Comparative assessment of two circularity indicators for the case of reusable versus single-use secondary packages for fresh foods in Spain.

Sustainable packaging is a crucial focus in the context of circular economy efforts. This study evaluates the circularity of two secondary packaging systems used in Spanish fresh food produces: Reusable Plastic Crates and Single-use Cardboard Boxes. A Mass Flow Analysis was performed to assess the material flows in the production and use phases of both systems and two circular indicators were applied: the Material Circularity Indicator and Product Circular Indicator. While most previous studies for single-use packaging use these indicators at the product level, this study applies a system approach since the Reusable Plastic Crates can be reused 100 times. The functional unit was defined as the distribution of 1000 tonnes of fresh products, resulting in the distribution of 6,666,700 packages with 15 kg of products. The Material Circularity Indicator and Product Circular Indicator results show that Reusable Plastic Crates are more circular than Single-use Cardboard Boxes. The Product Circular Indicator provides a more comprehensive assessment of circularity by considering multiple life cycle stages, efficiency, and unrecoverable waste, resulting in a difference in circularity evaluations. The indicators used have limitations as they do not consider the resource stock. Further research is needed to explore this aspect.

Edible Insect Consumption for Human and Planetary Health: A Systematic Review.

This systematic review aimed to examine the health outcomes and environmental impact of edible insect consumption. Following PRISMA-P guidelines, PubMed, Medline ProQuest, and Cochrane Library databases were searched until February 2021. Twenty-five articles met inclusion criteria: twelve animal and six human studies (randomized, non-randomized, and crossover control trials), and seven studies on sustainability outcomes. In animal studies, a supplement (in powdered form) of 0.5 g/kg of glycosaminoglycans significantly reduced abdominal and epididymal fat weight (5-40% and 5-24%, respectively), blood glucose (10-22%), and total cholesterol levels (9-10%), and a supplement of 5 mg/kg chitin/chitosan reduced body weight (1-4%) and abdominal fat accumulation (4%) versus control diets. In other animal studies, doses up to 7-15% of edible insect inclusion level significantly improved the live weight (9-33%), reduced levels of triglycerides (44%), cholesterol (14%), and blood glucose (8%), and increased microbiota diversity (2%) versus control diet. In human studies, doses up to 7% of edible insect inclusion level produced a significant improvement in gut health (6%) and reduction in systemic inflammation (2%) versus control diets and a significant increase in blood concentrations of essential and branched-chain amino acids and slowing of digestion (40%) versus whey treatment. Environmental indicators (land use, water footprint, and greenhouse gas emissions) were 40-60% lower for the feed and food of edible insects than for traditional animal livestock. More research is warranted on the edible insect dose responsible for health effects and on environmental indicators of edible insects for human nutrition. This research demonstrates how edible insects can be an alternative protein source not only to improve human and animal nutrition but also to exert positive effects on planetary health.

Water-Energy-Food Nexus and Life Cycle Thinking: A New Approach to Environmental and Nutritional Assessment of Potato Chips.

The water-energy-food (WEF) nexus has become a key concept to promote the cross-sectoral coordination toward sustainable development. In particular, understanding the interdependences of these pillars, as well as addressing a life cycle perspective, is essential when evaluating food production systems. This study explores the environmental impacts and nutritional quality of potato chips, addressing life cycle thinking and a WEF nexus approach. For this purpose, the combined application of life cycle assessment (LCA) and the Nutrient-Rich Food 9.3 (NRF9.3) index was considered to identify the main environmental hotspots and advanced opportunities. The results indicated a major contribution of the cultivation stage on water use, whereas the processing accounted for most of the impacts in energy-related indicators and eutrophication potentials. Improvement opportunities reside in the joint application of drip irrigation, allowing to achieve important water savings, as well as the use of natural gas or pellets instead of diesel, which constitute cleaner energy sources. On the other hand, a poor nutritional density of potato chips became evident from the quantification of the NRF9.3, which can be significantly improved if potatoes undergo a roasted process instead of frying.

Scenario analysis on optimal farmed-fish-species composition in China: A theoretical methodology to benefit wild-fishery stock, water conservation, economic and protein outputs under the context of climate change.

Fish production from aquaculture and wild captures suffers from the rising risk of climate change. This impacts the livelihoods of fishers and fish farmers by shrinking wild fishery stocks, inland water scarcity, and consequent declines in economic and protein productions. China, feeding the most fish of the world with water-intensive crops, faces challenges of water scarcity but still be premature in developing strategies to adapt to climate change. Here, focusing on methodology development, we quantified the water footprint of fish-farming and economic and protein productions in the baseline year 2014. Then, 29 scenarios of farmed-fish-species composition (FFSC, i.e., tons of each farmed fish species) were developed for the target year 2020. The baseline 2014 shows that fish farming generates an average of 150 billion m3 of water footprint, 4.70 million tons of protein, and 263 billion RMB of economic output (~39 billion USD). Uncertainty optimizations were conducted to generate the optimal FFSC solutions that show a potential to increase fish production by 22%, economic and protein output by 18% and 29%, respectively and simultaneously lower water footprint by 22% to the maximum extent. Nine scenarios that lower wild fishery captures were further examined, with optimal FFSC solution that encourages aquaculture of Grass carp, Bighead Carp, and Silver Carp, and discourages Black carp, Tilapia, Crucian carp, Sea bass, and Wuchang bream. From a methodology aspect, this study pulls back policymakers from only focusing on the short-term economic interest of fish-farming and persuades them to rethink long-term adaptive strategies to climate change from multiple sustainable dimensions.

Potential climate benefits of reusable packaging in food delivery services. A Chinese case study.

In China, the food delivery packaging waste is increasing due to the rapid growth of the sector and the use of single-use packaging to transport the meals. In addition, the recycling rates of current municipal waste management are low. In this regard, this study aims at estimating the climate change impact of current food delivery packaging and its waste treatment, by performing a Life Cycle Assessment with a cradle-to-grave approach. In addition, this article explores the potential benefits of increasing the current recycling rates, the recycled content of the packaging as well as the use of reusable packaging. For this study, the food packaging of a typical dumpling-based meal of the popular Chinese restaurant Xijiade was selected. Based on this menu and the current Chinese consumption patterns, the food delivery packaging in China would have emitted about 13 million tons of CO2eq. Increasing current recycling rates to 35% would reduce 16% the emissions of single-use packaging, and further decrease (60%) could be found if half of the packaging was made of recycled material. In addition, if single-use packaging was replaced by reusable PP-based packaging (food container and carrier bag), the emissions would potentially be 63% lower than the current situation. In this case, doubling the recycling rates and the recycled content of the reusable food packaging would represent an extra 6 and 17% reduction of emissions, respectively.

Towards a Water-Energy-Food (WEF) nexus index: A review of nutrient profile models as a fundamental pillar of food and nutrition security.

The Water-Energy-Food (WEF) nexus approach should be promoted as a tool for sustainable management of resources through the interconnection of these three fundamental pillars. Particularly, food security must ensure healthy and balanced diets for everyone, but selecting individual indicators to assess all slants covered by this element is not an easy task. Hence, the objective of this paper is two-fold, to review nutrient profiling (NP) models that allow to categorize foods and evaluate diets based on their nutritional quality, and to choose the most appropriate model to be used within a WEF nexus index. To address this issue, a total of 159 documents were assessed, appraising the geographic distribution, and time evolution of the publications, as well as the characteristics and potential applications of the NP systems. The review concludes that the NRF9.3. model is the most liable option to be used in a WEF nexus index, presenting the best characteristics by means of the definition of scores and thresholds, and the use of an 'across-the-board' criteria and a reference quantity of 100 kcal, alongside offering higher ability to assess diets and foods than the other competitive model (HEI) through the evaluation of nutrients to encourage instead of foods. A secondary outcome of the review is the identification of the NP models as a useful tool to enable institutions with information to establish policies in the field of public health and facilitating the decision-making process according to the current healthy claims.

An explorative assessment of environmental and nutritional benefits of introducing low-carbon meals to Barcelona schools.

Shifting to plant-based and low-carbon diets is a key measure for climate change mitigation. In this regard, national and local governments are setting goals and actions to tackle this issue. The municipality of Barcelona has set an intervention for the academic year 2020-21: introducing low-carbon meals in public schools. This study assesses the environmental and nutritional benefits of this intervention by applying the Life Cycle Assessment (LCA) methodology, with an energy and nutritional functional unit; and combined it with the Water-Energy-Food (WEF) nexus approach, by considering three WEF resources-based impacts (Blue Water Footprint (BWF), Primary Energy Demand (PED) and Land Use (LU)) and the Global Warming Potential (GWP). The transition to a low-carbon meal would reduce between 46 and 60% the environmental impacts. These benefits could even be higher when extra interventions within the school boundaries are applied. More research in behavioural change is needed in order to evaluate both: the acceptance of the new menus by scholars and the adaptation of the school kitchen staff to the new menu. Finally, it is suggested to monitor the environmental and nutritional changes of the introduction of low-carbon meals within the school menus in an integrated way.

Multi-Objective Optimization of Nutritional, Environmental and Economic Aspects of Diets Applied to the Spanish Context.

Current food consumption patterns must be revised in order to improve their sustainability. The nutritional, environmental, and economic consequences of these dietary patterns must be taken into consideration when diet guidelines are proposed. This study applied a systematic optimization methodology to define sustainable dietary patterns complying with nutritional, environmental, and economic issues. The methodology was based on a multi-objective optimization model that considered a distance-to-target approach. Although the three simultaneous objectives (maximal nutritional contribution, minimal greenhouse gas emissions, and minimal costs) could be divergent, the proposed model identified the optimal intake of each food product to achieve the maximal level of nutritional, environmental, and economic diets. This model was applied to six different eating patterns within the Spanish context: one based on current food consumption and five alternative diets. The results revealed that dietary patterns with improved nutritional profiles and reduced environmental impacts could be defined without additional costs just by increasing the consumption of vegetables, fruits, and legumes, while reducing the intake of meat and fish.

Environmental and nutritional impacts of dietary changes in Spain during the COVID-19 lockdown.

The COVID lockdown has affected food purchases and eating habits. In this regard, this short communication assesses the nutritional and environmental impacts of these changes during the COVID lockdown in Spain, by applying Life Cycle Assessment and an energy- and nutrient-corrected functional unit. Three environmental impacts were studied (Global Warming Potential, Blue Water Footprint and Land Use) and a total of seven weekly diet scenarios were designed: two pre-COVID diets for March and April in 2019 (MAR19, APR19), one COVID diet (COVID) and two alternative diets, one based on the National Dietary Guidelines (NDG) and another one on the Planetary Health Diet (PHD). Results show that the COVID diet had larger energy intake and lower nutritional quality, as well as higher environmental impacts (between 30 and 36%) than the pre-COVID eating patterns. Further research is needed to account for food affordability within this assessment, as well as to analyze how eating patterns will evolve after the COVID lockdown. Finally, the definition of short guidelines for sustainable food behaviors for future possible lockdowns is suggested, as well as the introduction of sustainable indicators within NDGs.

Correction to: Incidence of dyschromatopsy in glaucoma.

In the original publication, the family and given name of authors were swapped incorrectly in the author group.

Incidence of dyschromatopsy in glaucoma.

PURPOSE: As proven in studies dating back to the eighteenth century, color vision changes may occur early in the course of glaucoma. Our aim was to reevaluate the incidence of acquired color vision deficiency in glaucoma patients of the University hospital Zürich by using the Panel D-15 test. METHODS: Inclusion criteria of the study involved a diagnosis of glaucoma, age equal or greater than 18 years with no upper limit and a best-corrected visual acuity (BCVA) smaller than ≤ 0.7 logMAR. All volunteers were tested twice monocularly for color vision with (1) the Ishihara color plate test and (2) the Farnsworth and Lanthony Panel D-15 test by one examiner (L.B.). Using the Moment of Inertia Method of Vingrys and King-Smith (Investig Ophthalmol Vis Sci 29(1):50-63, 1988), we measured the color defect type (blue-yellow, red-green or non-selective). RESULTS: One hundred and fifty-one eyes of 87 glaucoma patients were included in this study. Nine eyes showed a deficient result in the Ishihara test, which proves a congenital red-green weakness. Fifty-one (33.8%) eyes showed color vision anomalies in the desaturated test and 24 (15.9%) eyes in the saturated Panel D-15 test. A total of 25.2% and 8.6% of eyes in the desaturated and saturated test were diffuse dyschromatopsia, respectively. The second most prevalent deficiencies were blue-yellow defects with 4.0% and 4.6% of saturated and desaturated results. Just the covariate visual acuity had a significant influence on the Panel D-15 result, whereas other variables like age, sex or intraocular pressure did not show any impact. CONCLUSION: This study ascertains that the long-known theory of color vision defects in patients with glaucoma is also relevant in our sample of 151 eyes, providing continuity to claims firstly reported many years ago. Despite our results highlighting more diffuse dyschromatopsia than other similar experiments, we have also proven that the tritanomalous defects occur more frequently than other color defects.

An energy- and nutrient-corrected functional unit to compare LCAs of diets.

Dietary choices, a main driver of food production, play a significant role within the climate change arena. Consequently, there is a growing trend on publishing research assessing the environmental impacts of diets and dietary shifts, mainly following the life cycle assessment (LCA) methodology. However, several methodological issues still bring a challenge, especially in the definition of the function and the quantification of the functional unit (FU). The FU is the reference unit of an LCA study, and it is the basis for allowing comparison among different systems. This short communication defines the function of diets as the supply of the daily required amount of calories and nutrients, and it proposes a novel FU that accounts for the energy intake and the nutritional quality of the diet. In order to compare the performance of the proposed FU to the most commonly ones used for diet LCAs (mass-based and isocaloric), dietary scenarios within the Spanish context are assessed. On the one hand, using a mass-based FU, greenhouse gas (GHG) emissions are underestimated, since the nutrition properties of food are not considered, and, on the other hand, the isocaloric substitution does not allow comparison among diets with different levels of energy intake. In contrast, the proposed caloric- and nutrient-corrected FU allows to compare diets that differ in energy and nutritional quality in a fairer way. Finally, it is recommended to use this FU for future diet LCAs.

Shift from feeding to sustainably nourishing urban China: A crossing-disciplinary methodology for global environment-food-health nexus.

Dietary change is a win-win opportunity to address the nexus of health and the environment. To prevent city dwellers from developing non-communicable diseases, in 2013, China updated the 2000 version of nutrition-based dietary reference intake (DRI) guidelines. However, whether the DRI guidelines have a positive effect on the environment is not well understood. Here, we explored the systematic effects of urbanization on China's health and environmental nexus based on survey data. Then, we optimized the diets of 18 age-gender groups to reduce carbon emissions, water consumption, and land use while meeting the healthy nutrition goals of both DRI guidelines. The results showed that the optimal diets based on the DRI 2013 outperformed these on DRI 2000 in improving China's environmental sustainability, although these diets did not always perform better at an individual scale. Our findings suggest that dietary changes can reduce carbon, water, and ecological footprints by 24%, 15%, and 22% in 2050, respectively; however, the differences in age-specific and gender-specific health goals cannot be neglected.

How a retrotransposon exploits the plant's heat stress response for its activation.

Retrotransposons are major components of plant and animal genomes. They amplify by reverse transcription and reintegration into the host genome but their activity is usually epigenetically silenced. In plants, genomic copies of retrotransposons are typically associated with repressive chromatin modifications installed and maintained by RNA-directed DNA methylation. To escape this tight control, retrotransposons employ various strategies to avoid epigenetic silencing. Here we describe the mechanism developed by ONSEN, an LTR-copia type retrotransposon in Arabidopsis thaliana. ONSEN has acquired a heat-responsive element recognized by plant-derived heat stress defense factors, resulting in transcription and production of full length extrachromosomal DNA under elevated temperatures. Further, the ONSEN promoter is free of CG and CHG sites, and the reduction of DNA methylation at the CHH sites is not sufficient to activate the element. Since dividing cells have a more pronounced heat response, the extrachromosomal ONSEN DNA, capable of reintegrating into the genome, accumulates preferentially in the meristematic tissue of the shoot. The recruitment of a major plant heat shock transcription factor in periods of heat stress exploits the plant's heat stress response to achieve the transposon's activation, making it impossible for the host to respond appropriately to stress without losing control over the invader.

Assessment of rates of overweight and obesity and symptoms of posttraumatic stress disorder and depression in a sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans.

OBJECTIVE: We examined rates of overweight and obesity in a sample of Operation Enduring Freedom/Operation Iraqi Freedom Veterans setting up routine care within 1 Veterans Affairs medical center and examined associations between weight and measures of symptoms of posttraumatic stress disorder (PTSD) and depression. METHODS: Retrospective chart reviews were conducted to collect data on weight and symptoms of PTSD and depression. RESULTS: Mean body mass index (=27 kg/m2, SD = 4.47) was within the overweight range. Veterans had rates of overweight that were higher than those of national samples of individuals in the same age group, but had lower rates of obesity. Measures of symptoms of PTSD and depression were not associated with weight. CONCLUSIONS: A high proportion of individuals in this group of Operation Enduring Freedom/Operation Iraqi Freedom Veterans is overweight with rates consistent with the larger active duty population. Overweight was not associated with psychological distress. These data raise concerns for long-term problems with weight in this group of Veterans.

Ending treatment: the course of emotional adjustment and quality of life among breast cancer survivors immediately following radiation therapy.

GOAL OF WORK: This study investigated changes in psychological adjustment and quality of life among breast cancer patients following completion of radiation therapy. PATIENTS AND METHODS: Ninety-four patients completed measures of depressed mood, anxiety, and quality of life via interview at five time points: the end of radiation therapy, 2 weeks posttreatment, the first radiation oncology follow-up appointment (4-6 weeks after treatment), 3 months posttreatment, and 6 months posttreatment. MAIN RESULTS: At the conclusion of radiation treatment, participants reported elevated levels of depression, low levels of anxiety, and diminished quality of life. By 2 weeks posttreatment, depression decreased significantly and overall quality of life improved significantly, as well as quality of life in the specific FACT-B domains of Physical and Functional Well Being and the Breast Cancer Subscale. Following that time, the only significant change involved further improvement in breast-cancer-specific concerns. CONCLUSIONS: Results suggest that the primary psychological changes associated with ending breast cancer treatment occur quickly following the conclusion of treatment. Thereafter, psychological status appears to stabilize. The implications of these findings for treatment and directions for future research are discussed.

Effect of warfarin nonadherence on control of the International Normalized Ratio.

OBJECTIVE: The frequency and causes of ab- errant International Normalized Ratios (INRs) in warfarin recipients and the percentage explainable by warfarin nonadherence were studied. METHODS: The medical records of patients whose warfarin therapy was monitored by a telephone-based anticoagulation service in a Midwestern urban hospital between March 2000 and March 2001 were reviewed for causes of out-of-range INRs, the percentage of out-of-range INRs attributable to warfarin nonadherence, and demographic and clinical variables predictive of nonadherence. RESULTS: Data from 347 patients were studied. The cohort yielded 4305 INRs, of which 1002 (23%) were out of range (lower than 1.8 or higher than 3.4). Thirty-six percent of the out-of-range INRs were due to warfarin or dietary nonadherence, 9% were due to medical systems problems (including drug interactions), 18% were due to a change in clinical status, and 38% were idiopathic. Age younger than 65 years, age greater than 80 years, and living closer to the laboratory were predictive of warfarin nonadherence. CONCLUSION: Warfarin nonadherence was the most common cause of explainable aberrant INRs in patients taking warfarin. Age younger than 65 years, age greater than 80 years, and living close to the laboratory were predictive of warfarin nonadherence.