Food production is a source of various pollutants in aquatic systems. For example, nutrients are lost from fertilized fields, and pathogens from livestock production. Water pollution may impact society and nature. Large-scale water pollution assessments, however, often focus on single pollutants and not on multiple pollutants simultaneously. This study draws lessons from air pollution control for large-scale water quality assessments, where multi-pollutant approaches are more common. To this end, we present a framework for future water pollution assessments searching for optimistic and optimal solutions. We argue that future studies could shift their focus to better account for societal and economic targets. Participatory approaches can help to ensure the feasibility of future solutions to reduce water pollution from food production.