Limiting vs. diversifying patterns of recommendations for key protein sources emerging: A study on national food guides worldwide from a health and sustainability perspective

– A shift to a healthy and sustainable diet (as recommended by the EAT Lancet Commission) needs to have a strong societal legitimation. This makes it relevant to investigate to what extent countries are using their Food-Based Dietary Guidelines (FBDGs) in ways that can stimulate such a shift.. – Given the pivotal role of protein, we examined what patterns of protein-related recommendations are used to guide consumers and how these patterns are related to specific contexts and societal priorities of the countries. The analysis of data from 93 countries worldwide revealed two emerging patterns of recommendations. One pattern (found in a cluster of 23% of the countries) combined positive advice about key protein sources with limiting messages to reduce (or replace) the consumption of animal protein. The other pattern (found in a cluster of 24%) encouraged both animal and plant protein, thereby diversifying the set of protein sources, without negative advice on animal-based food sources. The two patterns of recommendations were differently associated with health and nutrition variables, including the countries’ level of animal protein supply (in particular, dairy) and the prevalence of overweight among adult men. For all stakeholders, it is of crucial importance to realize that an increasing number of countries in the world are moving into the direction of acknowledging and addressing the diet-health-environment nexus by adapting their patterns of recommendations for key protein sources. This study is the first that reveals patterns in recommendations with respect to protein sources by different nations worldwid