Perspective: Nutrition Health Disparities Framework: A Model to Advance Health Equity.

Disparities in nutrition, such as poor diet quality and inadequate nutrient intake, arise from multiple factors and are related to adverse health outcomes such as obesity, diabetes, cardiovascular disease, and some cancers. The aim of the current perspective is to present a nutrition-centric socioecological framework that delineates determinants and factors that contribute to diet and nutrition-related disparities among disadvantaged populations. The Nutrition Health Disparities Framework (NHDF) describes the domains (biological, behavioral, physical/built environment, sociocultural environment, and healthcare system) that influence nutrition-related health disparities through the lens of each level of influence (that is, individual, interpersonal, community, and societal). On the basis of the scientific literature, the authors engaged in consensus decision making in selecting nutrition-related determinants of health within each domain and socioecological level when creating the NHDF. The framework identifies how neighborhood food availability and access (individual/built environment) intersect with cultural norms and practices (interpersonal/sociocultural environment) to influence dietary behaviors, exposures, and risk of diet-related diseases. In addition, the NHDF shows how factors such as genetic predisposition (individual/biology), family dietary practices (interpersonal/behavioral), and food marketing policies (societal) may impact the consumption of unhealthy foods and beverages and increase chronic disease risk. Family and peer norms (interpersonal/behavior) related to breastfeeding and early childhood nutrition interact with resource-poor environments such as lack of access to preventive healthcare settings (societal/healthcare system) and low usage of federal nutrition programs (societal/behavioral), which may increase risk of poor nutrition during childhood and food insecurity. The NHDF describes the synergistic interrelationships among factors at different levels of the socioecological model that influence nutrition-related outcomes and exacerbate health disparities. The framework is a useful resource for nutrition researchers, practitioners, food industry leaders, and policymakers interested in improving diet-related health outcomes and promoting health equity in diverse populations.

Integrating health, nutrition, and environmental impacts of foods: a life cycle impact assessment and modelling analysis of foods in Canada.

BACKGROUND: Given the urgency of transitioning towards sustainable nutrition, dietary shifts that provide co-benefits to human health and the environment are imperative. There is currently no database of the environmental impacts of foods that reflects Canada's unique geographical and agri-climatic context and regional inputs and emissions. To determine sustainable diets, harmonising nutritional considerations with environmental impacts is also essential for an equitable comparison of foods. We aimed to develop a Canadian Food Life Cycle Inventory database and a multidimensional index to enable a joint assessment of the health and environmental impacts of foods in Canada. METHODS: The Canadian Food Life Cycle Inventory database uses life cycle assessment methodology to evaluate environmental impacts. The datasets mirror Canada's food consumption patterns, averaging the spectrum of agricultural practices weighted by domestic production and import shares. The database is structured according to the nomenclature and categorisation of the Canadian Nutrient File. Environmental sustainability is assessed using a cradle-to-grave approach, including indicators such as greenhouse gas emissions, eutrophication, particulate matter, freshwater usage, land use, non-renewable energy consumption, and food loss and waste. Environmental impacts are quantified through an environmental impact score (EIS) assigned to each impact category for a given food. The EIS-nutrition (EIS-N) integrates the evaluation of nutritional quality with environmental impacts using Nutri-Score, a validated food nutrient-profiling tool. The EIS-N is modelled as a ratio of the EIS to the Nutri-Score values. FINDINGS: Preliminary results show the greatest environmental impacts for animal-based foods, particularly beef, in agreement with current literature. Foods with greater nutritional quality also generally show greater environmental sustainability, with some exceptions for particular impact categories. INTERPRETATION: The database and index have potential to serve as powerful tools to support researchers, policy makers, and consumers, harnessing big data to drive efficient food and climate solutions for systems transformation. FUNDING: Province of Ontario and University of Toronto, CIHR SMART Healthy Cities Training Platform, and University of Toronto's Temerty Faculty of Medicine.

Ecological momentary assessment of digital food and beverage marketing exposure and impact in young adults: A feasibility study.

Unhealthy food marketing is contributing to the obesity epidemic, but real-time insights into the mechanisms of this relationship are under-studied. Digital marketing is growing and following food and beverage (F&B) brands on social media is common, but measurement of exposure and impact of such marketing presents novel challenges. Thus, this study aimed to evaluate the feasibility of collecting data on exposure and impact of digital F&B marketing (DFM) using a smartphone-based ecological momentary assessment (EMA) methodology. We hypothesized that DFM-induced food cravings would vary based on whether (or not) participants engaged with F&B brands online. Participants were Singapore residents (n = 95, 21-40 years), recruited via telephone from an existing cohort. Participants were asked to upload screenshots of all sightings of online F&B marketing messages for seven days, and answer in-app contextual questions about sightings including whether any cravings were induced. Participants provided a total of 1310 uploads (median 9 per participant, Q1-Q3: 4-21) of F&B marketing messages, 27% of which were provided on Day 1, significantly more than on other days (P < 0.001). Followers of food/beverage brands on social media encountered 25.6 percentage points (95% CI 11.4, 39.7) more marketing messages that induced cravings than participants who were not followers. University education was also associated with more (18.1 percentage points; 95% CI 3.1, 33.1) encounters with marketing messages that induced cravings. It was practical and acceptable to participants to gather insights into digital F&B marketing exposure and impact using EMA in young adults, although a shorter study period is recommended in future studies. Followers of food and beverage brands on social media appear to be more prone to experience cravings after exposure to digital F&B marketing.

Wasted Food, Wasted Resources? A Critical Review of Environmental Impact Analysis of Food Loss and Waste Generation and Treatment.

Food loss and waste (FLW) comes with significant environmental impacts and thus prevents a sustainable food system transition. Here we conducted a systematic review of 174 screened studies that assessed the environmental impacts of FLW generation and treatment. We found that the embodied impacts of FLW along the supply chain and impacts from FLW treatment received equal attention, but few studies have included both. The reviewed studies show narrow geographical (mostly conducted in industrialized countries) and food supply chain (mostly focused on the consumption stage) coverage. Life cycle analysis (LCA), material flow analysis (MFA), or their combination are the most commonly used to quantify FLW related environmental impacts. More method standardization, integration, and innovation and better FLW data with regional and stage resolution from a first-hand source are badly needed. Among the various proposed mitigation strategies covering technology, economy, behavior, and policy aspects, process optimization and waste management options are the most discussed. Our review calls for a more holistic environmental impact assessment of FLW generation and treatment and analysis of the trade-offs among different environmental impact categories and between supply chain stages, which would better inform relevant policy on effective environmental impact mitigation strategies toward sustainable food systems.

3D Printing Technology: Role in Safeguarding Food Security.

The rising threats to food security include several factors, such as population growth, low agricultural investment, and poor distribution systems. Consequently, food insecurity results from a confluence of issues, including diseases, processing limitations, and distribution deficiencies. Food insecurity usually occurs in vulnerable areas where certain technologies and traditional food safety testing are not a viable solution for foodborne disease detection. In this regard, 3D printing technologies and 3D printed sensors open the platform to produce portable, accurate, and low-cost sensors that address the gaps and challenges in food security. In this paper, we discuss the perspective role of 3D printed sensors in food security in terms of food safety and food quality monitoring to provide reliable access to nutritious, affordable food. In each section, we highlight the advantages of 3D printing technology in terms of cost-effectiveness, accuracy, accessibility, and reproducibility compared to traditional manufacturing methodologies. Recent developments in robotic technologies for mechanization, such as food handling with soft grippers, are also discussed. Lastly, we delve into the applications of advanced 3D printing technologies in agricultural monitoring, particularly the future of plant wearables, environmental sensing, and overall plant health monitoring.

Effect of a Multicomponent Food Pantry Intervention in Client Subgroups.

Nutrition promotion programs may have varying effects and influence health disparities. SuperShelf promotes healthy choices in food pantries through inventory changes and nudge implementation (e.g., choice architecture). This secondary analysis of the SuperShelf cluster-randomized trial assessed whether the effect of SuperShelf on client diet quality differed by equity characteristics. English-, Spanish-, or Somali-speaking adult clients from 11 food pantries in Minnesota were included (N = 193). We measured change in diet quality by the Healthy Eating Index 2015 (HEI-2015; maximum score 100) using up to two 24 h dietary recalls from pre-intervention and post-intervention periods. We used linear mixed-effects models to determine whether the effect of SuperShelf on diet quality varied by self-reported gender, race/ethnicity, education, and employment status. In separate adjusted models, the interactions of SuperShelf and gender, education, or employment status were not significant. The interaction of SuperShelf and race/ethnicity was significant (p-interaction = 0.008), but pairwise comparisons in diet quality were non-significant in all racial/ethnic subgroups. SuperShelf did not have differential effects on diet quality by gender, race/ethnicity, education, or employment status, suggesting it does not worsen dietary disparities among food pantry clients, though more subgroup analyses are needed to explore potential racial/ethnic disparities in this context.

Food Choice and Dietary Perspectives of Young, Urban, Black Pregnant Women: A Focus Group Study.

Black pregnant women in Chicago are disproportionately affected by maternal morbidity and mortality and are more likely to reside in neighborhoods that experience greater economic hardships and food apartheid than any other race/ethnicity. Addressing social determinants of health such as structural inequities, economic environment, and food apartheid issues may provide insights into eliminating Black maternal morbidity and mortality disparities. This study explores food choice determinants and dietary perspectives of young, urban, Black pregnant women. Two audio-recorded focus groups were conducted in Chicago, IL between March 2019 and June 2019 to discuss pregnancy experiences and factors affecting maternal nutrition. Thematic analysis was used to identify the codes, themes, and subthemes of the data. Data analysis was guided by the Social Ecological Model (SEM) as a theoretical framework. Eleven, young, Black women were recruited. Three major themes were discussed across the SEM levels that influenced food choice including food access, stress and family influences on eating, and the need for nutritional education during pregnancy. These choices were primarily rooted in the detrimental effects of food apartheid experienced within the participants' neighborhoods. Therefore, acknowledging, understanding, and addressing food apartheid and its impact on Black maternal health disparities is needed in clinical practice, research, and policy change.

The role of the health sector in tackling climate change: A narrative review.

Climate change is one of the largest threats to population health and has already affected the ecosystem, food production, and health and wellbeing of populations all over the world. The healthcare sector is responsible for around 5 % of greenhouse gas emissions worldwide and can play a key role in reducing global warming. This narrative review summarized the information on the role of healthcare systems in addressing climate change and strategies for reducing its negative impact to illustrate different types of actions that can support the ecological transformation of healthcare systems to help reaching sustainable development goals. A wide range of green interventions are shown to be effective to reduce the carbon footprint of healthcare and can have a meaningful impact if implemented systematically. However, these would not suffice unless accompanied by systemic mitigation strategies altering how healthcare is provided and consumed. Sustainable healthcare strategies such as reducing waste and low-value care will have direct benefits for the environment while improving economic and health outcomes. The healthcare sector has a unique opportunity to leverage its position and resources to provide a comprehensive strategy for fighting climate change and improving population health and the environment on which it depends.

Eco-efficiency as a prioritization tool in the reduction of food waste in restaurants.

Striving towards eco-efficiency means creating more value while generating a product or service with a reduced environmental impact. This quest makes it possible to link objectives associated with both the environmental and the economic pillars of sustainable development. Eco-efficiency could therefore be an interesting tool to evaluate the impacts of food waste (FW) and the potential of various food waste reduction strategies (FWRSs). However, the use of eco-efficiency to assess the interest in implementing FWRSs has never been explored in the foodservice sector. This work firstly aims to carry out an in-depth analysis of the costs of the FW generation of an independent restaurant. Secondly, based on these costs data and on some previously documented environmental impact data with a life cycle assessment according to ISO 14045:2012, this work also aims to model and evaluate the performance of FWRSs from a perspective of improving a restaurant eco-efficiency. The impact of each FWRS on the eco-efficiency of the restaurant under study was measured by modeling their economic and environmental net benefits over three implementation periods (one week, one month and six months) and under scenarios of strong and weak adherence. The study identified the most eco-efficient FWRSs to be implemented to reduce FW in the studied restaurant. In addition, key factors affecting eco-efficiency were raised, namely the period following the implementation of FWRSs, the FW reduction rate between FWRSs affecting the same type of FW, the specificity of the FWRSs and their ability to limit the waste of vegetables, meat, sea products and food requiring significant processing time by the cooks. Thus, these elements will guide foodservice managers in adopting FWRSs aimed at reducing FW generated in their restaurant and at improving its eco-efficiency. In addition, this work proposes a new methodology intended for the scientific community to identify FWRSs that have a strong impact on a restaurant eco-efficiency.

Differences in children's exposure to television advertising of unhealthy foods and beverages in Spain by socio-economic level.

BACKGROUND: The influence of food advertising on food preferences and consumption could also contribute to the socio-economic inequalities among Spanish children in terms of eating habits and childhood obesity. Although the main food advertising channel targeted at children in Spain is television, available studies estimate exposure indirectly by combining content data with audience data. The aim of this study was therefore to describe the frequency of exposure to television advertising of unhealthy foods and drinks, measured directly, among Spanish children and adolescents, and analyse its socio-economic inequalities. METHODS: Observational study of television advertising impacts in a sample of 1590 children aged 4 to 16 years drawn from a consumer panel representative of the Spanish population in this age group, over the course of a full week of broadcasting in February 2022. The sample was obtained through stratified random sampling by Autonomous Region, with quotas being set by reference to socio-demographic variables. Exposure was measured with an audiometer, and the nutrient content of the food and drink advertised was analysed using the nutrient profile of the WHO Regional Office for Europe. We used the Chi-squared test to analyse possible differences in advertising coverage by socio-economic level. RESULTS: The participants saw a weekly mean of 82.4 food and drink commercials, 67.4 of which were for unhealthy products (81.8%), mostly outside the child-protection time slot. On average, low-social class participants received 94.4% more impacts from unhealthy food and drink advertising than did high-class participants (99.9 vs. 51.4 respectively). The mean advertising coverage of unhealthy foods and drinks was 71.6% higher in low-class than in high-class participants (10.9% vs. 18.7%; p = 0.01). CONCLUSION: Spanish children and adolescents received an average of 10 impacts per day from television spots for unhealthy foods and drinks. The exposure of low-class children is double that of high-class children, a finding compatible with the high prevalence of childhood obesity in Spain and the related socio-economic inequalities. To protect Spanish minors from the harmful effects of food advertising and reduce the related social health inequalities would require the implementation of a 24:00 watershed for unhealthy food advertising on television.

Construction of China's food security evaluation index system and spatiotemporal evolution.

Food security is a vital material foundation for a nation's development and has been a topic of significant concern on the international stage in recent years. With a population exceeding 1.4 billion, China is not only a major producer but also a substantial consumer of food. Ensuring food security in China is not only a top priority for its socio-economic development but also a driving force in maintaining the stability of the global food supply chain and reducing the number of hungry people worldwide. However, a lack of comprehensive research into the Chinese food security system remains. This study addresses this gap by constructing a comprehensive evaluation framework encompassing four dimensions: food supply, accessibility, production stability, and sustainability. Utilizing the Moran's Index and generating LISA (Local Indicators of Spatial Association) maps, we analyze the spatial correlations of food security. The Dagum Gini coefficient and kernel density estimation are applied to assess heterogeneity and spatial disparities. Furthermore, this research employs the Exponential Smoothing (ETS) model to forecast food security trends. The findings reveal that the overall composite food security score exhibited fluctuations, initially increasing and reaching its peak of 0.407 in 2003, followed by a subsequent sharp decline after 2019. Spatially, food security exhibits correlations, with the Huang-Huai-Hai Plain and Northeast regions consistently showing high-high clustering. In contrast, the Western and Southern regions exhibit low-low clustering at specific periods. The Dagum Gini coefficient indicates that overall food security disparities are relatively small. However, these disparities have gradually expanded in recent years, with inter-group differences becoming predominant after 2005. As indicated by the kernel density estimation, the dynamic distribution of food security initially widens and then narrows, suggesting a shift from dispersed to concentrated data distribution. This phenomenon is accompanied by polarization and convergence trends, particularly evident after 2015. According to the ETS model, the study forecasts a substantial risk of declining food security in China over the next decade, largely influenced by the ongoing pandemic. In conclusion, this research provides a comprehensive assessment of the changing status of food security in China. It offers early warnings through predictive analysis, addressing the existing research gaps in the field of food security.

Changes in UK price disparities between healthy and less healthy foods over 10 years: An updated analysis with insights in the context of inflationary increases in the cost-of-living from 2021.

Food prices and affordability play an important role in influencing dietary choices, which in turn have implications for public health. With inflationary increases in the cost-of-living in the UK since 2021, understanding the dynamics of food prices becomes increasingly important. In this longitudinal study, we aimed to examine changes in food prices from 2013 to 2023 by food group and by food healthiness. We established a dataset spanning the years 2013-2023 by combining price data from the UK Consumer Price Index for food and beverage items with nutrient and food data from the UK nutrient databank and UK Department of Health & Social Care's National Diet and Nutrition Survey data. We calculated the price (£/100 kcal) for each food item by year as well as before and during the period of inflationary pressure, and classified items into food groups according to the UK Eatwell Guide and as either "more healthy" or "less healthy" using the UK nutrient profiling score model. In 2023, bread, rice, potatoes and pasta was cheapest (£0.12/100 kcal) and fruit and vegetables most expensive (£1.01/100 kcal). Less healthy food was cheaper than more healthy food (£0.33/100 kcal versus £0.81/100 kcal). Before the inflationary pressure period (from 2013 to late 2021), the price of foods decreased by 3%. After this period, the price of food increased by 22%: relative increases were highest in the food group milk and dairy food (31%) and less healthy category (26%). While healthier foods saw smaller relative price increases since 2021, they remain more expensive, potentially exacerbating dietary inequalities. Policy responses should ensure food affordability and mitigate price disparities via, for example, healthy food subsidies.

Exploring fungal bioemulsifiers: insights into chemical composition, microbial sources, and cross-field applications.

The demand for emulsion-based products is crucial for economic development and societal well-being, spanning diverse industries such as food, cosmetics, pharmaceuticals, and oil extraction. Formulating these products relies on emulsifiers, a distinct class of surfactants. However, many conventional emulsifiers are derived from petrochemicals or synthetic sources, posing potential environmental and human health risks. In this context, fungal bioemulsifiers emerge as a compelling and sustainable alternative, demonstrating superior performance, enhanced biodegradability, and safety for human consumption. From this perspective, the present work provides the first comprehensive review of fungal bioemulsifiers, categorizing them based on their chemical nature and microbial origin. This includes polysaccharides, proteins, glycoproteins, polymeric glycolipids, and carbohydrate-lipid-protein complexes. Examples of particular interest are scleroglucan, a polysaccharide produced by Sclerotium rolfsii, and mannoproteins present in the cell walls of various yeasts, including Saccharomyces cerevisiae. Furthermore, this study examines the feasibility of incorporating fungal bioemulsifiers in the food and oil industries and their potential role in bioremediation events for oil-polluted marine environments. Finally, this exploration encourages further research on fungal bioemulsifier bioprospecting, with far-reaching implications for advancing sustainable and eco-friendly practices across various industrial sectors.

Environmental sustainability assessment of a new food waste anaerobic digestion and pyrolysis hybridization system.

This research conducted an environmental life cycle assessment (LCA) to evaluate an anaerobic digestion-co-pyrolysis (ADCo-Py) system in which pyrolysis was added to traditional food waste (FW) anaerobic digestion (AD) systems to treat the solid fraction and impurities separated from FW. The solid fraction, including impurities such as wooden chopsticks, plastics, eggshells, and bones, is usually incinerated, while pyrolysis can be a viable alternative to optimize FW treatment. The environmental impact of ADCo-Py was compared with stand-alone AD, pyrolysis, and ADCo-INC (AD with incineration of separated solids). The results indicated that both ADCo-Py (-1.726 kg CO2-Eq/kgFW) and ADCo-INC (-1.535 kg CO2-Eq/kgFW) outperform stand-alone AD (-0.855 kg CO2-Eq/kgFW) and pyrolysis (-0.181 kg CO2-Eq/kgFW) in mitigating global warming potential (GWP). Additionally, pretreatments were found to have the most significant influence on GWP, ecotoxicity potential (ETP), and acidification potential (AP). The two-step pretreatment in ADCo-Py, including the separation of solids and drying, significantly improved the environmental sustainability of the system when compared with standalone pyrolysis.

Cost and Affordability of Habitual and Recommended Diets in Welfare-Dependent Households in Australia.

It is crucial to ensure healthy diets are affordable in low socioeconomic groups, such as welfare-dependent households, who experience higher rates of diet-related disease than others. This study assessed the cost of habitual (unhealthy) and recommended (healthy) diets in six welfare-dependent and six other, comparable Australian households, using either popular branded products or the cheapest available alternatives. It also assessed diet affordability in welfare-dependent households, before and after modest increases in government welfare payments introduced in early September 2023. Results confirmed that recommended diets were less expensive than habitual diets in all households unless the cheapest available products were included. This strategy reduced habitual diet costs by 35-37% and recommended diet costs by 30-32%. The lower cost differential could aid perceptions that healthy foods are more expensive than unhealthy foods. In April 2023, 23-37% of the income of welfare-dependent households with children was required to purchase recommended diets; this reduced only to 20-35% in September 2023. Hence, the increases in welfare payments were insufficient to meaningfully improve the affordability of healthy diets in the most vulnerable Australians. In the current cost-of-living crisis, there is an urgent need for more welfare support to help purchase healthy diets. Monitoring of diet cost and affordability is also required.

Innovations in Food Packaging for a Sustainable and Circular Economy.

Packaging is fundamental to maintaining the quality of food, but its contribution with a negative footprint to the environment must be completely changed worldwide to reduce pollution and climate change. Innovative and sustainable packaging and new strategies of reutilization are necessary to reduce plastic waste accumulation, maintain food quality and safety, and reduce food losses and waste. The purpose of this chapter is to present innovations in food packaging for a sustainable and circular economy. First, to present the eco-design packaging approach as well as new strategies for recycled or recyclable materials in food packaging. Second, to show current trends in new packaging materials developed from the use of agro-industrial wastes as well as new methods of production, including 3D/4D printing, electrostatic spinning, and the use of nanomaterials.

The impact of the cost of living crisis and food insecurity on food purchasing behaviours and food preparation practices in people living with obesity.

Lower income households are at greater risk of food insecurity and poor diet quality than higher income households. In high-income countries, food insecurity is associated with high levels of obesity, and in the UK specifically, the cost of living crisis (i.e., where the cost of everyday essentials has increased quicker than wages) is likely to have exacerbated existing dietary inequalities. There is currently a lack of understanding of the impact of the current UK cost of living crisis on food purchasing and food preparation practices of people living with obesity (PLWO) and food insecurity, however this knowledge is critical in order to develop effective prevention and treatment approaches to reducing dietary inequalities. Using an online survey (N = 583) of adults residing in England or Scotland with a body mass index (BMI) of ≥30 kg/m2, participants self-reported on food insecurity, diet quality, perceived impact of the cost of living crisis, and their responses to this in terms of food purchasing behaviours and food preparation practices. Regression analyses found that participants adversely impacted by the cost of living crisis reported experiencing food insecurity. Additionally, food insecurity was associated with use of specific purchasing behaviours (i.e., use of budgeting, use of supermarket offers) and food preparation practices (i.e., use of energy-saving appliances, use of resourcefulness). Exploratory analyses indicated that participants adversely impacted by the cost of living crisis and who used budgeting had low diet quality, whereas use of meal planning was associated with high diet quality. These findings highlight the fragility of food budgets and the coping strategies used by PLWO and food insecurity during the cost of living crisis. Policy measures and interventions are urgently needed that address the underlying economic factors contributing to food insecurity, to improve access to and affordability of healthier foods for all.

Health-environment efficiency of diets shows nonlinear trends over 1990-2011.

Understanding the impacts of diets on health and the environment, as well as their association with socio-economic development, is key to operationalize and monitor food systems shifts. Here we propose a health-environment efficiency indicator defined as a ratio of health benefits and four key food-related environmental impacts (greenhouse gas emissions, scarcity-weighted water withdrawal, acidifying and eutrophying emissions) to assess how diets have performed in supporting healthy lives in relation to environmental pollution and resource consumption across 195 countries from 1990 to 2011. We find that the health-environment efficiency of each environmental input follows a nonlinear path along the Socio-Demographic Index gradient representing different development levels. Health-environment efficiency first increases thanks to the elimination of child and maternal malnutrition through greater food supply, then decreases driven by additional environmental impacts from a shift to animal products, and finally shows a slow growth in some developed countries again as they shift towards healthier diets.