Examining sustainability in food-based dietary guidelines : an international comparison and systems thinking framework for sustainable dietary guideline development

International appeals from the United Nations and a growing group of nutrition, policy, and environmental science experts have called for integration of sustainability into national food policies. As of 2018, at least fifteen countries had sustainability considerations in their food-based dietary guidelines (FBDG) or supporting documentation, yet little scholarship has examined sustainability framing within these guidelines. This study therefore examined sustainability inclusion and framing in international FBDG. Qualitative content analysis was used to analyze FBDG distinguished by the UN as having considered sustainability. The aim of this study was to explore the sustainability inclusion process within international FBDG and to identify common elements regarding sustainability inclusion. Eleven documents used by 15 countries were analyzed. This content analysis revealed five main themes about the framing and inclusion of sustainability in international FBDG: i) explicit sustainability documents were recently published, and the process for inclusion varied with country context; ii) multiple sectors and myriad stakeholders contributed to guidelines, instilling broad interests and a wide conceptual framing; iii) sustainability was primarily framed through health and nutrition, yet other sustainability domains also emerged as salient; iv) the most explicit sustainability considerations were found in documents that are focused more on the context of eating, with less explicit focus on specific nutrients; and v) consistent main messages were revealed across explicit sustainability documents. Based on these analyses, a proposed framework was developed to examine how sustainability has been included in dietary guidelines. The analysis of FBDG documents informed the development of a framework adapted from existing literature on food policy. The resulting framework to assess the interconnected inclusion of sustainability concepts in FBDG has five core domains: health and nutrition, food security and agriculture, ...