Sustainable Plant-Based Diets in Children and Adolescents: Current Evidence on Metabolic Syndrome and Cardiometabolic...

This review summarizes current evidence on the role of plant-based and sustainable dietary patterns in relation to metabolic syndrome (MetS) during childhood and adolescence and examines how sustainability-oriented nutrition indices can be used to assess both health and environmental outcomes in younger populations, highlighting their potential role in supporting long-term metabolic health.

Childhood and adolescence are critical periods for establishing lifelong dietary behaviors and preventing metabolic and cardiovascular diseases. Well-planned plant-based diets, rich in fiber, antioxidants, and phytochemicals, are associated with improved glycemic control, lipid profiles, and body composition, thereby positively influencing key components of MetS. Beyond these metabolic benefits, plant-based diets are associated with lower environmental impacts, including reductions in greenhouse gas emissions and a decreased use of natural resources. Several dietary indices have been developed to evaluate these relationships in children and adolescents, including the Planetary Health Diet Index (PHDI and PHDI-C), the Mediterranean Diet Quality Index (KIDMED), the DASH diet index, and the Plant-Based Diet Index (PDI). However, most available studies are cross-sectional, and longitudinal or randomized controlled trials investigating causal associations between sustainable diets and metabolic health outcomes in youth remain limited. Current evidence suggests that plant-based, nutritionally adequate, and sustainable diets during childhood and adolescence may contribute to improved metabolic health, a lower risk of MetS, and healthy growth and development. Integrating sustainability concepts into nutrition policies, dietary guidelines, and educational programs may promote healthier dietary behaviors and increase awareness among children, adolescents, and their families. However, current evidence is largely based on cross-sectional studies, and well-designed longitudinal and intervention studies are needed to strengthen the evidence base and clarify causal relationships.