Perspective: The Place of Milk, Yogurt, and Cheese in Sustainable Healthy Diets in France.

The 4 pillars of sustainable healthy diets are health, economics, society, and the environment. The place of milk, yogurt, and cheese in the sustainability framework was examined using publicly available government agency databases from France. Nutrient composition data came from CIQUAL (Centre d'Information sur la Qualité des Aliments). Data on greenhouse gas emissions (GHGE) and total environmental impact of foods came from Agribalyse. Data on food costs came from published reports. Dietary intakes came from the INCA 3 study (Étude Individuelle Nationale des Consommations Alimentaires) of French children (3-17 y, n = 1775) and adults (18-79 y, n = 2121). Two version of the Nutrient Rich Food Index (NRF6.3 and NRF9.3) were applied to protein foods and to milk, yogurt, and cheese. The NRF model is composed of 2 subscores NR and LIM. The protein component of NR was corrected for PDCAAS (Protein Digestibility-Corrected Amino Acid Score. The LIM component was based on saturated fat, added sugar, and sodium. Diet quality metrics were based on the ratio of nutrients to calories. Nutrient density scores for dairy spanned a wide range from skim milk to blue cheese. Based on Agribalyse data for France, milk and dairy were associated with lower GHGE and environmental cost than red meat and were closer to eggs and some plant proteins. The cost in euros per kilogram and per 100 kcal was lower than red meat but above eggs and legumes. Diet-level analyses showed that milk, yogurt, and cheese provided more nutrients than calories to the total diet, meeting the definition of nutrient-rich foods. Milk, yogurt, and especially cheese, with its rich culinary history, are integral components of the French diet. Dairy foods provide affordable nutrient density and have a relatively low impact on the environment.