{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T21:19:00Z","timestamp":1783631940106,"version":"3.55.0"},"reference-count":64,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Policies encouraging shifts towards more plant-based diets can lead to shortfalls in micronutrients typically present in animal products (B-vitamins, vitamin D, calcium, iodine, iron, selenium, zinc, and long-chain omega-3 fatty acids). We modelled the effect of fortifying foods with these critical micronutrients, with the aim of achieving nutrition and sustainability goals, using food consumption data from Dutch adults (19\u201330 years). Three dietary scenarios were optimized for nutritional adequacy and 2030 greenhouse gas emissions (GHGE-2030) targets, respectively, with the fewest deviations from the baseline diet: (i) the current diet (mainly vitamin A- and D-fortified margarine, iodized bread, and some calcium- and vitamin D-fortified dairy alternatives and iron- and vitamin B12-fortified meat alternatives); (ii) all plant-based alternatives fortified with critical micronutrients; and (iii) fortified bread and oils. Optimizing the current diet for nutrition and GHGE-2030 targets reduced animal-to-plant protein ratios from ~65:35, to 33:67 (women) and 20:80 (men), but required major increases in legumes and plant-based alternatives. When fortifying all plant-based alternatives and, subsequently, bread and oil, smaller dietary changes were needed to achieve nutrition and GHGE-2030 targets. Fortifying food products with critical micronutrients, ideally with complementary education on plant-based foods, can facilitate the transition to healthier and more sustainable diets.<\/jats:p>","DOI":"10.3390\/nu15112473","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T02:00:19Z","timestamp":1685066419000},"page":"2473","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["The Potential of Food Fortification as an Enabler of More Environmentally Sustainable, Nutritionally Adequate Diets"],"prefix":"10.3390","volume":"15","author":[{"given":"Alessandra C.","family":"Grasso","sequence":"first","affiliation":[{"name":"Blonk Sustainability Tools, 2805 TD Gouda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia J. F.","family":"Besselink","sequence":"additional","affiliation":[{"name":"dsm-firmenich, Taste, Texture and Health, 2613 AX Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Tyszler","sequence":"additional","affiliation":[{"name":"Blonk Sustainability Tools, 2805 TD Gouda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9517-4617","authenticated-orcid":false,"given":"Maaike J.","family":"Bruins","sequence":"additional","affiliation":[{"name":"dsm-firmenich, Taste, Texture and Health, 2613 AX Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1038\/s43016-022-00588-7","article-title":"Global food systems transitions have enabled affordable diets but had less favourable outcomes for nutrition, environmental health, inclusion and equity","volume":"3","author":"Ambikapathi","year":"2022","journal-title":"Nat. Food"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1016\/S0140-6736(19)30041-8","article-title":"Health effects of dietary risks in 195 countries, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"393","author":"Afshin","year":"2019","journal-title":"Lancet"},{"key":"ref_3","unstructured":"Shukla, P.R., Skea, J., Calvo Buendia, E., Masson-Delmotte, V., P\u00f6rtner, H.O., Roberts, D.C., Zhai, P., Slade, R., Connors, S., and Van Diemen, R. (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, Intergovernmental Panel on Climate Change (IPCC)."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1126\/science.aaq0216","article-title":"Reducing food\u2019s environmental impacts through producers and consumers","volume":"360","author":"Poore","year":"2018","journal-title":"Science"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5751\/ES-09595-220408","article-title":"Agriculture production as a major driver of the Earth system exceeding planetary boundaries","volume":"22","author":"Campbell","year":"2017","journal-title":"Ecol. Soc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.jclepro.2019.04.054","article-title":"Biodiversity impacts due to food consumption in Europe","volume":"227","author":"Crenna","year":"2019","journal-title":"J. Clean. Prod."},{"key":"ref_7","unstructured":"Food and Agriculture Organization of the United Nations (FAO) (2022). The State of Food and Agriculture 2022. Leveraging Automation in Agriculture for Transforming Agrifood Systems, FAO."},{"key":"ref_8","unstructured":"World Health Organization (WHO) (2023, May 16). Obesity and Overweight Key Facts. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.worlddev.2018.08.011","article-title":"When food systems meet sustainability\u2014Current narratives and implications for actions","volume":"113","author":"Oosterveer","year":"2019","journal-title":"World Dev."},{"key":"ref_10","unstructured":"Intergovernmental Panel on Climate Change (IPCC) (2018). Global Warming of 1.5 \u00b0C: An IPCC Special Report on the Impacts of Global Warming of 1.5 \u00b0C above Pre-Industrial Levels and Related Global Greenhouse Gas Emission Pathways, in the Context of Strengthening the Global Response to the Threat of Climate Change, World Meteorological Organization."},{"key":"ref_11","unstructured":"European Commission (EC) (2023, May 16). The European Green Deal, Available online: https:\/\/www.eea.europa.eu\/policy-documents\/com-2019-640-final."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S0140-6736(18)31788-4","article-title":"Food in the Anthropocene: The EAT-Lancet Commission on healthy diets from sustainable food systems","volume":"393","author":"Willett","year":"2019","journal-title":"Lancet"},{"key":"ref_13","unstructured":"FMCG Gurus (2023, May 16). Meat & Plant-Based\u2014Global Report. Available online: https:\/\/fmcggurus.com\/reports\/fmcg-gurus-meat-plant-based-global-report-2022\/."},{"key":"ref_14","unstructured":"Food and Agriculture Organization of the United Nations (FAO) (2023). Contribution of Terrestrial Animal Source Food to Healthy Diets for Improved Nutrition and Health Outcomes, FAO."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Heerschop, S.N., Kanellopoulos, A., Biesbroek, S., and van\u2019t Veer, P. (2023). Shifting towards optimized healthy and sustainable Dutch diets: Impact on protein quality. Eur. J. Nutr., 1\u201314.","DOI":"10.1007\/s00394-023-03135-7"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Alessandrini, R., Brown, M.K., Pombo-Rodrigues, S., Bhageerutty, S., He, F.J., and MacGregor, G.A. (2021). Nutritional Quality of Plant-Based Meat Products Available in the UK: A Cross-Sectional Survey. Nutrients, 13.","DOI":"10.3390\/nu13124225"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"633S","DOI":"10.1093\/ajcn\/78.3.633S","article-title":"Bioavailability of iron, zinc, and other trace minerals from vegetarian diets","volume":"78","author":"Hunt","year":"2003","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Mayer Labba, I.C., Steinhausen, H., Almius, L., Bach Knudsen, K.E., and Sandberg, A.S. (2022). Nutritional composition and estimated iron and zinc bioavailability of meat substitutes available on the swedish market. Nutrients, 14.","DOI":"10.3390\/nu14193903"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e451","DOI":"10.1016\/S2542-5196(18)30206-7","article-title":"Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: A global modelling analysis with country-level detail","volume":"2","author":"Springmann","year":"2018","journal-title":"Lancet Planet Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1017\/S0029665109991868","article-title":"Plenary Lecture 3: Food and the planet: Nutritional dilemmas of greenhouse gas emission reductions through reduced intakes of meat and dairy foods","volume":"69","author":"Millward","year":"2010","journal-title":"Proc. Nutr. Soc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000456723","article-title":"Systematic review on n-3 and n-6 polyunsaturated fatty acid intake in European countries in light of the current recommendations\u2014focus on specific population groups","volume":"70","author":"Sioen","year":"2017","journal-title":"Ann. Nutr. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E10301","DOI":"10.1073\/pnas.1707322114","article-title":"Nutritional and greenhouse gas impacts of removing animals from US agriculture","volume":"114","author":"White","year":"2017","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.nutres.2015.12.016","article-title":"High compliance with dietary recommendations in a cohort of meat eaters, fish eaters, vegetarians, and vegans: Results from the European Prospective Investigation into Cancer and Nutrition-Oxford study","volume":"36","author":"Sobiecki","year":"2016","journal-title":"Nutr. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e233","DOI":"10.1016\/S2542-5196(23)00006-2","article-title":"Estimated micronutrient shortfalls of the EAT-Lancet planetary health diet","volume":"7","author":"Beal","year":"2023","journal-title":"Lancet Planet Health"},{"key":"ref_25","unstructured":"World Health Organization (WHO). Regional Office for Europe (2021). Plant-Based Diets and Their Impact on Health, Sustainability and the Environment: A Review of the Evidence, World Health Organization, Regional Office for Europe. WHO European Office for the Prevention and Control of Noncommunicable Diseases."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s00394-015-1079-7","article-title":"Micronutrient status and intake in omnivores, vegetarians and vegans in Switzerland","volume":"56","author":"Schupbach","year":"2017","journal-title":"Eur. J. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Elorinne, A.L., Alfthan, G., Erlund, I., Kivimaki, H., Paju, A., Salminen, I., Turpeinen, U., Voutilainen, S., and Laakso, J. (2016). Food and nutrient intake and nutritional status of finnish vegans and non-vegetarians. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0148235"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1016\/j.clnu.2020.11.035","article-title":"Intake and adequacy of the vegan diet. A systematic review of the evidence","volume":"40","author":"Bakaloudi","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1017\/S000711451200520X","article-title":"Plasma total homocysteine status of vegetarians compared with omnivores: A systematic review and meta-analysis","volume":"109","author":"Obersby","year":"2013","journal-title":"Br. J. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Selinger, E., Kuhn, T., Prochazkova, M., Andel, M., and Gojda, J. (2019). Vitamin B12 Deficiency Is Prevalent among Czech Vegans Who Do Not Use Vitamin B12 Supplements. Nutrients, 11.","DOI":"10.3390\/nu11123019"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.plipres.2016.05.001","article-title":"Global survey of the omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid in the blood stream of healthy adults","volume":"63","author":"Stark","year":"2016","journal-title":"Prog. Lipid Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.plefa.2009.05.013","article-title":"DHA status of vegetarians","volume":"81","author":"Sanders","year":"2009","journal-title":"Prostaglandins Leukot Essent Fat. Acids"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"61","DOI":"10.7812\/TPP\/12-085","article-title":"Nutritional update for physicians: Plant-based diets","volume":"17","author":"Tuso","year":"2013","journal-title":"Perm. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"761442","DOI":"10.3389\/fnut.2021.761442","article-title":"Proposed nutrient standards for plant-based beverages intended as milk alternatives","volume":"8","author":"Drewnowski","year":"2021","journal-title":"Front. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1177\/0884533610385707","article-title":"Nutrition concerns and health effects of vegetarian diets","volume":"25","author":"Craig","year":"2010","journal-title":"Nutr. Clin. Pract."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Mertens, E., Biesbroek, S., Dofkov\u00e1, M., Mistura, L., D\u2019Addezio, L., Turrini, A., Dubuisson, C., Havard, S., Trolle, E., and Geleijnse, J.M. (2020). Potential impact of meat replacers on nutrient quality and greenhouse gas emissions of diets in four European countries. Sustainability, 12.","DOI":"10.3390\/su12176838"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Tso, R., and Forde, C.G. (2021). Unintended consequences: Nutritional impact and potential pitfalls of switching from animal- to plant-based foods. Nutrients, 13.","DOI":"10.3390\/nu13082527"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Bruins, M.J., and Letinois, U. (2021). Adequate vitamin d intake cannot be achieved within carbon emission limits unless food is fortified: A simulation study. Nutrients, 13.","DOI":"10.3390\/nu13020592"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1093\/advances\/nmy049","article-title":"Mathematical optimization to explore tomorrow\u2019s sustainable diets: A narrative review","volume":"9","author":"Gazan","year":"2018","journal-title":"Adv. Nutr."},{"key":"ref_40","unstructured":"Blonk Sustainability Tools (2023, May 16). Optimeal. Available online: https:\/\/blonksustainability.nl\/tools\/optimeal."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1093\/ajcn\/nqaa217","article-title":"Future-proof and sustainable healthy diets based on current eating patterns in the Netherlands","volume":"112","author":"Broekema","year":"2020","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_42","unstructured":"van Rossum, C., Fransen, H., Verkaik-Kloosterman, J., Buurma-Rethans, E., and Ock\u00e9, M. (2011). Dutch National Food Consumption Survey 2007\u20132010: Diet of Children and Adults Aged 7 to 69 Years."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1017\/S1368980017000349","article-title":"Decreasing the overall environmental impact of the Dutch diet: How to find healthy and sustainable diets with limited changes","volume":"20","author":"Kramer","year":"2017","journal-title":"Public Health Nutr."},{"key":"ref_44","unstructured":"RIVM (National Institute for Public Health and the Environment) (2023, May 16). NEVO Online Version 2016\/5.0, Available online: https:\/\/www.rivm.nl\/documenten\/nevo-online-versie-50-2016-dat."},{"key":"ref_45","unstructured":"RIVM (National Institute for Public Health and the Environment) (2021, May 16). NEVO Online Version 2021\/7.0, Available online: https:\/\/nevo-online.rivm.nl\/Home\/En."},{"key":"ref_46","unstructured":"Health Council of the Netherlands (Gezondheidsraad) (2023, May 16). Guidelines for a Healthy Diet: 2006. (In Dutch), Available online: https:\/\/www.gezondheidsraad.nl\/documenten\/adviezen\/2006\/12\/18\/richtlijnen-goede-voeding-2006."},{"key":"ref_47","unstructured":"Health Council of the Netherlands (Gezondheidsraad) (2023, May 16). Dietary Reference Values for Vitamins and Minerals for Adults, Available online: https:\/\/www.healthcouncil.nl\/documents\/advisory-reports\/2018\/09\/18\/dietary-reference-values-for-vitamins-and-minerals-for-adults."},{"key":"ref_48","unstructured":"Health Council of the Netherlands (Gezondheidsraad) (2023, May 16). Dietary Reference Intakes: Energy, Proteins, Fats and Digestible Carbohydrates, Available online: https:\/\/www.healthcouncil.nl\/documents\/advisory-reports\/2001\/07\/18\/dietary-reference-intakes-energy-proteins-fats-and-digestible-carbohydrates."},{"key":"ref_49","unstructured":"Nordic Council of Ministers (2023, May 16). Nordic Nutrition Recommendations 2012: Integrating Nutrition And Physical Activity. Available online: https:\/\/www.norden.org\/en\/publication\/nordic-nutrition-recommendations-2012."},{"key":"ref_50","unstructured":"European Food Safety Authority (EFSA) (2023, May 16). Overview on Tolerable Upper Intake Levels as Derived by the Scientific Committee on Food (SCF) and the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA), Available online: https:\/\/www.efsa.europa.eu\/sites\/default\/files\/assets\/UL_Summary_tables.pdf."},{"key":"ref_51","unstructured":"Institute of Medicine (IOM) (2006). Dietary Reference Intakes: The Essential Guide to Nutrient Requirements, The National Academies Press."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1007\/s11367-016-1246-y","article-title":"ReCiPe 2016: A harmonized life cycle impact assessment method at midpoint and endpoint level Report I: Characterization","volume":"22","author":"Huijbregts","year":"2016","journal-title":"Int. J. Life Cycle Assess."},{"key":"ref_53","unstructured":"RIVM (National Institute for Public Health and the Environment) (2023, May 16). Environmental Impact of Foods, (In Dutch)."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2662","DOI":"10.1017\/S1368980016000653","article-title":"How low can dietary greenhouse gas emissions be reduced without impairing nutritional adequacy, affordability and acceptability of the diet? A modelling study to guide sustainable food choices","volume":"19","author":"Perignon","year":"2016","journal-title":"Public Health Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1007\/s00394-021-02757-z","article-title":"Contribution of fortified margarines and other plant-based fats to micronutrient intake in the Netherlands","volume":"61","author":"Nawijn","year":"2022","journal-title":"Eur. J. Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1017\/S1368980017000763","article-title":"Are more environmentally sustainable diets with less meat and dairy nutritionally adequate?","volume":"20","author":"Seves","year":"2017","journal-title":"Public Health Nutr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1017\/S1368980020003341","article-title":"Improving health and carbon footprints of European diets using a benchmarking approach","volume":"24","author":"Mertens","year":"2021","journal-title":"Public Health Nutr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1007\/s00394-023-03117-9","article-title":"Plant-based meat substitutes are useful for healthier dietary patterns when adequately formulated\u2014An optimization study in French adults (INCA3)","volume":"62","author":"Salome","year":"2023","journal-title":"Eur. J. Nutr."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"de Gavelle, E., Huneau, J.F., Bianchi, C.M., Verger, E.O., and Mariotti, F. (2017). Protein Adequacy Is Primarily a Matter of Protein Quantity, Not Quality: Modeling an Increase in Plant:Animal Protein Ratio in French Adults. Nutrients, 9.","DOI":"10.3390\/nu9121333"},{"key":"ref_60","unstructured":"(2023, May 16). Reluctant Gourmet: Bean Conversions. Available online: https:\/\/www.reluctantgourmet.com\/bean-conversions\/."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Eustachio Colombo, P., Elinder, L.S., Lindroos, A.K., and Parlesak, A. (2021). Designing nutritionally adequate and climate-friendly diets for omnivorous, pescatarian, vegetarian and vegan adolescents in sweden using linear optimization. Nutrients, 13.","DOI":"10.3390\/nu13082507"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"nzac144","DOI":"10.1093\/cdn\/nzac144","article-title":"A global analysis of national dietary guidelines on plant-based diets and substitutions for animal-based foods","volume":"6","author":"Klapp","year":"2022","journal-title":"Curr. Dev. Nutr."},{"key":"ref_63","unstructured":"Food and Agriculture Organization of the United Nations (FAO), and World Health Organization (WHO) (2023, May 16). Codex Alimentarius: General Standard for the Labelling of Prepackaged Foods CXS 1-1985 and Its Subsequent Revisions. Available online: https:\/\/www.fao.org\/fao-who-codexalimentarius\/codex-texts\/list-standards\/en\/."},{"key":"ref_64","unstructured":"(2023, May 16). Mintel: Global Market Research & Market Insight. Available online: www.mintel.com."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/11\/2473\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:42:23Z","timestamp":1760125343000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/11\/2473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,25]]},"references-count":64,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["nu15112473"],"URL":"https:\/\/doi.org\/10.3390\/nu15112473","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,25]]}}}