Relationship between food environment, social isolation and diet quality in Brazil / Relación entre el entorno alimentario, el aislamiento social y calidad de la dieta en Brasil. Introducción

Introduction. The COVID-19 pandemic has impacted diet quality in differentways. In this context, community, organizational and consumer nutrition environments can influence the eating pattern. Objective. The purpose of this study was to identify how quarantine during the COVID-19 pandemic changed the diet in Brazil. Materials and methods. A natural experiment organized into experimental (social-isolated group - SIG) and control groups (non-isolated group - CG) was conducted with data collection from an online survey at the beginning of the pandemic (T0) and in the less restrictive period of 2020 (T1). Pre-post improvements in diet quality (IDQ) were determined for the SIG and CG. Intro-intergroup changes were tested using the Mann­Whitney and Wilcoxon signed rank tests. The intervention effect was estimated using crude and adjusted difference- indifference in multilevel regression analysis accounting for repeated measures. Results. A sample of 565 Brazilian adults answered the questionnaire at T0 and T1. IDQ was favored twice or more by attitudes such as buying food directly from farmers/street markets, reducing requests for food delivery, and increasing time spent on eating activities and the frequency of cooking. The isolated group had no IDQ at T1, whereas the no isolated group, who worsened diet quality (6.1%) at T0, improved it at T1 (4.8%). Conclusions. The restrictive quarantine forced the non-isolated population to have an experience comparable to a food desert, negatively affecting their diet(AU)

COVID-19 ha impactado la calidad de la dieta de diferentes maneras. Los entornos comunitarios, organizacionales y nutricionales de los consumidores pueden influir en los patrones dietéticos. Objetivo. el objetivo de este estudio fue identificar cómo la cuarentena durante la pandemia de COVID-19 cambió la dieta en Brasil. Materiales y métodos. Se realizó un experimento natural organizado en grupos experimental (grupo socialmente aislado - SIG) y control (grupo no aislado - GC) con datos recolectados en una encuesta en línea al inicio de la pandemia (T0) y en el momento menos restrictivo de 2020 (T1). Se determinaron mejoras pre-post en la calidad de la dieta (IDQ) para SIG y GC. Los cambios intra-intergrupo se probaron utilizando las pruebas de rangos con signos de Mann-Whitney y Wilcoxon. El efecto de la intervención se estimó utilizando diferencias crudas y ajustadas en el análisis de regresión multinivel, teniendo en cuenta medidas repetidas. Resultados. Una muestra de 565 adultos brasileños respondió el cuestionario en T0 y T1. IDQ se vio favorecido dos o más veces por actitudes como comprar alimentos directamente de los agricultores/mercados callejeros, reducir los pedidos de entrega de alimentos y aumentar el tiempo dedicado a las actividades alimentarias y la frecuencia de cocinar. El grupo aislado no mostró IDQ en T1, mientras que el grupo no aislado, que tenía peor calidad de la dieta (6,1%) en T0, mejoró en T1 (4,8%). Conclusiones. La cuarentena restrictiva obligó a la población no aislada a tener una experiencia comparable a un desierto alimentario, afectando negativamente su dieta(AU)

Guías alimentarias, elementos para el camino hacia la sostenibilidad / Dietary guidelines, elements for the path towards sustainability

La preservación de la triada salud, bienestar y desarrollo del potencial del individuo descansa sobre una adecuada alimentación. Esta revisión pretende abordar algunos elementos a considerar ante una inminente actualización de las guías alimentarias hacia la sostenibilidad. La transformación de los sistemas alimentarios es una prioridad, dada la relación entre estos y la mejora de la salud poblacional y no solo de la salud ambiental. Un consumo responsable con dietas de calidad beneficia a la sociedad local e internacional, la ecología y la economía y las guías alimentarias siguen siendo la herramienta para llevar a la práctica las diferentes recomendaciones en materia alimentaria, alineadas con los principios de la Organización Mundial de la Salud y el desarrollo sostenible. La comparación entre las guías alimentarias existentes mostró algunos elementos útiles para su actualización con enfoque sostenible, siendo ellos: el contexto, el propósito, la necesidad de armonización, el significado de la sostenibilidad, la inclusión y el impacto sobre el ambiente-salud-producción. La actualización de las guías alimentarias es útil y necesaria para brindar estrategias y respuestas oportunas ante una población cada vez más responsable de su autocuidado y de su papel de cara a la preservación del medio ambiente para las futuras generaciones. Desafíos tan importantes como el incremento en el consumo de alimentos de origen vegetal, la preferencia por pescado o ave frente a la de carnes rojas y la reducción de las pérdidas y el desperdicio de alimentos y el equilibrio entre beneficios nutricionales y ambientales siguen siendo los principales hitos en la actualización de guías alimentarias basadas en la sostenibilidad(AU)

The preservation of the triad of health, well-being and development of the individual's potential rests on adequate nutrition. This review aims to address some elements to consider in the face of an imminent update of dietary guidelines towards sustainability. The transformation of food systems is a priority, given the relationship between these and the improvement of population health and not only environmental health. Responsible consumption with quality diets benefits local and international society, ecology and the economy, and dietary guidelines continue to be the tool to put into practice the different recommendations on food matters aligned with the principles of the World Health Organization and sustainable development. The comparison between existing dietary guidelines showed some useful elements for their update with a sustainable approach, these being: the context, the purpose, the need for harmonization, the meaning of sustainability, inclusion and the impact on the environment-health-production. The update of dietary guidelines is useful and necessary to provide timely strategies and responses to a population that is increasingly responsible for its self-care and its role in preserving the environment for future generations. Challenges as important as the increase in the consumption of plant-based foods, the preference for fish or poultry over red meat, the reduction of food losses and waste, and the balance between nutritional and environmental benefits remain the main milestones in the updating of food guidelines based on sustainability(AU)

The (scarce and circumscribed) culinary content in food-based dietary guidelines around the world: 1991-2021.

OBJECTIVE: To evaluate the culinary content of key messages contained in food-based dietary guidelines (FBDG) available at the global online repository of the FAO of the UN. DESIGN: Document analysis was conducted in August 2021 with data extraction of key messages explicitly related to cooking present in FBDG. Data were analysed inductively using thematic analysis. SETTING: The FAO's global repository of FBDG. PARTICIPANTS: Not applicable. RESULTS: Just over half (n 39; 53·4 %) of the seventy-three FBDG analysed included at least one key message about cooking. The Latin American and Caribbean FBDG presented the greatest amount and variety of content about cooking in the key messages, whereas the Near East and North America placed less emphasis on cooking. We identified three themes: (i) healthy food preparation (n 35; 61·4 % of the fifty-seven culinary key messages identified); (ii) food hygiene (n 14; 24·6 %) and (iii) the promotion of culinary practices (n 7; 12·3 %). Albania's key message covered two themes (food hygiene and healthy food preparation) (n 1; 1·8 %). CONCLUSION: FBDG are official documents that express recommendations for a healthy diet. As most of these recommendations throughout the world include foods that must be cooked prior to consumption, culinary content should gain more visibility and be presented more broadly in these official documents.

The health, environmental, and economic dimensions of future dietary transitions in Argentina.

Diets link human health with environmental sustainability, offering promising pressure points to enhance the sustainability of food systems. We investigated the health, environmental, and economic dimensions of the current diet in Argentina and the possible effects of six dietary change scenarios on nutrient adequacy, dietary quality, food expenditure, and six environmental impact categories (i.e., GHG emissions, total land occupation, cropland use, fossil energy use, freshwater consumption, and the emission of eutrophying pollutants). Current dietary patterns are unhealthy, unsustainable, and relatively expensive, and all things being equal, an increase in income levels would not alter the health dimension, but increase environmental impacts by 33-38%, and costs by 38%. Compared to the prevailing diet, the six healthier diet alternatives could improve health with an expenditure between + 27% (National Dietary Guidelines) to -5% (vegan diet) of the current diet. These dietary changes could result in trade-offs between different environmental impacts. Plant-based diets showed the lowest overall environmental impact, with GHG emissions and land occupation reduced by up to 79% and 88%, respectively, without significant changes in cropland demand. However, fossil energy use and freshwater consumption could increase by up to 101% and 220%, respectively. The emission of eutrophying pollutants could increase by up to 54% for all healthy diet scenarios, except for the vegan one (18% decrease). We conclude that the health and environmental crisis that Argentina (and other developing countries) currently face could be mitigated by adopting healthy diets (particularly plant-based), bringing in the process benefits to both people and nature. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11625-021-01087-7.

Eat Well to Fight Obesity and Save Water: The Water Footprint of Different Diets and Caloric Intake and Its Relationship With Adiposity.

Water scarcity and excess adiposity are two of the main problems worldwide and in Mexico, which is the most obese country in the world and suffers from water scarcity. Food production represents 90% of a person's water footprint (WF), and healthy diets can lead to less WF than do unhealthy diets related to obesity. We calculated the WF of the diet and caloric intake of adults in Mexico and analyzed its relationship with adiposity. Also, the risk of water expenditure due to adiposity and adherence to dietary recommendations regarding WF of international healthy diets were examined. A Food Consumption Frequency Questionnaire (FCFQ) was applied to 395 adults. Body mass index (BMI), associated with adiposity indicators, was used as a reference for grouping a sample into adiposity levels. The WF was calculated according to the WF Assessment Method, considering correction factors and accounting for water involved in cooking and food washing. Our results showed that the Mexican diet spends 6,056 liters per person per day (L p-1d-1) and is 55% higher than international healthy diets WF. Consumption of beef, milk, fruits, chicken, and fatty cereals represented 56% of total WF. Strong relations appeared between hypercaloric diets and high WF. Diets of people with excess adiposity generated statistically higher WF with extra expenses of 729 L p-1d-1 compared with the normal adiposity population. Following nutritional recommendations offers a protective factor in water care, whereas not adhering to these represents a risk up to 93 times greater of water expenditure regarding international healthy diets. Therefore, both for the general population and to regulate obesity, adequate diets can help mitigate the problem of water scarcity.

Factors associated with diet changes during the COVID-19 pandemic period in Brazilian adults: Time, skills, habits, feelings and beliefs.

This study aimed to identify individual, household and sociodemographic factors associated with changes in food consumption that lead to changes in the diet quality, in the context of the COVID-19 pandemic concerning Brazilian adults. Improvements or worsening in diet quality (IDQ or WDQ) were verified using an exploratory online survey which investigated whether participants (n = 4780) increased or decreased their consumption of food subgroups that mark positive or negative food patterns. Respondents also agreed or disagreed with their beliefs about food safety, cooking skills, family support, home characterization, feelings and behaviors. All factors of influence on the IDQ or WDQ groups were always compared against the general participants (who did not change their diet sufficiently to be classified into these groups). Individuals from the IDQ group spent more time on food (81.4% versus 62.0%), started to cook more often (91.4%), were more confident with their cooking skills (p < 0.01) and positive feelings were at least 2.5 times more prevalent. Adjusted analysis showed the chance to improve diet was 1.39 higher among those who did not feel overworked and increased 1.07 in each additional cooking chore shared between household members. For each additional positive feeling, the odds were 1.41 to IDQ and 0.67 to WDQ. Moreover, for each additional negative feeling the chances for WDQ were 1.21 and 0.90 for IDQ. Those in the WDQ group were more unaware of issues related to contagion during meals, they were not afraid of eating food prepared outside their home and agreed that industrialized food is safer (OR = 1.85). These results highlight the associated factors in improving or worsening diet patterns as a consequence of the COVID-19 pandemic, supporting messages presented in Dietary Guidelines.

Toward a healthy and sustainable diet in Mexico: where are we and how can we move forward?

BACKGROUND: Dietary recommendations worldwide have focused on promoting healthy diets to prevent diseases. In 2019, the EAT-Lancet Commission presented global scientific targets for healthy diets and sustainable food production and proposed a healthy reference diet (EAT-HRD) that can be adapted to the culture, geography, and demography of the population and individuals in any country. OBJECTIVES: We aimed to describe the daily energy intake from food groups and subgroups in Mexican adults relative to the EAT-HRD and propose an adaptation of the EAT-HRD to the Mexican context. METHODS: We analyzed data from the Mexican National Health and Nutrition Surveys in 2012 and 2016. Diet information was obtained using the 5-step multiple-pass 24-h dietary recall method. We estimated the mean energy intake from food groups and subgroups and compared these figures with the midpoint of the EAT-HRD and with the Mexican Dietary Guidelines (MDGs). We also proposed an adaptation of the EAT-HRD to the Mexican context based on the mean energy intake and the comparison between the MDGs and the EAT-HRD. RESULTS: Mexican adults consume higher than the EAT-HRD for grains (mostly refined), dairy, added sugars, and animal-based proteins (particularly red meat, poultry, eggs, and processed meats); and lower than the EAT-HRD for vegetables, fruits, legumes, nuts, tubers and starchy vegetables, fish, and added fats. Based on these findings, we propose a healthy and sustainable reference diet adapted for the Mexican population. CONCLUSIONS: Mexican adults have a diet that is far from being healthy and is not sustainable. The adaptation of the EAT-HRD to the Mexican context is a timely input for current government efforts to move to a sustainable and healthy food system, including the update of the current MDGs.

EAT-Lancet diet score requires minimum intake values to predict higher micronutrient adequacy of diets in rural women of reproductive age from five low- and middle-income countries.

The EAT-Lancet Commission promulgated a universal reference diet. Subsequently, researchers constructed an EAT-Lancet diet score (0-14 points), with minimum intake values for various dietary components set at 0 g/d, and reported inverse associations with risks of major health outcomes in a high-income population. We assessed associations between EAT-Lancet diet scores, without or with lower bound values, and the mean probability of micronutrient adequacy (MPA) among nutrition-insecure women of reproductive age (WRA) from low- and middle-income countries (LMIC). We analysed single 24-h diet recall data (n 1950) from studies in rural DRC, Ecuador, Kenya, Sri Lanka and Vietnam. Associations between EAT-Lancet diet scores and MPA were assessed by fitting linear mixed-effects models. Mean EAT-Lancet diet scores were 8·8 (SD 1·3) and 1·9 (SD 1·1) without or with minimum intake values, respectively. Pooled MPA was 0·58 (SD 0·22) and energy intake was 10·5 (SD 4·6) MJ/d. A one-point increase in the EAT-Lancet diet score, without minimum intake values, was associated with a 2·6 (SD 0·7) percentage points decrease in MPA (P < 0·001). In contrast, the EAT-Lancet diet score, with minimum intake values, was associated with a 2·4 (SD 1·3) percentage points increase in MPA (P = 0·07). Further analysis indicated positive associations between EAT-Lancet diet scores and MPA adjusted for energy intake (P < 0·05). Our findings indicate that the EAT-Lancet diet score requires minimum intake values for nutrient-dense dietary components to avoid positively scoring non-consumption of food groups and subsequently predicting lower MPA of diets, when applied to rural WRA in LMIC.

Why Food System Transformation Is Essential and How Nutrition Scientists Can Contribute.

BACKGROUND: The International Union of Nutritional Sciences held its 21st International Congress of Nutrition in October 2017 in Buenos Aires, Argentina under the theme - From Sciences to Nutrition Security. In addition to multiple sessions on food systems and their links to diet, nutrition and health, the Congress closing lecture focused on the need to transform food systems so as to increase their capacity to provide healthy diets, making a call for greater involvement of nutrition scientists. SUMMARY: This article presents the main messages of that lecture, providing (i) an overview of global nutrition trends and their links to diets, food environments and food systems, (ii) a synopsis of the current global momentum for food system transformation and (iii) the need for nutrition scientists to leverage this momentum in terms of increased evidence generation and policy advocacy. Key Messages: Poor quality diets are increasingly leading to the compromising of human health as never before; the prevalence of undernutrition persists and remains acute in vulnerable regions, and hunger is increasing concomitantly with an unprecedented rise in overweight, obesity and nutrition-related non-communicable diseases. Increasing access to healthy diets through faster, stronger implementation of supply and demand-side strategies that address the underlying drivers of today's faulty food systems is imperative to solve these problems, as well as to address related environmental and economic costs. The global momentum for such action is increasing, but the evidence base needed to galvanize governments and hold stakeholders accountable remains yet a fledgling. To date, inputs from nutrition scientists to this reform agenda have been weak, especially given the unique contributions the field can make in terms of rigorous analysis and technical advice. Strengthened participation will require innovations in metrics and methodologies, combined with new thinking on what constitutes viable evidence and a greater willingness to engage with private sector agri-food actors.