Metabolic and Environmental Benefits of Following the Healthy and Sustainable Dietary Recommendations for the Spanish Population: The AWHS Study

Gimeno-Ruiz, Sofía; Guallar-Castillón, Pilar; López-García, Esther; Torrijo-Belanche, Carolina; Muñoz-Cabrejas, Ainara; Morales-Suárez-Varela, María; Moreno-Franco, Belén

doi:10.3390/nu17233725

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Metabolic and Environmental Benefits of Following the Healthy and Sustainable Dietary Recommendations for the Spanish Population: The AWHS Study

by

Sofía Gimeno-Ruiz

¹

,

Pilar Guallar-Castillón

^2,3,4,*

,

Esther López-García

^2,3

,

Carolina Torrijo-Belanche

¹

,

Ainara Muñoz-Cabrejas

⁵

,

María Morales-Suárez-Varela

^6,7

and

Belén Moreno-Franco

^1,5,8

¹

Department of Preventive Medicine and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain

²

Instituto Madrileño de Estudios Avanzados en Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional Universidad Autónoma de Madrid + Consejo Superior de Investigaciones Científicas (CEI UAM + CSIC), 28049 Madrid, Spain

³

Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain

⁴

Department of Epidemiology, New York University School of Global Public Health, New York, NY 10003, USA

⁵

Instituto de Investigación Sanitaria Aragón, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain

⁶

Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, Universitat de València, 46100 Valencia, Spain

⁷

Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain

⁸

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain

^*

Author to whom correspondence should be addressed.

Nutrients 2025, 17(23), 3725; https://doi.org/10.3390/nu17233725

Submission received: 22 October 2025 / Revised: 24 November 2025 / Accepted: 26 November 2025 / Published: 27 November 2025

(This article belongs to the Topic The Link Between Dietary Patterns and Health Outcomes)

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Abstract

Background/Objectives: Emerging approaches aim to protect both human and environmental health. Therefore, we hypothesise that adherence to the Healthy and Sustainable Dietary Recommendations for the Spanish Population Index (HS-DRSI) is inversely associated with the occurrence of Metabolic Syndrome (MetS) and promotes environmental sustainability. Methods: A cross-sectional analysis was performed with 2286 middle-aged men, with no previous cardiovascular disease and belonging to the Aragon Workers’ Health Study (AWHS). Diet was collected with a 136-item food-frequency questionnaire. Adherence to the recommendation was assessed with the HS-DRSI, which assigns one point for each of 19 food categories. The National Cholesterol Education Programme-Adult Treatment Panel III (NCEP-ATP III) definition was used to define MetS. Logistic regressions were used to estimate the association between adherence to the HS-DRSI and presence of MetS. Environmental assessment was calculated based on the 2016 European database. Results: Higher adherence to the HS-DRSI was inversely associated with MetS and elevated waist circumference. The odds ratio (OR) of having MetS for participants in the highest (9–13 points) vs. lowest (1–5 points) quartile of adherence to the diet score was 0.72 (95% CI, 0.52–0.99) and the OR of elevated waist circumference was 0.69 (95% CI, 0.48–0.99), with consistent results per 1 SD increase (2 points). In addition, greenhouse gas emissions (GHGE) decreased progressively across adherence quartiles (from 6.10 to 5.70 kg CO₂-eq/day). Conclusions: Adherence to the HS-DRSI was associated with a lower risk of MetS and may contribute to lower GHGE production.

Keywords: dietary guidelines; sustainability; epidemiology; metabolic syndrome

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MDPI and ACS Style

Gimeno-Ruiz, S.; Guallar-Castillón, P.; López-García, E.; Torrijo-Belanche, C.; Muñoz-Cabrejas, A.; Morales-Suárez-Varela, M.; Moreno-Franco, B. Metabolic and Environmental Benefits of Following the Healthy and Sustainable Dietary Recommendations for the Spanish Population: The AWHS Study. Nutrients 2025, 17, 3725. https://doi.org/10.3390/nu17233725

AMA Style

Gimeno-Ruiz S, Guallar-Castillón P, López-García E, Torrijo-Belanche C, Muñoz-Cabrejas A, Morales-Suárez-Varela M, Moreno-Franco B. Metabolic and Environmental Benefits of Following the Healthy and Sustainable Dietary Recommendations for the Spanish Population: The AWHS Study. Nutrients. 2025; 17(23):3725. https://doi.org/10.3390/nu17233725

Chicago/Turabian Style

Gimeno-Ruiz, Sofía, Pilar Guallar-Castillón, Esther López-García, Carolina Torrijo-Belanche, Ainara Muñoz-Cabrejas, María Morales-Suárez-Varela, and Belén Moreno-Franco. 2025. "Metabolic and Environmental Benefits of Following the Healthy and Sustainable Dietary Recommendations for the Spanish Population: The AWHS Study" Nutrients 17, no. 23: 3725. https://doi.org/10.3390/nu17233725

APA Style

Gimeno-Ruiz, S., Guallar-Castillón, P., López-García, E., Torrijo-Belanche, C., Muñoz-Cabrejas, A., Morales-Suárez-Varela, M., & Moreno-Franco, B. (2025). Metabolic and Environmental Benefits of Following the Healthy and Sustainable Dietary Recommendations for the Spanish Population: The AWHS Study. Nutrients, 17(23), 3725. https://doi.org/10.3390/nu17233725

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Metabolic and Environmental Benefits of Following the Healthy and Sustainable Dietary Recommendations for the Spanish Population: The AWHS Study

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