Food consumption in Europe is associated with increasing health- and environmental impacts and innovative interventions for healthy and sustainable eating are needed throughout the continent. These interventions need to be based on a solid, holistic understanding of the drivers and implications of dietary choices and dietary change. We contributed to this knowledge as we explored dietary patterns and dietary change in five European countries and investigated into the associated health- and environmental impacts. Based on 3833 observations from an online survey in Germany, France, Italy, England and Ireland, we first investigated into the drivers and barriers for dietary change using bivariate and multivariate methods. We then used individual dietary intake data to derive diet patterns and explore changes therein. Finally, we quantified the greenhouse gas emissions and the disability-adjusted-lifeyears of dietary choices- and changes. We found that increasing age was a major barrier for healthy and environmentally sustainable dietary change, because the propensity for dietary change, as well as the quality of a potential dietary change decreased with increasing age. Furthermore, our results showed that health concerns such as trying to eat healthier or losing weight were the key drivers for dietary change while environmental concerns and animal welfare were of higher relative importance in younger age groups. Additionally, we found that the experience of certain life events, a higher endowment and higher pro-environmental values were drivers for dietary change. Due to the higher likelihood of success and the higher likelihood of a beneficial dietary change, we suggest that public information campaigns should focus on younger age groups and put forward both, the health- and environmental aspects of food consumption. Furthermore, we derived nine dietary patterns, that widely differed in terms of environmental and health impacts. We found that detrimental health effects were mainly associated with the consumption of processed meats, alcohol, soda and sweets, while environmental impacts were mainly due to the consumption of animal-based products. Accordingly, we found that the most beneficial dietary changes for health and the environment were from a pattern high in meat products, to patterns high in plant-based foods. Interestingly, we found a small trend towards no-meat diets, which opposes the global trend towards higher meat consumption. Our results suggest that future dietary intervention strategies for healthy and sustainable eating should focus on promoting the substitution of animal-based products (particularly processed- and red meats) for plant-based foods such as fruits, vegetables, nuts and seeds. Lastly, we found the adherence to dietary patterns in our sample to be strongly associated with socioeconomic characteristics and that males with lower education, lower social status and lower physical activity levels were overrepresented in unhealthy and environmentally unsustainable eating patterns. For a maximum effect, we suggest that interventions should specifically target young-male specific eating patterns and consider those of lower socioeconomic status.