Indices for measurement of sustainable diets: A scoping review.

INTRODUCTION: The current food system is associated with negative impacts on health, food insecurity and environmental harm. Sustainable diets have attracted increasing interest and novel proposals with a global scope have emerged. This scoping review aims to give an overview of the analysis of all the available evidence related to the sustainable diet indices that have been developed based on the EAT-Lancet Commission. METHODS: Searches were conducted in the PubMed, Embase, Web of Science, Scopus and Science Direct databases. This review was conducted following the PRISMA-ScR guidelines. The target population were studies addressed the use of an index or metric for assessing sustainable diets based on the EAT-Lancet Commission Summary Report were included. PCC acronym was used in the design of the study to describe eligibility criteria: P (Population)-Indexes; C (Concept)-Sustainable diets; C (Context)-Knowledge on the structure and applicability of measurement indices of sustainable diets based on EAT-Lancet recommendations available in the literature. Study eligibility criteria were restricted to papers published in English, from January 2019 through October 2022, with no population restriction. RESULTS: A total of 1,458 papers were retrieved, 14 of which were included in the review. Seven measures of sustainable diets were identified as follow: EAT-Lancet diet score (ELD-I), New EAT-Lancet diet score (EAT), Planetary Health Diet Index (PHDI), Sustainable Diet Index (SDI), Sustainable-HEalthy-Diet (SHED), novel Nutrient-Based EAT index (NB-EAT) and World Index for Sustainability and Health (WISH). Most studies were conducted in developed countries, where greater adherence to this type of diet was found. Estimated greenhouse gas emissions was the most reported indicator of sustainability, followed by diet quality and the benefits of sustainable diets with regards to health outcomes. DISCUSSION: We identified barriers that hinder progress towards sustainable diets, including the difficulty of comparing different indices and the tendency to neglect social aspects and the lack of common definitions and metrics. Despite being challenge, we highlight the importance of using indices that assess sustainable diets that harmonize various indicators, as recommended by the EAT-Lancet Commission, in order to promote positive changes towards a more sustainable future.

[Acceptance of school food by Brazilian adolescents: individual and school context determinants]. / Adesão à alimentação escolar por adolescentes brasileiros: determinantes individuais e do contexto escolar.

The scope of this study was to evaluate the acceptance of school food by Brazilian adolescents, taking individual and school context determinants into consideration. A total of 10,262 adolescents in public schools of the 2015 Brazilian National Survey of School Health (PeNSE 2015) were assessed. Multilevel regression was used to estimate the effect of variables of the individual context and the school environment on low acceptance of school food by adolescents. The prevalence of low acceptance (consumption of school meals ≤ 2 days/week) was 64.2% in this group. The explanatory model showed less acceptance of this practice among female adolescents (PR=1.09; CI: 1.03-1.14), among those aged 15 years or older (PR=1.08; CI: 1.02-1.14), those who regularly consumed soft drinks (PR=1.09; CI: 1.03-1.15), those who did not regularly have lunch and dinner with parents and guardians (PR=1.08; CI: 1.02-1.14), and those who lived in households with less than 4 people (PR=1.07; CI: 1.02-1.13). Concerning the school environment, studying in schools with more than 1,000 students (PR=1.22; CI: 1.12-1.33) and the presence of a cafeteria (PR=1.15; CI: 1.08-1.22) led to low acceptance. The results revealed the importance of the school context in determining the consumption of school meals by adolescents.

Objetivou-se avaliar a adesão à alimentação escolar por adolescentes brasileiros considerando determinantes individuais e do contexto escolar. Foram avaliados 10.262 adolescentes de escolas públicas da Pesquisa Nacional de Saúde do Escolar de 2015. Regressão multinível foi utilizada para estimar o efeito de variáveis do contexto individual e do ambiente escolar na ocorrência da baixa adesão à alimentação escolar por adolescentes. A prevalência dessa baixa adesão (consumo da alimentação escolar ≤2dias/semana) foi 64,2% nesse grupo. O modelo explicativo evidenciou menor adesão a essa prática entre adolescentes do sexo feminino (RP=1,09; IC: 1,03-1,14), entre aqueles com 15 anos ou mais de idade (RP=1,08; IC: 1,02-1,14), que tinham consumo regular de refrigerantes (RP=1,09; IC: 1,03-1,15), que não realizavam regularmente almoço e jantar com pais e responsáveis (RP=1,08; IC: 1,02-1,14), e que moravam em domicílios com menos de 4 pessoas (RP=1,07; IC: 1,02-1,13). Em relação ao ambiente escolar, estudar em escolas com mais de 1.000 alunos (RP=1,22; IC: 1,12-1,33) e com presença de cantina (RP=1,15; IC: 1,08-1,22) determinaram a baixa adesão. Os resultados demonstram importante efeito do contexto escolar na determinação do consumo da alimentação escolar por adolescentes.

Adesão à alimentação escolar por adolescentes brasileiros: determinantes individuais e do contexto escolar / Acceptance of school food by Brazilian adolescents: individual and school context determinants

Resumo Objetivou-se avaliar a adesão à alimentação escolar por adolescentes brasileiros considerando determinantes individuais e do contexto escolar. Foram avaliados 10.262 adolescentes de escolas públicas da Pesquisa Nacional de Saúde do Escolar de 2015. Regressão multinível foi utilizada para estimar o efeito de variáveis do contexto individual e do ambiente escolar na ocorrência da baixa adesão à alimentação escolar por adolescentes. A prevalência dessa baixa adesão (consumo da alimentação escolar ≤2dias/semana) foi 64,2% nesse grupo. O modelo explicativo evidenciou menor adesão a essa prática entre adolescentes do sexo feminino (RP=1,09; IC: 1,03-1,14), entre aqueles com 15 anos ou mais de idade (RP=1,08; IC: 1,02-1,14), que tinham consumo regular de refrigerantes (RP=1,09; IC: 1,03-1,15), que não realizavam regularmente almoço e jantar com pais e responsáveis (RP=1,08; IC: 1,02-1,14), e que moravam em domicílios com menos de 4 pessoas (RP=1,07; IC: 1,02-1,13). Em relação ao ambiente escolar, estudar em escolas com mais de 1.000 alunos (RP=1,22; IC: 1,12-1,33) e com presença de cantina (RP=1,15; IC: 1,08-1,22) determinaram a baixa adesão. Os resultados demonstram importante efeito do contexto escolar na determinação do consumo da alimentação escolar por adolescentes.

Abstract The scope of this study was to evaluate the acceptance of school food by Brazilian adolescents, taking individual and school context determinants into consideration. A total of 10,262 adolescents in public schools of the 2015 Brazilian National Survey of School Health (PeNSE 2015) were assessed. Multilevel regression was used to estimate the effect of variables of the individual context and the school environment on low acceptance of school food by adolescents. The prevalence of low acceptance (consumption of school meals ≤ 2 days/week) was 64.2% in this group. The explanatory model showed less acceptance of this practice among female adolescents (PR=1.09; CI: 1.03-1.14), among those aged 15 years or older (PR=1.08; CI: 1.02-1.14), those who regularly consumed soft drinks (PR=1.09; CI: 1.03-1.15), those who did not regularly have lunch and dinner with parents and guardians (PR=1.08; CI: 1.02-1.14), and those who lived in households with less than 4 people (PR=1.07; CI: 1.02-1.13). Concerning the school environment, studying in schools with more than 1,000 students (PR=1.22; CI: 1.12-1.33) and the presence of a cafeteria (PR=1.15; CI: 1.08-1.22) led to low acceptance. The results revealed the importance of the school context in determining the consumption of school meals by adolescents.