The True Costs of Food Database is the first publicly available database worldwide to apply a True Cost Accounting (TCA) approach, providing comprehensive data on the environmental and health impacts and hidden costs of food products consumed in the EU. The database contains information on over 2,000 food items, sourced from 81 countries. This Documentation and User Manual provides detailed information on the sources and methodologies used to construct the database, as well as guidance on how to work with the data. It describes how the database builds on existing sustainability data from Sustainability Assessment of Foods and Diets (SAFAD) to provide data on a range of production-related health and environmental impacts of food: greenhouse gas emissions, water consumption, marine eutrophication, freshwater eutrophication, ecosystem toxicity, human toxicity, and health damage from ammonia emissions. To calculate the true costs, it uses two established monetization approaches (the rights-based approach from True Price and the damage costs approach from CE Delft).