"Planeterranean" diet: the new proposal for the Mediterranean-based food pyramid for Asia.

BACKGROUND AND OBJECTIVES: The Mediterranean Diet (MD) has been recognized for its benefits for human health and sustainability for the planet, but it has considered not easy to reproduce in other populations. The United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair on Health Education and Sustainable Development is fostering a research project (Planeterranea), aiming to identify a healthy dietary pattern based on local foods with the same MD features. The aim of our study is to develop a MD-based food pyramid for Asian populations. METHODS: Asia was stratified into six areas according to pedo-climatic conditions. For each region a comprehensive scoping review of local crops and typical foods was conducted on several databases such as the US Department of Agriculture (USDA)'s database, the Food and Agriculture Organization of the United Nations (FAO) website, and PubMed, focusing on both plant-based and animal-based foods. Narrative review was then conducted on the identified foods to determine their nutritional composition and planetary health impact. Finally, the collected information was used to build up the Asian food pyramid with details for each respective region. RESULTS: We proposed a food pyramid for Asian countries, guaranteeing the same nutritional intake and health benefits as MD, by considering dietary habits and typical foods of this population. From the bottom to the top, Asian fruits and vegetables present similar nutritional profile as those in MD. Whole grains (barley) may represent valid alternative to white rice. Sesame oil represents a source of unsaturated fats and an alternative to olive oil. Legumes (soybean), edible insects, mushrooms and algae, guarantee an adequate intake of plant-based proteins with a complete amino-acid profile and a low environmental impact with respect to animal-based ones. CONCLUSIONS: This work is a new insight of healthy and sustainable local food system based on MD principles for the Asian population.

The relationship between the World Index for Sustainability and Health (WISH) score and mental health in women: a cross-sectional study.

Diet quality has been associated with mental health, and recently, there has been growing interest in the association between the sustainability of diets and human health. The objective of this cross-sectional study was to explore the relationship between a newly developed dietary index for health and sustainability and psychological disorders among Iranian women. Participants in this cross-sectional study included 479 women living in Tehran with no history of chronic disease. A validated 168-item FFQ was used to assess dietary intake. The World Index for Sustainability and Health was calculated, consisting of four sub-scores: less healthy, healthy, low environmental impact and high environmental impact. Participants' psychological status was assessed using the Depression Anxiety Stress Scale-21. Logistic regression models were used to examine the association between the World Index for Sustainability and Health and psychological disorders. Participant ages ranged from 20 to 50 years, with a mean age of 31·86 (sd 7·68) years. After adjusting for potential confounders (age, energy, BMI, marital status, education, family history of chronic disease, body satisfaction, socio-economic status, physical activity, smoking), women in the highest tertile of the healthy sub-score had significantly lower odds of experiencing depression (OR 0·40; 95 % CI 0·24, 0·67), anxiety (OR 0·45; 95 % CI 0·23, 0·87) and psychological distress (OR 0·46; 95 % CI 0·28, 0·77) compared with the reference group. Similarly, the less healthy sub-score was significantly associated with depression (OR 0·51; 95 % CI 0·32, 0·89), anxiety (OR 0·44; 95 % CI 0·25, 0·78) and psychological distress (OR 0·57; 95 % CI 0·36, 0·90). An inverse association was observed between the low environmental impact sub-score and depression (OR 0·32; 95 % CI 0·19, 0·54), anxiety (OR 0·38; 95 % CI 0·18, 0·76) and psychological distress (OR 0·30; 95 % CI 0·17, 0·51). However, no further significant associations were found with the high environmental impact sub-score, except with depression (OR 0·57; 95 % CI 0·33, 0·96). The healthy and low environmental impact sub-scores of the World Index for Sustainability and Health were found to be inversely associated with depression, anxiety and psychological distress. However, due to the cross-sectional study design, causality cannot be inferred. Further prospective studies are required to validate and expand upon these findings and explore potential mechanisms and alternative explanations, such as reverse causation. While this study suggests that choosing a diet that is both healthy for individuals and sustainable for the environment may be associated with a lower risk of mental health issues among women, more research is needed.

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.

Environmental impact of Norwegian self-selected diets: comparing current intake with national dietary guidelines and EAT-Lancet targets.

OBJECTIVES: Dietary environmental impact in a Norwegian adult population was estimated for six environmental impact categories. Moreover, environmental benefits of scenario diets complying with the Norwegian Food-Based Dietary Guidelines (FBDG) and the EAT-Lancet reference diet were assessed. DESIGN: The current diet of Norwegian adults was estimated according to 24-h dietary recall data from a national dietary surveillance survey (Norkost 3). Scenario diets were modelled to represent the Norwegian FBDG and the EAT-Lancet healthy reference diet. Dietary environmental impact in terms of global warming potential, freshwater and marine eutrophication, terrestrial acidification, water use and transformation and use of land was estimated for the current and scenario diets using environmental impact data representative of the Norwegian market. Significant associations between impact and gender/educational attainment were assessed at P < 0·05. SETTING: Norway. PARTICIPANTS: Adults (n=1787) aged 18-70 years who participated in the Norkost 3 survey (2010-2011). RESULTS: Environmental impact varied significantly by gender and educational attainment. The food groups contributing most to environmental impact of Norwegian diets were meat, dairy, beverages, grains and composite dishes. Compared with the current Norwegian diet, the FBDG scenario reduced impacts from 2 % (freshwater eutrophication) to 32 % (water use), while the EAT-Lancet scenario reduced impacts from 7 % (marine eutrophication) to 61 % (land use). The EAT-Lancet scenario resulted in 3-48 % larger reductions in impact than the FBDG scenario. CONCLUSIONS: The Norwegian FBDG, while not as environmentally friendly as the EAT-Lancet reference diet, can still be an important tool in lessening environmental burden of Norwegian diets.

Evaluation of the relationship between the Mediterranean diet adherence and sleep quality in adults.

PURPOSE: To investigate the association between Mediterranean diet adherence (MDA) and sleep quality in adults. METHODS: This cross-sectional research was conducted among adults aged 19-64 years in Ankara, Türkiye. Data on demographics, education, lifestyle, and physical activity habits were collected. Mediterranean diet adherence was assessed with the Mediterranean Diet Adherence Screener (MEDAS). Healthy eating attitudes were evaluated with the Attitude Scale for Healthy Nutrition (ASHN). Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Data were gathered using an online format. RESULTS: Among 1031 participants enrolled (74% women), mean age was 28.6 ± 8.3 years. Median age increased with MDA (p = 0.001). As individuals' MDA increased, ASHN total and subgroup scores also increased significantly (p < 0.001). The total sleep duration of the participants with low MDA was significantly lower than the other groups (p = 0.003). Pittsburgh Sleep Quality Index score and MEDAS (ß = - 0.222, p < 0.001), ASHN (ß = - 0.043, p < 0.001) and ASHN subgroups (ß = (- 0.086) - (- 0.031)) were found to have a weakly signficant negative relation. CONCLUSIONS: The findings suggest that healthy eating attitudes and nutritional behavior in accordance with the Mediterranean diet are associated with sleep quality.

Health or environment? Understanding which informative message is more effective in replacing red meat with mushroom-based alternatives.

Current concerns regarding the health and environmental consequences associated with excessive meat consumption have underscored the importance of guiding consumers towards more sustainable diets. Given this perspective, this study seeks to evaluate the effectiveness of tailored informative messages in shaping consumer behaviour, particularly within the framework of replacing meat with mushroom-based alternatives. Additionally, it explores the factors influencing informative message effectiveness. An experimental online survey was conducted on a sample of 951 Italian consumers. Specifically, the sample was divided into three groups, of which 309 individuals formed the control group, 311 participants received informative messages on the health risks associated with red meat consumption, and 331 participants received informative messages emphasizing the environmental damages linked to red meat consumption. In both treatments, there was support for mushroom-based alternatives. Analyses included subgroup assessments, tests to verify treatments effectiveness, along with OLS regression to pinpoint variables influencing message effectiveness. The results underscore a fair positive impact of the two informative messages (mean scores: 8.75 for health message; 7.01 for environmental message). Noteworthy psychosocial variables, including lifestyle patterns, nutritional perceptions, and ecological attitudes, emerged as determinants in shaping consumers' food choices. While health-related messages exhibit marked influence, the nuanced landscape of diverse drivers and barriers necessitates judicious communication strategies. These insights bear significance for policymakers, health professionals, and marketers, offering guidance for interventions that effectively influence consumer behaviour toward more sustainable and healthier food practices.

Adherence to the Mediterranean diet is associated with sustainable nutrition and environmental footprints on higher educated individuals.

INTRODUCTION: This study aimed to investigate the relationship between Med-Diet adherence with sustainable nutrition and environmental footprints in academicians. METHODS: The study involved 153 academicians aged 23-64 working in a university in Turkey. Data were collected through a questionnaire including socio-demographic characteristics, anthropometric measurements, Mediterranean Diet Adherence Scale (MEDAS) and Sustainable and Healthy Eating Behaviours Scale (SHEBS). Carbon and water footprints were calculated. RESULTS: All sub-scales of SHEBS were higher in individuals who adhered to Med-Diet than those who did not (p<0.05). The carbon and water footprints of individuals with high adherence to the Med-Diet were lower than those of no adherence (p<0.05). Each 1-point increase in MEDAS score was associated with a 1-point increase in SHEBS score, a 0.15 CO2 eq/kg and a 0.001 m3/year decrease in the amount of carbon and water footprint of food. CONCLUSION: Higher adherence to the Med-Diet was associated with higher sustainable nutrition behaviours, and lower environmental footprints.

The EAT-Lancet diet, genetic susceptibility and risk of atrial fibrillation in a population-based cohort.

BACKGROUND: The EAT-Lancet Commission proposed a global reference diet with both human health benefits and environmental sustainability in 2019. However, evidence regarding the association of such a diet with the risk of atrial fibrillation (AF) is lacking. In addition, whether the genetic risk of AF can modify the effect of diet on AF remains unclear. This study aimed to assess the association of the EAT-Lancet diet with the risk of incident AF and examine the interaction between the EAT-Lancet diet and genetic susceptibility of AF. METHODS: This prospective study included 24,713 Swedish adults who were free of AF, coronary events, and stroke at baseline. Dietary habits were estimated with a modified diet history method, and an EAT-Lancet diet index was constructed to measure the EAT-Lancet reference diet. A weighted genetic risk score was constructed using 134 variants associated with AF. Cox proportional hazards regression models were applied to estimate the hazard ratio (HR) and 95% confidence interval (CI). RESULTS: During a median follow-up of 22.9 years, 4617 (18.7%) participants were diagnosed with AF. The multivariable HR (95% CI) of AF for the highest versus the lowest group for the EAT-Lancet diet index was 0.84 (0.73, 0.98) (P for trend < 0.01). The HR (95% CI) of AF per one SD increment of the EAT-Lancet diet index for high genetic risk was 0.92 (0.87, 0.98) (P for interaction = 0.15). CONCLUSIONS: Greater adherence to the EAT-Lancet diet index was significantly associated with a lower risk of incident AF. Such association tended to be stronger in participants with higher genetic risk, though gene-diet interaction was not significant.

An update on nutritional profile, phytochemical compounds, health benefits, and potential applications in the food industry of pulses seed coats: A comprehensive review.

Pulses, as a sustainable source of nutrients, are an important choice for human diets, but vast quantities of seed coats generated in pulses processing are usually discarded or used as low-value ruminant feed. It has been demonstrated that pulses seed coats are excellent sources of dietary nutrients and phytochemicals with potential health benefits. With growing interest in the sustainable use of resources and the circular economy, utilization of pulses seed coats to recover these valuable components is a core objective for their valorization and an important step toward agricultural sustainability. This review comprehensively provides a comprehensive insight on the nutritional and phytochemical profiles presented in pulses seed coats and their health benefits obtained from the findings of in vitro and in vivo studies. Furthermore, in the food industry, pulses seed coats can be acted as potential food ingredients with nutritional, antioxidant and antimicrobial characteristics or as the matrix or active components of films for food packaging and edible coatings. A better understanding of pulses seed coats may provide a reference for increasing the overall added value and realizing the pulses' sustainable diets.

Adapting the Planetary Health Diet Index for children and adolescents.

BACKGROUND: Tools for measuring adherence to sustainable healthy diets among children and adolescents are lacking. OBJECTIVE: To advance methods for measuring adherence to sustainable healthy diets among children and adolescents by adapting an existing index, compare scores obtained using the original and adapted versions of the index in a sample of Chilean children, and describe the adapted index association with diet characteristics. METHODS: The Planetary Health Diet Index (PHDI) was adapted to better reflect children's and adolescents' nutritional requirements. The adapted index (PHDI-C) comprises 16 components with a maximum score of 150 points. PHDI-C was piloted among a sample of 958 Chilean children (3-6 years) using dietary data collected in 2016 through single 24-h recalls. A decision tree and food disaggregation methodology were developed to guide the calculation of scores. Scores obtained using the original and adapted versions of the index were compared. Linear regression models adjusted by child's gender and age were fitted to explore associations between total PHDI-C score, dietary recall characteristics and nutritional composition of children's diets. RESULTS: PHDI accounted for 75.7% of children's total caloric intake, whereas PHDI-C accounted for 99.6%. PHDI & PHCI-C scores were low among this sample of children; however, mean total score was lower when using PHDI compared to PHDI-C [40.7(12.1) vs 50.1(14.6)]. Children's scores were very low for nuts & peanuts, legumes, dark green vegetables, whole cereals, tubers & potatoes, and added sugars components across both indices, but were higher for dairy products and eggs & white meats components when using the PHDI-C due to adjustments made to ensure nutritional adequacy. Mean total PHDI-C score was significantly lower on weekends and special occasions, and significantly higher when children reported having a special diet (e.g., vegetarian). Total PHDI-C score was negatively associated with total sugars, saturated fats, trans fats, and animal-based protein intake, and positively associated with total protein, plant-based protein, total carbohydrates, and total fibre intake. CONCLUSIONS: This study provides a replicable method for measuring adherence to sustainable healthy diets among children and adolescents that can be used to monitor trends and measure the effectiveness of actions targeting improving children's diets.

Interaction between genetics and inulin affects host metabolism in rainbow trout fed a sustainable all plant-based diet.

Inulin affects nutrition and metabolism in many animals. Although inulin is widely used in the diet of teleosts, its mechanism of action is unknown. Here, we investigated the effect of inulin (2 %) on the intestinal microbiome and metabolism in rainbow trout (Oncorhynchus mykiss) selected for growth and survival when fed a 100 % plant-based diet (suave) and a control line (temoin). Metabolic responses to the two factors (line and inulin) in liver, intestine, muscle and adipose were tissue-specific, with line and interaction between the two factors influencing overall expression in liver. In the intestine, inulin and line and in muscle, line influenced the expression of metabolic genes. Microbiota between the mucus and digestive contents was significantly different, with genera from Proteobacteria being more abundant in the mucus, whereas genera from the Firmicutes and Planctomycetes being more abundant in contents. Effect of inulin and interaction between factors on the microbiome was evident in contents. The significant taxa of control and inulin-fed groups differed greatly with Streptococcus and Weissella being significantly abundant in the inulin-fed group. There was a general trend showing higher levels of all SCFA in temoin group with propionic acid levels being significantly higher. An operational taxonomic unit (OTU) belonging to the Ruminococcaceae was significantly abundant in suave. The tissue-specific correlations between OTU and gene expression may indicate the link between microbiome and metabolism. Together, these results suggest that line and inulin impact the gene expression in a tissue-specific manner, possibly driven by specific OTUs enriched in inulin-fed groups and suave.

Adherence to the EAT-Lancet sustainable reference diet and cardiometabolic risk profile: cross-sectional results from the ELSA-Brasil cohort study.

PURPOSE: The EAT-Lancet Commission released a reference sustainable diet to improve human health and respect the planetary boundaries. The Planetary Health Diet Index (PHDI) was developed with the purpose of evaluate the adherence to this reference diet. The aim of the present study was to evaluate the association between adherence to the EAT-Lancet diet with cardiometabolic risk profile. METHODS: We used the cross-sectional baseline data from 14,155 participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter ongoing cohort study. Dietary data were collected using a 114-item validated food frequency questionnaire. The PHDI was used to assess the adherence to the EAT-Lancet diet. It consists of 16 components and the total score can range from 0 to 150 points. Linear, logistic and quasi-Poisson regression models were built to evaluate the associations between PHDI and the outcomes. RESULTS: Individuals with higher adherence to EAT-Lancet diet (PHDI, 5th quintile) had lower values for systolic blood pressure (ß - 0.84; 95% CI - 1.66: - 0.01), diastolic blood pressure (ß - 0.70; 95% CI - 1.24: - 0.15), total cholesterol (ß - 3.15; 95% CI - 5.30: - 1.01), LDL-c (ß - 4.10; 95% CI - 5.97: -  2.23), and non-HDL-cholesterol (ß - 2.57; 95% CI - 4.62: - 0.52). No association was observed for HDL-c, triglycerides and HOMA-IR. CONCLUSIONS: Our results indicate that higher adherence to the EAT-Lancet diet is associated with lower levels of blood pressure, total cholesterol, LDL-c, and non-HDL-c.

Environmental and nutritional assessment of young children's diets in Norway: comparing the current diet with national dietary guidelines and the EAT-Lancet reference diet.

PURPOSE: Introducing healthy and sustainable diets early in life can promote lifelong healthy dietary patterns with a low environmental impact. Therefore, we aimed to estimate the environmental and nutritional consequences of a dietary change for 2-year-old children in Norway towards healthier dietary patterns. METHODS: Environmental impacts of the current habitual diet among 2-year-olds (n = 1413) were estimated for six impact categories and compared with scenario diets based on the Norwegian food-based dietary guidelines (FBDG) and the EAT-Lancet Commission reference diet. Last, we evaluated the nutritional adequacy of the diets against the Norwegian nutrition recommendations for children aged 2-5 years. The current diet was assessed by an FFQ. RESULTS: Environmental impacts of the current habitual diet were up to two times higher than those of the scenario diets. Compared with the current diet, impacts from the FBDG scenario diet were reduced by 35% for water use and 18% for terrestrial acidification, whereas impacts from the EAT-Lancet scenario diet were reduced by 51% for water use, 57% for terrestrial acidification, 36% for global warming potential and 27% for freshwater eutrophication. Milk and dairy products were the main contributors to environmental impacts in both the current diet and the FBDG scenario diet. The scenario diets were nutritionally adequate and improved the dietary quality among Norwegian 2-year-olds. CONCLUSION: Compared to current diets among young children, more plant-based dietary patterns in line with national FBDG or the EAT-Lancet Commission reference diet can improve the nutritional adequacy of diets and simultaneously reduce environmental impacts.

Discretionary foods and drinks in Norwegian children and adolescents' diet: data from the national dietary survey Ungkost 3.

OBJECTIVE: This study aimed to identify the amount of discretionary foods and drinks consumed by Norwegian children and adolescents, describe how such products contribute to the intake of total energy and nutrients, and study the distribution in intake of discretionary foods and drinks across different meals. Secondly, the aim was to explore factors associated with those children and adolescents having the highest consumption of discretionary foods and drinks. DESIGN: Secondary analysis of data from a national survey of dietary intake among Norwegian children and adolescents. SETTING: Schools in fifty randomly selected municipalities in Norway. PARTICIPANTS: The study population included 636 pupils in 4th grade (9-11 years) and 687 pupils in 8th grade (12-14 years). RESULTS: Discretionary foods and drinks contributed to about 20 % of the children and adolescents' total energy intake. These products contributed to about two-thirds of the participants' intake of added sugar, and limited amounts of dietary fibre, vitamins and minerals. The quartile which had the lowest proportion of their energy intake from discretionary foods and drinks seemed to have a higher intake of whole grains, and fish and seafood. CONCLUSIONS: Almost all 4th and 8th graders in Norway consumed discretionary foods and drinks, and these products contributed to a substantial proportion of the total energy intake and limited amounts of nutrients. Those children and adolescents consuming the least discretionary foods and drinks had a higher intake of whole grains, fish and seafood, indicating healthier and more sustainable food habits.

Testing the impact of overt and covert ordering interventions on sustainable consumption choices: A randomised controlled trial.

Food products have significant impacts on the environment over their life cycle. We investigated whether displaying products in ascending order of carbon footprint in an online supermarket environment can shift consumer choices towards more sustainable options. We examined whether the effect of the ordering intervention differs when the ordering is overt (information about the ordering is explicit), compared to when it is covert (participants not told about the ordering). We conducted a three-arm parallel-group randomised trial using 1842 online participants from England, Wales, and Northern Ireland. Participants shopped for a meal, choosing one product from each of six product categories in a simulated online supermarket. Six products were listed vertically on each product-category page. Products were randomly ordered for the control arm but ordered by carbon footprint in the covert and overt ordering arms. In the overt ordering arm, a statement was displayed at the top of each product page about the ordering of products. The primary outcome was whether one of the three most sustainable products was chosen in each product category. There was no effect of the covert ordering on the probability of choosing more sustainable products compared with the control arm (OR = 0.97, 95% CI 0.88-1.07, p = 0.533). Furthermore, we did not find evidence that the effects of the covert ordering and overt ordering differed (p = 0.594). Within the control condition, products in different positions were chosen with similar frequencies, suggesting that product positioning does not have an impact on choices. This may explain why re-ordering products had no effect. In the overt condition, only 19.5% of people correctly answered that the products were ordered according to sustainability in a follow-up question, suggesting that they didn't notice the statement. Results suggest that choices for grocery products might be too ingrained to be changed by subtle rearrangements of choice architecture like the ordering interventions, and highlight the difficulty of conveying information effectively to consumers in the online grocery shopping environment.

Socioeconomic Level and the Relationship in Glycemic Behavior in the Mexican Population. A Nutritional Alternative Focused on Vulnerable Populations.

In this study, numerical approximations were generated to analyze the behavior of glycemic variations in the non-diabetic population of the Mexican republic. The main objective of this work is to obtain an overview of the glycemic variations in the non-diabetic population from different socioeconomic statuses in Mexico (Medium-high, medium, and low). Thus, evaluating the effect on the glucose level under a healthy diet considering the socioeconomic capabilities of the population. Through the national health and nutrition survey of Mexico 2020 and the Mexican food base, 1420 virtual patients were proposed (522 low status, 485 medium status and 413 Medium-High status) focused on simulating the glycemic behavior in each of the survey participants. Considering that the average food expenditure of the Mexican population is $107.00 MXN, and the cost of a healthy diet is $66.50 MXN, the economic sustainability of the Mexican population to adopt a healthy diet is revealed. The particularity of this work is focused on obtaining diverse data that are difficult to access in the development of population analyses. Such is the case of the approach proposed for different socioeconomic statuses. In this way, the proposed methodology provides a framework for complementary research contributions to the subject.

Sustainability analysis of Finnish pre-schoolers' diet based on targets of the EAT-Lancet reference diet.

PURPOSE: The EAT-Lancet reference diet is a healthy plant-based diet produced within planetary boundaries. To inform the food system transformation, we compared Finnish pre-schoolers' food consumption with the reference diet's food group targets. METHODS: Food record data for 3- to 6-year-old pre-schoolers were collected in the cross-sectional DAGIS survey. Ingredients of composite dishes were available in the data. In addition, we manually decomposed industrial products such as sausages and biscuits by estimating the shares of ingredients. We also estimated the consumption of added sugars and converted the consumption of dairy products into milk equivalents. We used usual intake modelling to estimate the mean consumption and the proportion of children who met the reference diet's targets. We set the target amounts separately for 3- to 4-year-olds and 5- to 6-year-olds in grams by proportioning the published target amounts (assuming a 2500 kcal diet) to the children's mean reported energy intake. RESULTS: For both age groups (3- to 4-year-olds, n = 460; 5- to 6-year-olds, n = 402), the daily mean consumption of whole grains, vegetables, legumes, nuts, and unsaturated oils was below targets, whereas the consumption of red meat, dairy foods, tubers, and added sugars was above targets. The consumption of fruit and fish was in line with targets. CONCLUSION: To comply with the reference diet's targets, major changes in the diets of Finnish children are needed. The key food groups targeted for higher consumption are whole grains and legumes and targeted for lower consumption red meat and dairy products.

The importance of protein variety in a higher quality and lower environmental impact dietary pattern.

OBJECTIVE: Eating a variety of nutritious foods is fundamental to good nutrition. However, this principle is challenged when recommendations seeking to improve the environmental sustainability of diets call for avoidance of foods considered to have a higher environmental footprint, such as animal-sourced foods. Our objective was to assess the implications for nutritional adequacy of protein choice across Australian adult diets preselected as having higher quality and lower environmental impact scores. DESIGN: Each individual diet was assessed for variety of food choice within the 'Fresh meat and alternatives' food group defined in the Australian Dietary Guidelines, which includes protein-rich foods such as eggs, nuts, tofu and legumes in addition to animal meats. Diets were grouped according to variety score and whether they included only animal meats, only alternatives or a variety of meat and alternatives. Nutrient content was assessed relative to estimated average requirements (EAR). SETTING: Australia. PARTICIPANTS: 1700 adults participating in the Australian Health Survey. RESULTS: For diets with higher diet quality and lower environmental impact, the likelihood of achieving nutrient EAR significantly increased as variety of food choice in the 'Fresh meat and alternatives' food group increased (P < 0·001). Variety score and number of serves were also correlated (r = 0·52, P < 0·001) which is relevant since most diets did not meet the recommended minimum number of serves for this food group. CONCLUSIONS: Greater variety within the 'Fresh meat and alternatives' food group is beneficial to meeting EAR and lower environmental impact diets can include three or more selections including foods of animal origin.

Nutritional content, protein quantity, protein quality and carbon footprint of plant-based drinks and semi-skimmed milk in the Netherlands and Europe.

OBJECTIVE: To compare the nutritional composition of bovine milk and several plant-based drinks with a focus on protein and essential amino acid content and to determine the ratio of essential amino acids to greenhouse gas emission. DESIGN: Nutritional information on the label was extracted for semi-skimmed milk, soy, oat, almond, coconut and rice drink from the Innova database between January 2017 and March 2020 for the Netherlands, Belgium, Germany, Spain, Italy, and Sweden. Protein and amino acids were measured and carbon footprint was calculated for a selection of Dutch products. Protein quality was determined by calculating the contribution to the WHO essential amino acids requirements. SETTING: The bovine milk and plant-based drinks market in Netherlands, Belgium, Germany, Spain, Italy, and Sweden. PARTICIPATING PRODUCTS: Semi-skimmed bovine milk and soy-, oat-, almond-, coconut- and rice drink. RESULTS: Nutritional label information was collected for 399 products. Milk naturally contains many micronutrients, e.g. vitamin B2, B12, and calcium. Approximately 50% of the regular plant-based drinks was fortified with calcium, whereas the organic plant-based drinks were mostly unfortified. Protein quantity and quality were highest in milk. Soy drink had the best protein quality to carbon footprint ratio and milk came second. CONCLUSIONS: The nutrition - climate change balance presented in this study, is in line with previous literature, which shows that semi-skimmed bovine milk and fortified soy drink deserve a place in a sustainable diet.

Sustainable diet and cruciform ethics during COVID-19.

Health inequalities in food challenge sustainable prospects during the pandemic. Basic sustainable diet practices may address this issue, but problems of nutrition arise due to unhealthy eating habits. An inductive approach through curbing one's diet forms certain ethics, which takes into account one's sacrifices for the collective. This article proposes that cruciform ethics can introduce a reimagination of sustainable diets during coronavirus disease 2019.