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A global transformation towards sustainable food systems is crucial for delivering on climate change mitigation targets worldwide. In high- and middle-income settings, plant-based meat and dairy alternatives present potential substitutes for animal sourced foods, and a pathway to transition to more sustainable diets. We examined plant-based alternative foods (PBAF) consumption trends in the UK by analysing repeated cross-sectional food consumption data from the National Diet and Nutrition Survey 2008-2019. Dietary data for 15,655 individuals aged 1.5 years and over were analysed to assess aggregate change in intake of PBAF and six other food groups that play a role in transformative dietary change. Characteristics associated with consumption of PBAF were explored using logistic regression, and consumption patterns in high and low meat consumers were explored by examining intake of potential animal product substitute food groups. The proportion of individuals reporting consumption of any PBAFs increased from 6.7% in 2008-2011, to 13.1% in 2017-2019 (p < 0.01). Compared to 2008-2011 PBAF consumption rose by 115% in 2017-2019 (p < 0.01). Females were 46% more likely than males to report consumption of PBAF (p < 0.01). Millennials (age 24-39 years) were the most likely generation to report PBAF consumption (p < 0.01 compared to generation Z (age 11-23 years) and traditionalists (age 75+ years)), as were individuals of the highest income tertile (p < 0.01). Among "low meat consumers", PBAF consumption was on average higher than "high meat consumers" (18.6 g versus 4.8 g PBAF per day, p < 0.01). Our results support the hypothesis of a pivotal role of PBAF in the transition towards sustainable food systems in the UK, by demonstrating they are becoming increasingly popular among UK consumers. This highlights the urgent need to assess in detail the environmental and health impacts of large scale and population-wide consumption of PBAF in comparison to their animal-based equivalents., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: To assess the health impacts and environmental consequences of adherence to national dietary recommendations (the Eatwell Guide (EWG)) in the UK., Design and Setting: A secondary analysis of multiple observational studies in the UK., Participants: Adults from the European Prospective Investigation into Cancer - Oxford(EPIC-Oxford), UK Biobank and Million Women Study, and adults and children aged 5 and over from the National Diet and Nutrition Survey (NDNS).Primary and secondary outcome measures risk of total mortality from Cox proportional hazards regression models, total greenhouse gas emissions (GHGe) and blue water footprint (WF) associated with 'very low' (0-2 recommendations), 'low' (3-4 recommendations) or 'intermediate-to-high' (5-9 recommendations) adherence to EWG recommendations., Results: Less than 0.1% of the NDNS sample adhere to all nine EWG recommendations and 30.6% adhere to at least five recommendations. Compared with 'very low' adherence to EWG recommendations, 'intermediate-to-high adherence' was associated with a reduced risk of mortality (risk ratio (RR): 0.93; 99% CI: 0.90 to 0.97) and -1.6 kg CO 2 eq/day (95% CI: -1.5 to -1.8), or 30% lower dietary GHGe. Dietary WFs were similar across EWG adherence groups. Of the individual Eatwell guidelines, adherence to the recommendation on fruit and vegetable consumption was associated with the largest reduction in total mortality risk: an RR of 0.90 (99% CI: 0.88 to 0.93). Increased adherence to the recommendation on red and processed meat consumption was associated with the largest decrease in environmental footprints (-1.48 kg CO 2 eq/day, 95% CI: -1.79 to 1.18 for GHGe and -22.5 L/day, 95% CI: -22.7 to 22.3 for blue WF)., Conclusions: The health and environmental benefits of greater adherence to EWG recommendations support increased government efforts to encourage improved diets in the UK that are essential for the health of people and the planet in the Anthropocene., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)