ORIGINAL RESEARCH article
Front. Nutr.
Sec. Food Policy and Economics
This article is part of the Research TopicFrom Production to Consumption: Reshaping Life Cycles Toward Sustainable Dietary Patterns and Food SystemsView all 11 articles
The hidden costs of Dutch dietary choices: Quantifying the health and environmental costs attributable to suboptimal diets
Provisionally accepted
- 1National Institute for Public Health and the Environment (Netherlands), Bilthoven, Netherlands
- 2Vrije Universiteit Amsterdam Afdeling Gezondheidswetenschappen, Amsterdam, Netherlands
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Background: National dietary guidelines can help in promoting healthier and more sustainable dietary patterns. Although the potential benefits of adherence are well documented, observed adherence in the Netherlands remains suboptimal. Objective: This study estimated the annual hidden health and environmental costs associated with suboptimal dietary patterns, defined here as low adherence to the Dutch dietary guidelines. Methods: Adherence to the Dutch dietary guidelines was assessed using the Dutch Healthy Diet index 2015 (DHD15). Individuals in the lowest (Q1) and highest (Q5) quintiles of adherence were compared based on food consumption data from the Dutch National Food Consumption Survey (DNFCS) 2019–2021 among adults aged 20–79 years. Hidden health costs were estimated as productivity losses using the Human Capital Approach (HCA) for diet-related non-communicable diseases (NCDs), along with the economic valuation of disability-adjusted life years (DALYs). Environmental costs were calculated across six indicators, including greenhouse gas (GHG) emissions, terrestrial acidification, freshwater eutrophication, marine eutrophication, land use, and blue water consumption, and were monetised using environmental shadow prices. Results: Low adherence to dietary guidelines is associated with EUR 410 million in productivity losses, with DALY-related costs ranging from EUR 910 million to 1.8 billion. Low adherence imposes EUR 3.0 billion more in annual environmental costs compared to high adherence. Discussion: These results reinforce calls for policies and interventions that promote healthier eating patterns as a cost-effective means of reducing the hidden costs embedded in current dietary habits and transforming the agrifood system toward health and sustainability goals.
Keywords: dietary guidelines, externalities, health effects, hidden costs, impact assessment, Sustainable food consumption, true costaccounting
Received: 02 Dec 2025; Accepted: 23 Jan 2026.
Copyright: © 2026 Florencio, Hoekstra, Temme, Vellinga and de Wit. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: L. Jacky Florencio
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