr. 6(11), nzac144, doi: 10.1093/cdn/nzac144.
[26]	Lei L., Shimokawa S., 2020. Promoting dietary guidelines and environmental sustainability in China. China Econ. Rev. 59, 101087, doi: 10.1016/j.chieco.2017.08.001.
[27]	Li H.M., Wu T., Wang X., et al., 2016. The greenhouse gas footprint of China’s food system: An analysis of recent trends and future scenarios. J. Ind. Ecol. 20(4), 803-817.
[28]	Li J.J., Song G.B., Ma S.M., et al, 2020. Dietary acculturation generates virtual carbon flow: The overlaid effects of geographically varied dietary patterns and population migration in urban and materials-flowing China. J. Clean Prod. 276, 124283, doi: 10.1016/j.jclepro.2020.124283.
[29]	Meier T., Christen O., 2013. Environmental impacts of dietary recommendations and dietary styles: Germany as an example. Environ. Sci. Technol. 47(2), 877-888.
[30]	Popkin B.M., 2014. Synthesis and implications: China’s nutrition transition in the context of changes across other low- and middle-income countries. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity. 15(Suppl 1), 60-67.
[31]	Renner B., Arens-Azevêdo U., Watzl B., et al., 2021. DGE position statement on a more sustainable diet. Nutr. Rev. 68(7), 144-154.
[32]	Ritchie H., Rosado P., Roser M., 2022. Environmental Impacts of Food Production. [2024-02-16]. https://ourworldindata.org/environmental-impacts-of-food.
[33]	Schäfer A.C., Schmidt A., Bechthold A., et al., 2021. Integration of various dimensions in food-based dietary guidelines via mathematical approaches: report of a DGE/FENS Workshop in Bonn, Germany, 23-24 September 2019. Br. J. Nutr. 126(6), 942-949.
[34]	Song G.B., Li M.J., Fullana-I-Palmer P., et al., 2017. Dietary changes to mitigate climate change and benefit public health in China. Sci. Total Environ. 577, 289-298.
[35]	Song G.B., Gao X.B., Fullana-I-Palmer P., et al., 2019. Shift from feeding to sustainably nourishing urban China: A crossing-disciplinary methodology for global environment-food-health nexus. Sci. Total Environ. 647, 716-724.
[36]	Springmann M., Godfray H.C.J., Rayner M., et al., 2016. Analysis and valuation of the health and climate change cobenefits of dietary change. Proc. Natl. Acad. Sci. U. S. A. 113(15), 4146-4151.
[37]	Springmann M., Clark M. A., Mason-D’Croz D., et al., 2018. Options for keeping the food system within environmental limits. Nature. 562(7728), 519-525.
[38]	Springmann M., Clark M.A., Rayner M., et al., 2021. The global and regional costs of healthy and sustainable dietary patterns: a modelling study. Lancet Planet. Health. 5(11), e797-e807.
[39]	Su B., Zhang C., Martens P., et al., 2022. A comparative study on the dietary ecological footprint in contemporary China. Sci. Total Environ. 8512, 158289, doi: 10.1016/j.scitotenv.2022.158289.
[40]	Sun Z.X., Scherer L., Tukker A., et al., 2022. Dietary change in high-income nations alone can lead to substantial double climate dividend. Nat. Food. 3(1), 29-37. doi: 10.1038/s43016-021-00431-5 pmid: 37118487
[41]	Textor C., 2024. Degree of Urbanization in China in Selected Years from 1980 to 2023. [2024-01-30]. https://www.statista.com/statistics/270162/urbanization-in-china/.
[42]	Tilman D., Clark M., Williams D.R., et al., 2017. Future threats to biodiversity and pathways to their prevention. Nature. 546(7656), 73-81.
[43]	Vermeulen S.J., Campbell B.M., Ingram J.S., 2012. Climate change and food systems. Annu. Rev. Environ. Resour. 37(1), 195-222.
[44]	Wang L., Gao B., Hu Y.C., et al., 2020. Environmental effects of sustainability-oriented diet transition in China. Resour. Conserv. Recycl. 158, 104802, doi: 10.1016/j.resconrec.2020.104802.
[45]	Wang L., Huang W., Zhao C., et al., 2022. Exploring the environment-nutrition-obesity effects associated with food consumption in different groups in China. J. Environ. Manage. 317, 115287, doi: 10.1016/j.jenvman.2022.115287.
[46]	WHO(World Health Organization), 1998. Preparation and Use of Food-Based Dietary Guidelines: Report of a Joint FAO/WHO Consultation. [2023-12-27]. https://www.who.int/publications/i/item/9241208805.
[47]	WHO, 2020. Healthy Det. [2023-12-27]. https://www.who.int/news-room/fact-sheets/detail/healthy-diet.
[48]	Willett W., Rockström J., Loken B., et al., 2019. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet. 393(10170), 447-492. doi: S0140-6736(18)31788-4 pmid: 30660336
[49]	Wirsam J., Leitzmann C., 2022. Measuring nutrition:our diet in annotated figures and data. Stuttgart: Verlag Eugen Ulmer, 448-449.
[50]	Wood A., Queiroz C., Deutsch L., et al., 2023. Reframing the local- global food systems debate through a resilience lens. Nat. Food. 4(1), 22-29.
[51]	Wu H.J., MacDonald G.K., Galloway J.N., et al., 2022. A new dietary guideline balancing sustainability and nutrition for China’s rural and urban residents. iScience. 25(10), 105048, doi: 10.1016/j.isci.2022.105048.
[52]	Yang Y.X., Wang X.L., Leong P.M., et al., 2018. New Chinese dietary guidelines: healthy eating patterns and food-based dietary recommendations. Asia Pac. J. Clin. Nutr. 27(4), 908-913. doi: 10.6133/apjcn.072018.03 pmid: 30045438
[53]	Yin J.G., Hua J.F., Zhang X.H., et al., 2023. Healthy Eating for All? The challenge of adhering to dietary guidelines for low-income groups in China. Nutrients. 15(12), doi: 10.3390/nu15122704.
[54]	Yu Y., Feng K., Hubacek K., et al., 2016. Global implications of China’s future food consumption. J. Ind. Ecol. 20(3), 593-602.
[55]	Zhang C.L., Qiang W.L., Niu S.W., et al., 2021. Options of Chinese dietary pattern based on multi-objective optimization. Agricultural and Food Sciences, Environmental Science. 43(6), 1140-1152 (in Chinese).
[56]	Zhu C.W., Kobayashi K., Loladze I., et al., 2018. Carbon dioxide (CO₂)levels this century will alter the protein, micronutrients, and vitamin content of rice grains with potential health consequences for the poorest rice-dependent countries. Sci. Adv. 4(5), eaaq1012, doi: 10.1126/sciadv.aaq1012.