Background: Current scientific literature suggests healthy dietary patterns may have less
environmental impact than current consumption patterns, but most of the studies rely on theoretical
modeling. The aim of this study was to assess the impact on resources (land, water, and energy)
use and greenhouse gas (GHG) emissions of healthy dietary patterns in a sample of Italian adults.
Methods: Participants (n = 1806) were recruited through random sampling in the city of Catania,
southern Italy. Dietary consumption was assessed through a validated food frequency questionnaire
(FFQ); dietary patterns were calculated through dietary scores. The specific environmental footprints
of food item production/processing were obtained from various available life-cycle assessments; a
sustainability score was created based on the impact of the four environmental components calculated.
Results: The contribution of major food groups to the environmental footprint showed that animal
products (dairy, egg, meat, and fish) represented more than half of the impact on GHG emissions and
energy requirements; meat products were the stronger contributors to GHG emissions and water
use, while dairy products to energy use, and cereals to land use. All patterns investigated, with
the exception of the Dietary Approach to Stop Hypertension (DASH), were linearly associated with
the sustainability score. Among the components, higher adherence to the Mediterranean diet and
Alternate Diet Quality Index (AHEI) was associated with lower GHG emissions, dietary quality
index-international (DQI-I) with land use, while Nordic diet with land and water use. Conclusions:
In conclusion, the adoption of healthy dietary patterns involves less use of natural resources and
GHG emissions, representing eco-friendlier options in Italian adults
