Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students.

BACKGROUND: Promoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors. METHODS: MD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed. RESULTS: A sample of 1485 participants (median (IQR) age 21.0 (19.0-22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen. CONCLUSIONS: Encouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.

Nutritional, environmental and economic implications of children plate waste at school: a comparison between two Italian case studies.

OBJECTIVE: This study aims at comparing two Italian case studies in relation to school children's plate waste and its implications, in terms of nutritional loss, economic cost, and carbon footprint. DESIGN: Plate waste was collected through an aggregate selective weighting method for 39 days. SETTING: Children from the first to the fifth grade from four primary schools, two in each case study (Parma and Lucca), were involved. RESULTS: With respect to the served food, in Parma the plate waste percentage was lower than in Lucca (p<0.001). Fruit and side-dishes were highly wasted, mostly in Lucca (>50%). The energy loss of the lunch meals accounted for 26% (Parma) and 36% (Lucca). Among nutrients, dietary fibre, folate and vitamin C, calcium and potassium were lost at most (26-45%). Overall, after adjusting for plate waste data, most of the lunch menus fell below the national recommendations for energy (50%, Parma; 79%, Lucca) and nutrients, particularly for fat (85%, Parma; 89%, Lucca). Plate waste was responsible for 19% (Parma) and 28% (Lucca) of the carbon footprint associated to the food supplied by the catering service, with starchy food being the most important contributor (52%, Parma; 47%, Lucca). Overall, the average cost of plate waste was 1.8 €/kg (Parma) and 2.7 €/kg (Lucca), accounting respectively for 4% and 10% of the meal full price. CONCLUSION: A re-planning of the school meals service organisation and priorities is needed to decrease the inefficiency of the current system and reduce food waste and its negative consequences.

Towards a sustainable diet combining economic, environmental and nutritional objectives.

Foods consumed and dietary patterns are strong determinants of health status. Diet and nutrition have a key role in health promotion and maintenance during the entire lifetime, but what we choose to eat and drink greatly affects the environmental impact on ecosystems as well as monetary resources. Some studies suggest that a healthy diet with a low environmental impact is not necessarily more expensive. This paper aims to identify a healthy, greener and cheaper diet based on current consumption patterns. Dietary information was collected from 104 young adults in the last year of high school in Parma (Italy). Diet was monitored with 7-day dietary records. Subsequently, food items were decoded to obtain nutritional, economic and environmental impact data. An optimization tool based on mathematical programming (Multi-Objective Linear Programming) was used to identify sustainable diet. Three different 7-day diets were identified, based on nutrition recommendations for the healthy Italian adult population, characterized by different targets and optimizing different impacts: first the diet at the lowest cost (Minimum Cost Diet - MCD), then the Environmentally Sustainable Diet (ESD) obtained by minimizing the three environmental indicators (CO2e emissions, H2O consumption and amount of land to regenerate the resources - m(2)). Finally, the Sustainable Diet (SD) was identified by integrating environmental and economic sustainability objectives. Lastly, suggestions and recommendations for communication campaigns and other interventions to achieve sustainable diet are suggested.

Strengths and weaknesses of food eco-labeling: a review.

Food labeling is increasingly expanding and adding more information to the food package. There is strong evidence about nutrition labeling effectiveness in driving food choice, especially if displayed in the front of package (FoP). Despite the growing attention to nutrition and sustainable diets, few countries have implemented sustainable labels or eco-labels that could address economic, social and/or environmental concerns. Implementing new techniques of eco-labeling emerges as a consumer-focused solution. However, evidence of the effectiveness of eco-labeling in driving consumers' choices is heterogeneous and not univocal. Thus, this review aims to summarize the evidence about the effectiveness of FoP eco-labeling in driving food choice and provide a reference framework of the eco-labeling initiatives relative to food package labeling. This narrative review addresses both the potential benefits as well as the main concerns that arise from the use of eco-labels. Although eco-labeling seems to provide a series of sustainability benefits for producers and consumers, the implementation of such policies should take into consideration potential trade-offs and inter-sectorial coordination to obtain bigger impacts, assuming that a policy itself cannot transform the whole food system. Eco-labeling could be encouraged and implemented within a set of policies shaping sustainable food systems.

Predicting the Adoption of a Sustainable Diet in Adults: A Cross-Sectional Study in Italy.

Shifting food choices towards sustainability entails the analysis of dietary behavior determinants. This study aimed to explain and predict the intention to follow a sustainable diet and its adoption in a representative sample of adults (n = 838) in Italy. An online survey based on the theory of planned behavior (TPB) was developed. The adoption of a sustainable diet was measured as self-perceived behavior, adherence to the Mediterranean diet (MD), and food consumption frequencies. Psychometric analysis and correlations between attitude, subjective norms, and perceived behavioral control (PBC) with both intention and behavior assessments were evaluated. Structural equation models were used to test whether and to what extent attitude, subjective norms, and PBC explained intention and behavior. Significant associations were found between TPB constructs and the behavior measures underlining the main role of intention and PBC in affecting behavior. The applied TPB models explained behavioral intention at most (78%). The results suggested promising interventions in narrowing the attitude-behavior gap to encourage specific adult population groups in Italy to adopt virtuous food consumption habits. Beside the implementation of price mechanism strategies, educational initiatives to increase awareness about food and diet sustainability issues and the reinforcement of the perceived control on food consumption at the individual level are recommended.

Consumer Preferences for Cheese Products with Quality Labels: The Case of Parmigiano Reggiano and Comté.

The paper examined the potential demand for a food specialty dairy product, cheese, with alternative multiple labels. A random-parameter logit model was applied to interpret the results of online discrete choice experiments (DCE) for the elicitation of the preference of the cheese consumers surveyed in two European countries, France (n = 400) and Italy (n = 408). We analyzed consumers' choices of quality-labeled cheeses, i.e., protected-designation-of-origin (PDO)-labeled Parmigiano Reggiano and Comté. Other features were tested, such as organic (Comté) and Mountain Product (Parmigiano Reggiano) labels, companies' brands and price. The paper contributes to the literature on credence attributes by examining consumers' willingness to pay (WTP) for differentiated cheese products in two EU countries, and by identifying the effects of personal characteristics, in terms of socio-demographics and level of product involvement, on the differences in preferences. The results show that price was the most important attribute in both countries, followed by the PDO quality label, particularly when paired with the second quality feature. Two cheese consumer segments were identified via latent class models in each country, helping producers to improve their marketing of agri-food products with a high gastronomic value and differentiation potential.

Strategies to Promote Healthy Eating Among University Students: A Qualitative Study Using the Nominal Group Technique.

INTRODUCTION: The years spent at university are critical in terms of altering people's dietary patterns. This study aimed to: (1) understand the main dietary changes that students experience after starting university; (2) determine the personal and objective factors that hinder healthy eating, and (3) define possible strategies to facilitate healthier diets among university students. METHODS: The nominal group technique (NGT) was used to elicit ideas from 39 students from the University of Parma, Italy. The sample comprised 16 freshmen and 23 non-freshmen. Participants prioritized and weighed their top five ideas regarding dietary changes, barriers to healthy eating, and possible strategies to maintain a healthy diet. A thematic analysis was conducted to compare the priorities across groups. RESULTS: Forty-three themes were elected as the most significant changes related to diet, 39 themes related to personal barriers, 43 themes related to objective barriers, and 55 themes related to strategies. A lack of time for cooking, low financial availability, consumption of unvaried food or junk food, and gaining knowledge about food were identified as the main changes. Personal barriers to eating healthy were intrinsic (i.e., lack of willpower, personal gluttony, and little effort in cooking preparation), poor dietary information, and a busy lifestyle. Market and financial factors (i.e., the high price of healthy products and low financial availability), as well as social factors (i.e., the negative influence of social networks, childhood food education, and origin/tradition), emerged as objective barriers. Possible strategies that could encourage students to adopt a healthy diet include varying the food products offered in university canteens, including organizing spaces where students who prepare meals from home can warm up and eat their food. Student discounts at supermarkets and information on nutrition and a healthy diet were also identified as important ways of supporting students. CONCLUSION AND IMPLICATION FOR PRACTICE: In order to make students part of the solution, the NGT provided them with the opportunity to equally contribute their ideas and opinions about having a healthy diet in a university context. This could potentially lead to tailor-made solutions for policymakers, educators, and foodservice providers in promoting healthy eating habits.

Exploring the Future of Edible Insects in Europe.

The effects of population increase and food production on the environment have prompted various international organizations to focus on the future potential for more environmentally friendly and alternative protein products. One of those alternatives might be edible insects. Entomophagy, the practice of eating insects by humans, is common in some places but has traditionally been shunned in others, such as European countries. The last decade has seen a growing interest from the public and private sectors to the research in the sphere of edible insects, as well as significant steps forward from the legislative perspective. In the EU, edible insects are considered novel foods, therefore a specific request and procedure must be followed to place them in the market; in fact, until now, four requests regarding insects as a novel food have been approved. Insects could also be used as feed for livestock, helping to increase food production without burdening the environment (indirect entomophagy). Market perspectives for the middle of this decade indicate that most of the demand will be from the feed sector (as pet food or livestock feed production). Undoubtedly, this sector is gaining momentum and its potential relies not only in food, but also in feed in the context of a circular economy.

Food Labeling: Analysis, Understanding, and Perception.

Food labels are the first informative tool found by the customers during shopping, and are informative in terms of ingredients, nutrient content, and the presence of allergens of the selected product [...].

Adherence to the Mediterranean Diet in Association with Self-Perception of Diet Sustainability, Anthropometric and Sociodemographic Factors: A Cross-Sectional Study in Italian Adults.

The adoption of sustainable dietary models, such as the Mediterranean Diet (MD), can be a valuable strategy to preserve ecosystems and human health. This study aims to investigate in an Italian adult representative sample the adherence to the MD and to what extent it is associated with the self-perceived adoption of a sustainable diet, the consideration of the MD as a sustainable dietary model, and anthropometric and sociodemographic factors. By applying an online survey (n = 838, 18-65 years, 52% female), an intermediate level of MD adherence (median: 4.0, IR: 3.0-4.0) in a 0-9 range was observed. Only 50% of the total sample confirmed the MD as a sustainable dietary model, and 84% declared no or low perception of adopting a sustainable diet. Being female, having a higher income and education level, considering the MD as a sustainable dietary model, as well as the perception of having a sustainable diet were the most relevant factors influencing the probability of having a high score (≥6) of adherence to the MD. This study suggests a gradual shift away from the MD in Italy and supports the need to address efforts for developing intervention strategies tailored to adults for improving diet quality. Furthermore, a public campaign should stress the link between a diet and its environmental impact to foster nutritionally adequate and eco-friendly dietary behaviors.

Choice Drivers for Quality-Labelled Food: A Cross-Cultural Comparison on PDO Cheese.

This study aims at examining the consumers' preferences and drivers affecting the choice of quality-labelled food products, i.e., protected designation of origin (PDO) labelled cheese. We applied the theory of planned behaviour (TPB) to analyse the purchase of Parmigiano Reggiano PDO and Comté PDO hard cheeses in Italy and France, respectively. A cross-sectional sample of 808 consumers (400 French and 408 Italian) completed a questionnaire. Structural equation modelling (SEM) indicated perceived behavioural control (PBC) and attitude to be significant predictors of intention to purchase PDO-labelled cheese in France and Italy. Subjective and moral norms affected intention in France. Intention significantly influenced the hard cheese purchase behaviour. The results confirm that the TPB model predicted the self-reported measure of behaviour more than the observed one, measured with a discrete choice experiment, in both countries. The TPB interrelationships varied between countries, suggesting that food systems operators and public authorities should carefully target their intervention to stimulate the demand of PDO-labelled products.

Determinants of US University Students' Willingness to Include Whole Grain Pasta in Their Diet.

College students' lifestyle and eating habits strongly affect their health. Among many healthy eating behaviors, including whole grain food in the diet is known as providing health benefits such as maintaining a steady blood sugar, lower cholesterol, and since it is rich in fiber and minerals, it is essential for the well-being. However, consumers' intakes of whole grain products remain below recommendation, including college students. This study aims to evaluate determinant factors contributing to college students' willingness to include whole grain pasta in their diets. A sample of 499 students enrolled in a US college participated in this study. Most students perceived whole grain pasta as healthy and filling and somewhat tasty. Availability and price were not barriers for consumption. Logistic regression results suggested that factors affecting students' willingness to consume whole grain pasta in the future were the desire to eat, cognitive and affective attitudes, perception of whole grain pasta, as well as having already chosen pasta thanks to its availability at the dining. Two student segments were identified according to their healthy eating perception: Uninvolved and Health-conscious. Cognitive attitudes such as beneficial and essential had positive effects on consumption in both segments, suggesting that information provision covering specific health/nutritional benefits of whole grains for students is crucial.

Insects as Feed for Farmed Poultry: Are Italian Consumers Ready to Embrace This Innovation?

The inclusion of insects as a protein source in feed production is not only related to technical, economical, and normative restrictions but is also affected by consumer acceptance. In this study, we evaluated consumers' attitudes, intention to purchase and eat, and willingness to pay for meat obtained from a farmed duck fed with insect-based meal or a live insect diet. We conducted a survey among a sample of 565 consumers to test the effects of information about the benefits of using insects as feed on consumers' attitudes towards animal-based products fed with insects. Providing information on the sustainability and nutritional benefits of using insects as feed increased both attitude towards and intention to purchase and eat meat products made from animals fed with insects. In the treatment group, we found a significant reduction from 21.9 to 14.0% in those who wanted to be compensated for buying a duck fed with an insect-based meal and an increase in those willing to pay the same price-from 64.9 to 72.7%. The information treatment significantly increased the intention to eat such products, suggesting that increasing consumers' knowledge might help in reducing the fears and misconceptions around the topic of using insects as a feed source.

Risk-benefit in food safety and nutrition - Outcome of the 2019 Parma Summer School.

Risk-benefit assessment is the comparison of the risk of a situation to its related benefits, i.e. a comparison of scenarios estimating the overall health impact. The risk-benefit analysis paradigm mirrors the classical risk analysis one: risk-benefit assessment goes hand-in-hand with risk-benefit management and risk-benefit communication. The various health effects associated with food consumption, together with the increasing demand for advice on healthy and safe diets, have led to the development of different research disciplines in food safety and nutrition. In this sense, there is a clear need for a holistic approach, including and comparing all of the relevant health risks and benefits. The risk-benefit assessment of foods is a valuable approach to estimate the overall impact of food on health. It aims to assess together the negative and positive health effects associated with food intake by integrating chemical and microbiological risk assessment with risk and benefit assessment in food safety and nutrition. The 2019 Parma Summer School on risk-benefit in food safety and nutrition had the objective was to provide an opportunity to learn from experts in the field of risk-benefit approach in food safety and nutrition, including theory, case studies, and communication of risk-benefit assessments plus identify challenges for the future. It was evident that whereas tools and approaches have been developed, more and more case studies have been performed which can form an inherent validation of the risk-benefit approach. Executed risk-benefit assessment case studies apply the steps and characteristics developed: a problem formulation (with at least 2 scenarios), a tiered approach until a decision can be made, one common currency to describe both beneficial and adverse effects (DALYs in most instances). It was concluded that risk-benefit assessment in food safety and nutrition is gaining more and more momentum, while also many challenges remain for the future. Risk-benefit is on the verge of really enrolling into the risk assessment and risk analysis paradigm. The interaction between risk-benefit assessors and risk-benefit managers is pivotal in this, as is the interaction with risk-benefit communicators.

Eliciting Egg Consumer Preferences for Organic Labels and Omega 3 Claims in Italy and Hungary.

This paper investigates consumers' preferences for egg purchase in two European countries, Hungary and Italy. We utilize random parameter logit models to interpret the results of discrete choice experiments (DCE) for the elicitation of preference of the egg consumers. A sample of 403 in the Hungarian survey and 404 in the Italian survey were recruited in summer 2018. The DCE questionnaire includes the following product and process characteristics: organic labels, nutrition and health claims, and price. Our results show that for Hungarian and Italian consumers, the price is the most important attribute, followed by the nutrition and health claim and the organic production labelling. Three egg consumer segments can be identified via latent class models for each country. In both countries, we found similar consumer groups, the Price Sensitive and Quality Optimizing Opportunist Consumers and Health Conscious Buyers, respectively. Particularly, compared to the other segments the Health Conscious Buyers (46% in Hungary and 49% in Italy) exhibited stronger preference for and are willing to pay a higher price premium for eggs with organic label and nutrition claims. In Italy, we identified a third segment with consumers preferring simpler labelling approach, whilst in Hungary we found a consumer segment distrusting the EU organic logo.

Consumers' Preferences and Willingness to Pay for Fish Products with Health and Environmental Labels: Evidence from Five European Countries.

Seafood products are important sources of protein and components of a healthy and sustainable diet. Understanding consumers' preferences for fish products is crucial for increasing fish consumption. This article reports the consumer preferences and willingness to pay (WTP) for different fish species and attributes on representative samples in five European countries (n = 2509): France, Germany, Italy, Spain, and the UK. Consumer choices were investigated for fresh fish in a retail market under hypothetical situations arranged by a labelled choice experiment conducted for seven fish species: Cod, herring, seabass, seabream, salmon, trout, and pangasius. The results show the highest premiums for wild-caught fish than farm-raised alternatives. Ready-to-cook products are generally preferred to whole fish, whereas fish fillet preference is more species-specific. The results show positive premiums for a sustainability label and nutrition and health claims, with high heterogeneity across countries and species. With consumers' preferences and WTP being largely country- and fish-dependent, businesses (fish companies, retailers, and others) should consider the specific market context and adapt their labelling strategies accordingly. Public authorities campaigns should inform consumers about the tangible benefits related with health and environmental labels.

Factors Predicting the Intention of Eating an Insect-Based Product.

This study provides a framework of the factors predicting the intention of eating an insect-based product. As part of the study, a seminar was carried out to explore how the provision of information about ecological, health, and gastronomic aspects of entomophagy would modify consumer beliefs regarding insects as food. Before and after the informative seminar, two questionnaires about sociodemographic attributes and beliefs about the consumption of insects as food were given. Participants were then asked to carry out a sensory evaluation of two identical bread samples, but one was claimed to be supplemented with insect powder. Results showed that perceived behavioral control is the main predictor of the intention, followed by neophobia and personal insect food rejection. The disgust factor significantly decreased after the participants attended the informative seminar. Sensory scores highlighted that participants gave "insect-labelled" samples higher scores for flavor, texture, and overall liking, nevertheless, participants indicated that they were less likely to use the "insect-labelled" bread in the future. Our findings provide a better understanding of insect food rejection behavior and help to predict the willingness to try insect-based products based on some important individual traits and information.

The Influence of Health Messages in Nudging Consumption of Whole Grain Pasta.

Health messages may be an important predictor in the selection of healthier food choices among young adults. The primary objective of our study is to test the impact of labeling whole grain pasta with a health message descriptor displayed at the point-of-purchase (POP) on consumer choice in a campus dining setting. The study was conducted in a large US college dining venue during lunch service; data were collected during a nine-week period, for a total of 18 days of observation. Each day, an information treatment (i.e., no-message condition; vitamin message; fiber message) was alternated assigned to whole grain penne. Over the study period, the selection of four pasta options (white penne, whole grain penne, spinach fettuccine, and tortellini) were recorded and compiled for analysis. Logistic regression and pairwise comparison analyses were performed to estimate the impact of health messages on diners' decisions to choose whole grain penne among the four pasta types. Our results indicate that only the message about vitamin benefits had a significant effect on this choice, with a 7.4% higher probability of selecting this pasta than the no-message condition and 6.0% higher than the fiber message condition. These findings suggest that psychological health claims (e.g., reduction of fatigue) of whole grains seem more attractive than physiological health claims (e.g., maintaining a healthy weight) for university students. In line with the 2015-2020 Dietary Guidelines for Americans, our results suggest that small changes made at the POP have the potential to contribute to significant improvements in diet (e.g., achieving recommended levels of dietary fiber). These findings have important implications for food service practitioners in delivering information with the greatest impact on healthy food choices.

Impact of climate change and human activity on soil landscapes over the past 12,300 years.

Soils are key to ecosystems and human societies, and their critical importance requires a better understanding of how they evolve through time. However, identifying the role of natural climate change versus human activity (e.g. agriculture) on soil evolution is difficult. Here we show that for most of the past 12,300 years soil erosion and development were impacted differently by natural climate variability, as recorded by sediments deposited in Lake Dojran (Macedonia/Greece): short-lived ( < 1,000 years) climatic shifts had no effect on soil development but impacted soil erosion. This decoupling disappeared between 3,500 and 3,100 years ago, when the sedimentary record suggests an unprecedented erosion event associated with the development of agriculture in the region. Our results show unambiguously how differently soils evolved under natural climate variability (between 12,300 and 3,500 years ago) and later in response to intensifying human impact. The transition from natural to anthropogenic landscape started just before, or at, the onset of the Greek 'Dark Ages' (~3,200 cal yr BP). This could represent the earliest recorded sign of a negative feedback between civilization and environmental impact, where the development of agriculture impacted soil resources, which in turn resulted in a slowdown of civilization expansion.

Explaining Vegetable Consumption among Young Adults: An Application of the Theory of Planned Behaviour.

Although fruit and vegetable consumption is highly recommended for a healthy and balanced daily diet, several European countries do not meet these recommendations. In Italy, only 45% of young people are consuming at least one portion of vegetables per day. Therefore, this paper aims to understand the main determinants of vegetables consumption among young adults to suggest possible intervention strategies. A cross-sectional study was conducted on a samples of Italian students (n = 751), using the theory of planned behaviour (TPB) as a conceptual framework. A structural equation model (SEM) was developed to test the TPB predictors for vegetable consumption, and the role of background factors (socio-demographic and personal characteristics) in improving the TPB model's explaining power. Overall, 81% and 68%, respectively, of intentions and behaviour variance is explained by the TPB model. Socio-demographic and personal characteristics were found to influence intentions and behaviour indirectly by their effects on the theory's more proximal determinants. Interventions should be targeted to improve perceived behavioural control (PBC), attitudes and subjective norms that significantly affect intentions. Tailored interventions for male students, enrolled in courses other than food science, and doing less physical activity may have a larger effect on behavioural change.