@article{fdi:010077307,
  title = {{H}ow to meet nutritional recommendations and reduce diet environmental impact in the {M}editerranean region ? {A}n optimization study to identify more sustainable diets in {T}unisia},
  author = {{P}erignon, {M}. and {S}infort, {C}. and {E}l {A}ti, {J}. and {T}raissac, {P}ierre and {D}rogue, {S}. and {D}armon, {N}. and {A}miot, {M}. {J}. and {A}chir, {N}. and {A}louane, {L}. and {E}l {A}ti, {J}. and {B}ellagha, {S}. and {B}osc, {P}. {M}. and {B}roin, {M}. and {D}armon, {N}. and {D}huique-{M}eyer, {C}. and {D}op, {M}. {C}. and {D}rogue, {S}. and {D}ury, {S}. and {F}erchoui, {A}. and {G}aillard, {C}. and {G}hrabi, {Z}. and {J}acquet, {F}. and {K}ameli, {Y}ves and {K}efi, {F}. and {K}hamassi, {F}. and {K}esse-{G}uyot, {E}. and {L}airon, {D}. and {M}artin-{P}r{\'e}vel, {Y}ves and {M}ejean, {C}. and {M}ouquet {R}ivier, {C}laire and {N}joumi, {S}. and {P}adilla, {M}. and {P}erignon, {M}. and {S}infort, {C}. and {T}raissac, {P}ierre and {V}erger, {E}ric and {M}edina {S}tudy {G}rp},
  editor = {},
  language = {{ENG}},
  abstract = {{T}unisia is a typical country of the {M}editerranean region where high prevalence of overweight, obesity and noncommunicable diseases co-exist with some micronutrient deficiencies, and diet-related environmental issues must be addressed. {I}ndividual food choices may influence both health and environment. {T}he aim of this study was to identify diets that are nutritionally adequate, culturally acceptable, and with low environmental impact for {T}unisian adults. {I}ndividual dietary data from a national {T}unisian survey on food consumption (n = 7209, 35-70 years) and the national food composition table were used to estimate the food and nutritional content of the mean observed ({OBS}) diet. {T}he diet environmental impact was assessed through seven metrics: water deprivation, land-use, land-use potential impacts on biodiversity loss, erosion resistance, mechanical filtration, groundwater replenishment, and biotic production. {Q}uadratic optimization models were implemented to obtain diets that met the nutritional recommendations, and concomitantly respected increasingly stringent environmental constraints and minimized the departure from the {OBS} diet. {W}ithout environmental constraints, the nutritional recommendations were met by increasing the amount of dairy, starch and vegetables, and decreasing foods high in fat/salt/sugar ({HFSS}) and added fat. {C}ompared with the {OBS} diet, the environmental impact of this diet increased: + 32% for water deprivation and + 46-48% for land use and its impacts. {W}hen a moderate environmental impact reduction (<= 30%) was added to the nutritional constraints, the dietary changes at the food group level were similar to those required to reach nutritional adequacy, except for a progressive decrease in meat/fish/egg quantities. {A}nimal-based product contributions to the total energy and protein content were close or slightly lower than in {OBS} diet, but a redistribution of sources was required: less meat in favor of dairy, egg and fish products. {S}tronger reductions (>= 40%) required substantial changes that might compromise the optimized diet acceptability. {T}argeting a nutritionally adequate diet without considering its environmental impact might increase water deprivation, land use and its impacts on biodiversity and soil quality. {I}n {T}unisia, moving towards healthy diets with lower environmental impact relied more on redistributing the sources of animal-based products rather than on reducing their total contribution, together with a decrease of {HFSS} and added fats, and an increase of vegetables. {A}ctions to favor the adoption of such dietary changes by consumers should be explored to promote more sustainable diets in the {M}editerranean region.},
  keywords = {{N}utrition ; {S}ustainability ; {D}iet ; {O}ptimization ; {M}athematical programming ; {M}ulti-criteria analysis ; {T}unisia ; {W}ater footprint ; {B}iodiversity ; {L}and-use ; {F}ood consumption ; {D}ietary shifts ; {M}editerranean region ; {TUNISIE} ; {ZONE} {MEDITERRANEENNE}},
  booktitle = {},
  journal = {{G}lobal {F}ood {S}ecurity},
  volume = {23},
  numero = {},
  pages = {227--235},
  ISSN = {2211-9124},
  year = {2019},
  DOI = {10.1016/j.gfs.2019.07.006},
  URL = {https://www.documentation.ird.fr/hor/fdi:010077307},
}