Introducing menus of three weekly insect- or plant-based dinner meals slightly reduced meat consumption in Danish families: Results of a randomized intervention study.

The environmental concerns associated with excess meat consumption have emphasized the need for sustainable alternatives. Edible insects offer a promising alternative due to their environmental efficiency and nutritious profile, but their widespread adoption in Western diets remains a challenge. The objective of the study was to investigate the impact of exposing families (parents and children) to insect-based or plant-based dinner menus on dietary pattern, meat intake, and protein intake over a six-week intervention period. The study was a two-arm randomized equivalence trial comparing an insect-based menu to a plant-based control. Families received either an insect or plant-based menu to replace meat in dinner meals three times a week for six weeks, aiming to replace 20% of their meat protein intake. Dietary changes were assessed through dietary registrations and daily questionnaires. Both adults and children maintained their estimated daily total protein intake, while reducing daily meat protein intake. Neither group met the 20% weekly meat replacement goal. In the insect-based menu group, adults and children reached an average 5.5% and 2.3% weekly meat replacement, respectively. In the plant-based menu group, adults and children replaced 9.0% and 4.3%, respectively. Meat attachment had an effect on meat protein intake. The menus slightly reduced meat protein intake. The weekly frequency of meat meals slightly declined, but portions remained the same. By enhancing insect and plant-based food quality and understanding consumer behavior, insect- and plant-based products have the potential to be a complementary alternative in a sustainable dietary transition without sacrificing nutrition. CLINICAL TRIAL REGISTRY: ClinicalTrials.gov: NCT05156853; clinicaltrials. gov/study/NCT05156853.

Meat and dairy consumption in Scottish adults: insights from a national survey.

BACKGROUND: Reducing meat and dairy consumption has been advocated for environmental benefits. This study aimed to better understand meat and dairy consumption in a population with high intakes. METHODS: Dietary data were obtained from up to two online 24-h dietary recalls of adults (≥16 years) in the 2021 Scottish Health Survey, a nationally representative, repeated cross-sectional survey. The contribution of food groups to meat and dairy intake and the nutritional contributions of meat and milk products to intake of 28 nutrients were examined. Weighted mean (95% confidence interval [CI]) daily intakes were reported per capita, overall, and by demographic subgroups (age, gender and Scottish Index of Multiple Deprivation). RESULTS: Mean daily intakes of total meat and dairy were 80.4 g (95% CI 77.1-83.7) and 238.6 g (95% CI 228.9-248.3) per capita, respectively. Chicken dishes, beef dishes and sandwiches were the primary contributors to meat intake, together accounting for 56.1% of meat consumed. Liquid milk accounted for 63.4% of the dairy consumed. Meat products were an important source of selenium and zinc (accounting for 26% and 25% of intake, respectively), whereas milk products were an important source of calcium (34%), iodine (38%) and vitamin A (25%). CONCLUSIONS: Although meat and dairy consumption in Scotland is high, a number of food groups contributed to meat intake, providing several opportunities to target for a reduction in line with climate change ambitions. However, careful attention is required for replacements to ensure Scottish diets are nutritionally adequate.

Validity and reliability of the Sustainable HEalthy Diet (SHED) index by comparison with EAT-Lancet diet, Mediterranean diet in Turkish adults.

Background: Food consumption and diet are strongly associated with sustainability. The Sustainable HEalthy Diet index was developed to measure the nutritional, environmental, and sociocultural components of sustainable diets and healthy eating patterns. However, a methodological approach has yet to be proposed for Turkish adults. This study aimed to determine the validity and reliability of the SHED index in Turkish adults. Methods: Data were collected from 558 healthy adults using a web-based questionnaire. Internal consistency reliability was evaluated using Cronbach's alpha coefficient, and repeatability was evaluated using the test-retest method. Construct validity was investigated using the EAT-Lancet diet and the Mediterranean Diet Adherence Screener (MEDAS), and the adapted SHED index structures' accordance was evaluated with confirmatory factor analysis. Results: Good reliability and repeatability were found (r = 0.758 and 0.795, respectively). A higher SHED index score was related to a greater intake of grains, fruits, and vegetables and a lower intake of meat, eggs, and dairy compared to EAT-Lancet diet food groups. A higher SHED index score was associated with a lower saturated fat and added sugar intake. While the SHED index was associated with greater adherence to the Mediterranean diet (r = 0.334, p < 0.001), it was negatively associated with non-alcoholic and diet non-alcoholic beverage consumption (r = -0.257 and -0.264, respectively; p < 0.001). Conclusion: The SHED index showed good validity and reliability in Turkish adults. Our results suggest that the SHED index can be used in epidemiological and intervention studies because it allows the measurement of diets in terms of health and sustainability to propose adaptations accordingly.

The EAT-Lancet diet associated cardiovascular health parameters: evidence from a Brazilian study.

BACKGROUND: The EAT-Lancet diet is a diet aimed at promoting population and planetary health from the perspective of sustainable diets in terms of environmental and health aspects. This study aimed to assess the association between adherence to the EAT-Lancet diet and cardiometabolic risk factors among adults and elderly individuals in a capital city in the northeastern region of Brazil. METHODS: This is an analytical cross-sectional observational study from a population-based sample conducted between 2019 and 2020, involving 398 non-institutionalized adults and elderly people, of both sexes from "Brazilian Usual Consumption Assessment" study (Brazuca-Natal). There was a 38% response rate due to the suspension of data collection due to the covid-19 pandemic, but According to the comparative analysis of socioeconomic and demographic variables between the surveyed and non-surveyed sectors, losses were found to be random (p = 0.135, Little's MCAR test). Socioeconomic and lifestyle data, anthropometric measurements, and dietary consumption were collected. We used the Planetary Health Diet Index (PHDI) and the Cardiovascular Health Diet Index (CHDI) for cardiovascular health to assess adherence to the diet's sustainability. The evaluated cardiometabolic parameters included fasting blood glucose, triglycerides, total cholesterol, HDL-C, LDL-C, and systolic and diastolic blood pressure measurements. We also assessed the presence of type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. For the data analyses, sample weights and the effect of the study design were taken into account. Pearson's chi-square test was used to evaluate the statistical significance of frequencies. Multiple linear regression models assessed the associations between PHDI and CHDI and its components and the cardiometabolic parameters. RESULTS: The mean PHDI was 29.4 (95% CI 28.04:30.81), on a total score ranging from 0 to 150 points and the mean CHDI was 32.63 (95% CI 31.50:33.78), on a total score ranging from 0 to 110 points. PHDI showed a significant positive association with the final CHDI score and components of fruits, vegetables, and legumes, and a negative association with Ultra-processed Food (UPF) (p < 0.05). Notably, among the most consumed UPF, the following stand out: "packaged snacks, shoestring potatoes, and crackers" (16.94%), followed by margarine (14.14%). The PHDI exhibited a significant association with diabetes and dyslipidemia, as well as with systolic blood pressure, total cholesterol, and LDL-C. CONCLUSIONS: The results suggest that adopting the EAT-Lancet diet is associated with the improvement of key cardiovascular health indicators.

Food choice, activity level, and carbon footprint: exploring potential for sustainable food consumption practices in young adults.

This study aims to explore climate consciousness in relation to food consumption in young adults, examining its relationship with physical activity level and gender. A mixed-method approach is utilized, integrating seven-day food records and semi-structured interviews, employing social practice theory in our analytical framework. Our cohort of 47 participants (25 women, 22 men) displays varied diets, from omnivores to vegans. Moderately-active women show the lowest carbon footprint, favoring climate-conscious choices related to lower energy needs and plant-based preferences. Highly-active individuals consume more energy, resulting in a higher carbon footprint. Gender differences are evident, women were inclined to climate-conscious food practices motivated by animal ethics and health concerns. Conversely, men demonstrated a tendency for meat consumption. Participants share an understanding of carbon footprint, reflecting a solid awareness of food-related climate impact but differ in priorities; performance for highly-active, and economy for moderately-active. This highlights a mix of commonalities and distinctions, informing flexible, sustainable food practices. Higher activity levels are linked to greater energy needs and a higher carbon footprint. Moderately-active women show the most climate-conscious food choices, leading to the lowest carbon footprint. Our findings indicate that highly-active individuals and men have significant potential to improve climate-adapted food consumption.

Effects of public policy interventions for environmentally sustainable food consumption: a systematic map of available evidence.

BACKGROUND: The global food system is inflicting substantial environmental harm, necessitating a shift towards more environmentally sustainable food consumption practices. Policy interventions, for example, information campaigns, taxes and subsidies and changes in the choice context are essential to stimulate sustainable change, but their effectiveness in achieving environmental goals remains inadequately understood. Existing literature lacks a comprehensive synthesis of evidence on the role of public policies in promoting sustainable food consumption. Our systematic map addressed this gap by collecting and categorising research evidence on public policy interventions aimed at establishing environmentally sustainable food consumption patterns, in order to answer the primary research question: What evidence exists on the effects of public policy interventions for achieving environmentally sustainable food consumption? METHODS: Searches for relevant records (in English) were performed in WoS, Scopus, ASSIA, ProQuest Dissertation and Theses, EconLit, Google Scholar and in bibliographies of relevant reviews. A grey literature search was also performed on 28 specialist websites (searches were made in the original language of the webpages and publications in English, Swedish, Danish and Norwegian were eligible) and Google Scholar (search in English). Screening was performed at title/abstract and full-text levels, with machine learning-aided priority screening at title/abstract level. Eligibility criteria encompassed settings, interventions (public policies on sustainable food consumption), target groups and outcomes. No critical appraisal of study validity was conducted. Data coding covered bibliographic details, study characteristics, intervention types and outcomes. Evidence was categorised into intervention types and subcategories. Visual representation utilised bar plots, diagrams, heatmaps and an evidence atlas. This produced a comprehensive overview of effects of public policy interventions on sustainable food consumption patterns. REVIEW FINDINGS: The evidence base included 227 articles (267 interventions), with 92% of studies in high-income countries and only 4% in low-income countries. Quantitative studies dominated (83%), followed by mixed methods (16%) and qualitative studies (1%). Most interventions were information-based and 50% of reviewed studies looked at labels. Information campaigns/education interventions constituted 10% of the sample, and menu design changes and restriction/editing of choice context 8% each. Market-based interventions represented 13% of total interventions, of which two-thirds were taxes. Administrative interventions were rare (< 1%). Proxies for environmental impact (85%) were more frequent outcome measures than direct impacts (15%). Animal-source food consumption was commonly used (19%) for effects of interventions on, for example, greenhouse gas emissions. Most studies used stated preferences (61%) to evaluate interventions. CONCLUSIONS: The literature assessing policies for sustainable food consumption is dominated by studies on non-intrusive policy instruments; labels, information campaigns, menu design changes and editing choice contexts. There is a strong need for research on sustainable food policies to leave the lab and enter the real world, which will require support and cooperation of public and private sector stakeholders. Impact evaluations of large-scale interventions require scaling-up of available research funding and stronger multidisciplinary research, including collaborations with industry and other societal actors. Future research in this field should also go beyond the European and North American context, to obtain evidence on how to counteract increasing environmental pressures from food consumption worldwide.

Thailand - how far are we from achieving a healthy and sustainable diet? A longitudinal ecological study.

Background: Newly industrialized countries like Thailand have been influenced by globalization, westernization, and urbanization over the last decades, leading to changes in dietary habits as well as food production. Consequences of these changes include rising non-communicable diseases (NCDs) and environmental degradation, which are defined as the leading global challenges today. The objectives of this study are to identify Thailand's dietary changes, considering health and sustainability aspects, and to determine correlations between these changes and NCD cases as well as environmental impacts (GHG emissions, land-, nitrogen-, phosphorus-use). In this way, diet-related adjustments can be identified to promote planetary and human health. Methods: In this longitudinal ecological study, relative differences between the average food consumption in Thailand and the reference values of a healthy and sustainable diet, the Planetary Health Diet (PHD), were calculated. Furthermore, a bivariate correlation analysis was conducted, using data, based on Food and Agriculture Organization's (FAO's) data, results from the Global Burden of Disease Study (GBD), and PHD's reference values. Findings: The consumption quantities of meat, eggs, saturated oils, and sugar increased significantly since 1961. The food groups, that have exceeded PHD's upper reference values, include sugar (+452%), red meat (+220%), grains (+143%), saturated oils (+20%) and eggs (+19%), while vegetables (-63%), and unsaturated oils (-61%) have fallen below PHD's lower limits. Concerning the bivariate correlation analyses, all investigated variables show significant correlations. The most significant correlations were found in NCD cases (r = 0.903, 95% CI 0.804-0.953), nitrogen use (r = 0.872, 95% CI 0.794-0.922), and land use (r = 0.870, 95% CI 0.791-0.921), followed by phosphorus use (r = 0.832, 95% CI 0.733-0.897), and green-house gas (GHG) emissions (r = 0.479, 95% CI 0.15-0.712). Interpretation: The results show, that the determined differences of unhealthy or unsustainable food groups have increased concurrently with NCD cases and environmental impacts over the last decades in Thailand. A shift towards a reduced intake of sugar, red meat, grains, saturated oils and eggs along with an increase in vegetables and unsaturated oils, might support environmental and human health. Funding: None.

Disaggregation of Dairy in Composite Foods in the United Kingdom.

Dairy, especially cheese, is associated with high levels of greenhouse gas emissions. Accurate estimates of dairy consumption are therefore important for monitoring dietary transition targets. Previous studies found that disaggregating the meat out of composite foods significantly impacts estimates of meat consumption. Our objective was to determine whether disaggregating the dairy out of composite foods impacts estimates of dairy consumption in Scotland. Approximately 32% of foods in the UK Nutrient Databank contain some dairy. In the 2021 Scottish Health Survey, mean daily intakes of dairy with and without disaggregation of composite foods were 238.6 and 218.4 g, respectively. This translates into an 8% underestimation of dairy consumption when not accounting for dairy in composite foods. In particular, milk was underestimated by 7% and cheese and butter by 50%, whereas yogurt was overestimated by 15% and cream by 79%. Failing to disaggregate dairy from composite foods may underestimate dairy consumption.

Can micronutrient requirements be met by diets from sustainable sources: outcomes of dietary modelling studies using diet optimization.

BACKGROUND: Consumption of diets from sustainable sources is required for planetary health, however, large sections of the population, including females of reproductive age and children, will be at risk of not meeting their micronutrient (MN) requirements in a complete transition to plant-based foods. Constrained diet optimization methods use mathematical programming to construct diets that meet predefined parameters and may contribute towards modelling dietary solutions that meet nutritional and planetary targets. OBJECTIVE: Review the evidence from diet optimization studies proposing solutions to ensure MN availability in the context of a transition to diets from sustainable sources. APPROACH: Narrative review focusing on literature published over the last five years. RESULTS: Dietary modelling using diet optimization can design a range of omnivorous and plant-based diets that meet individual MN requirements, have reduced environmental impacts, and minimize deviation from culturally acceptable dietary practices. Using data from large-scale dietary surveys, diet optimization can support development of food-based dietary guidelines; identify limiting MNs in a particular context or a conflict between constraints e.g. nutrition and environment; explore food-based strategies to increase nutrient supply, such as fortification; and support trial design. Methods used and outcomes reported are sources of variability. Individual-level dietary data and MN requirements for population sub-groups such as females of reproductive age and children are important requirements. Although maintaining iron and zinc intakes are regularly reported to present challenges in diets from sustainable sources, few studies have considered bioavailability, which reduces with increased dietary phytate. These and other data gaps including acceptability and affordability must be addressed to improve the applicability of modelling outcomes in population recommendations. CONCLUSIONS: Dietary modelling using diet optimization can be useful in the design of more sustainable diets that meet MN requirements, however, translation of outcomes into dietary intervention studies is required to test real-world application and adoption into dietary guidelines.

A widespread shift towards plant-based diets could increase the risk of inadequate intakes of micronutrients typically sourced in foods of animal origin, particularly among females of reproductive age and children.Modelling of dietary intake data collected among individuals using techniques such as diet optimization could be helpful in guiding recommendations and intervention strategies; translation into intervention studies is required.Representative data in different population groups and settings, with methods incorporated to address data gaps on bioavailability of micronutrients, food fortification, and affordability, will improve the applicability of modelling outcomes.

Green hospitals: Mitigating water footprint and greenhouse gas emissions through sustainable menu planning in Turkish state university hospitals.

Considering the importance of sustainable nutrition, it is important that hospitals' meal menus are planned to ensure the lowest possible environmental footprint. In this study, we aimed to evaluate the environmental effects of hospital menus and the changes that may occur when these menus are planned according to the Turkey Dietary Guidelines and Mediterranean diet recommendations. In this context, first, the yearly environmental footprints of the standard meal menus of the state university hospitals in Turkey (n = 42), including water footprint (WF) and greenhouse gas emission (GHGE) values, were determined. Second, changes in the environmental footprint as a result of arranging the standard meal menus of state university hospitals according to the Turkey Dietary Guidelines and Mediterranean nutritional models were evaluated. It was determined that the average WF and GHGE values of hospital menus were 137,280 ± 18537.2 L/month and 140.0 ± 18.4 kg CO2-eq/month, respectively. Adjusting state university hospitals' standard meal menus according to Turkey Dietary Guidelines and Mediterranean nutritional models reduced WF by 24.8% to 103206.7 L/month and 37.8% to 85420.5 L/month, and GHGEs by 31.7% to 95.5 kg CO2-eq/month and 49% to 71.3 kg CO2-eq/month, respectively. In addition, it was determined that hospital meal menus planned according to the Turkey Dietary Guidelines and the Mediterranean nutritional model contained lower saturated fat and cholesterol and higher dietary fiber. In conclusion, planning hospital menus according to the Turkey Dietary Guidelines and Mediterranean nutritional recommendations can reduce the environmental footprint of hospital food services.