The environmental impact of nutrition transition in three case study countries

Evaluating the Economic Impacts of a Cage-Free Animal Welfare Policy in Southeast Asian and Indian Egg Production: A Systematic Review

Animal welfare is increasingly understood to be a key component of sustainable agricultural production. Southeast Asia and India are witnessing an emerging market for cage-free egg production. To evaluate the economic sustainability of cage-free policies in the region, it is critical to understand how this transition will affect farmers' costs and revenues. In this article, we provide an overview of the available information that can inform evaluations of cage-free egg production in Southeast Asia and India. Cage-free egg producers around the world tend to experience higher costs, but these costs are offset by higher revenues. As demand for cage-free eggs is stimulated in Southeast Asia and India by retailer or government policies, we expect that producers will be capable of meeting this demand. In Asia specifically, the dominant cost component is poultry feed. We conclude that the economic viability of egg production in the region is likely to be driven by feed prices and associated government policies, rather than production system per se.

Environmental imprints of agricultural and livestock produce: A scoping review from South Asian countries

BACKGROUND

Agricultural activities in 2020 have resulted in 5.5 billion tons of CO2 equivalent globally, which is expected to rise because the food system would have to grow 70% more food for the population in 2050. Research suggests that agricultural productivity in South Asian countries, will increase food security; however, the role of their food crops and livestock products in environmental imprints is uncertain. This review aimed to assess the environmental impacts resulting from pre- and post-production agricultural activities related to edible food crops and livestock products consumed in eight South Asian countries.

METHODS

Studies were retrieved using three databases (PubMed, Google Scholar and Science Direct) from 2011 to 2022. The protocol for this scoping review was not registered.

RESULTS

Twenty-seven studies met the inclusion criteria. Most studies were conducted in India. Twenty-four articles assessed greenhouse gases (GHG) emissions, followed by water footprints (n = 5), nitrogen and phosphorus (N&P) emissions (n = 4), and land requirements (n = 4). The production of rice and wheat was identified as a significant contributor to GHG emissions. In India, Bangladesh and Sri Lanka, the production of livestock (meat/bovine/shrimp and milk) was reported to be harmful to the environment. Inconclusive data were retrieved for other environment variables.

CONCLUSIONS

Diversification in food production and cultivating additional coarse cereals (millets) offer opportunities for GHG reduction. Nevertheless, more comprehensive and longitudinal studies for South Asian countries are essential to make precise conclusions and validate the present review.

Fish-To Eat or Not to Eat? A Mixed-Methods Investigation of the Conundrum of Fish Consumption in the Context of Marine Pollution in Indonesia

Background: The Indonesian government faces a dilemma of promoting fish consumption for its health benefits and to ease food insecurity, while at the same time seeking effective approaches to reduce the high levels of marine pollution. However, the factors associated with fish consumption in the face of persistent high levels of marine pollution are not well elucidated in the literature. Objectives: This was an explorative study to investigate the sociodemographic factors related to fish consumption and to understand the perspectives of expert informants on marine pollution and its impact on fish quality and availability in Indonesia. Methods: We characterized fish consumption among respondents aged 15 years and older in the fifth wave of the Indonesian Family Life Survey (n = 31,032), based on their sociodemographic profiles, and developed multinomial regression models to assess the relationship between respondents' sociodemographic profiles and quintiles of fish consumption. We also conducted in-depth interviews on fish consumption and marine pollution with key informants from Indonesia (n = 27). We then used a convergent mixed-methods design to synthesize the results of both datasets. Results: Fish was the most frequently consumed animal-source food reported by survey respondents: 2.8 (±2.6) days/week. More younger respondents (15-19 years) reported relatively lower consumption of fish (9.3% in Q1 versus 5.9% in Q5) compared to respondents 50 years and older (37% in Q1 versus 39.9% in Q5; p < 0.01). When classified by region, more respondents from the Java region reported lower consumption of fish (86.5% in Q1 versus 53% in Q5; p < 0.01). Key-informants' perspectives corroborated the survey results by indicating that the younger generation tends not to want to consume fish; informants expanded the survey results by suggesting that fish is scarce in the Java region due to high levels of marine pollution. Informants further implied that there is low awareness about the impact of marine pollution on fish quality among most of the Indonesian population. Conclusion: Evidence from both data sources converge on differential preference for fish consumption by age group. Informants' perspectives also link marine pollution to fish scarcity, which poses a threat to food security among low-income Indonesians and to human health globally. More studies are needed to corroborate our findings and inform policy guidelines to reduce marine pollution while promoting fish consumption in Indonesia.

Sustainable dietary weight loss intervention and its effects on cardiometabolic parameters and greenhouse gas emissions: study protocol of a randomised controlled trial with overweight and obese adults in Ouagadougou, Burkina Faso

INTRODUCTION

The global obesity epidemic and its adverse health effects have reached sub-Saharan Africa. In some urban settings, like Burkina Faso's capital Ouagadougou, up to 43% of the adult population are overweight or obese. At the same time, modernised food systems are responsible for 26% of global greenhouse gas emissions, 50% of land use and 70% of freshwater use. International guidelines on the treatment of overweight and obesity recommend dietary intervention programmes that promote reduced calorie intake and increased physical activity. So far, weight loss interventions rarely consider sustainable dietary concepts, including healthfulness, affordability, cultural appropriateness and environmental friendliness. Therefore, we present a study protocol of a novel randomised controlled trial that aims to establish the effects of a sustainable weight loss intervention on cardiometabolic and environmental outcomes in urban Burkina Faso.

METHODS AND ANALYSIS

We conduct a non-blinded randomised controlled trial, comparing a 6-month sustainable diet weight loss intervention programme (n=125) with a standard weight loss information material and 5 min oral counselling at baseline (n=125). Primary outcome is a reduction in fasting plasma glucose of ≥0.1 mmol/L. Outcome measures are assessed at baseline, after 6 months and after 12 months.

ETHICS AND DISSEMINATION

Ethical approval for the study has been obtained from the Medical Faculty of Heidelberg University (S-376/2019) and from the Ministry of Health and the Ministry of Higher Education, Scientific Research and Innovation in Ouagadougou, Burkina Faso (No 2021-01-001). The results of the study will be disseminated to local stakeholders at a final project meeting and to the wider research community through peer-reviewed publications and conferences.

TRIAL REGISTRATION NUMBER

DRKS00025991.

Understanding the corporate political activity of the ultra - processed food industry in East Asia: a Philippines case study

BACKGROUND

Evidence is mounting that the ultra - processed food industry seeks to influence food and nutrition policies in ways that support market growth and protect against regulatory threats, often at the expense of public health. However, few studies have explored how this occurs in lower - middle income countries. We aimed to explore if and how the ultra - processed food industry seeks to influence food- and nutrition - related policy processes in the Philippines, a lower - middle income country in East Asia.

METHODS

Semi - structured key informant interviews were conducted with ten representatives from the Philippines government and non - government organisations closely involved with nutrition policy making in the Philippines. Interview schedules and data analysis were guided by the policy dystopia model, which we used to identify the instrumental and discursive strategies used by corporate actors to influence policy outcomes.

RESULTS

Informants were of the view that ultra - processed food companies in the Philippines sought to delay, prevent, water - down and circumvent implementation of globally recommended food and nutrition policies by engaging in a range of strategies. Discursive strategies included various tactics in which globally recommended policies were framed as being ineffective or highlighting potential unintended negative impacts. Instrumental strategies included: directly engaging with policymakers; promoting policies, such as industry - led codes and practices, as substitutes for mandatory regulations; presenting evidence and data that industry has generated themselves; and offering gifts and financial incentives to government individuals and agencies.

CONCLUSIONS

In the Philippines, the ultra - processed food industry engaged in overt activities designed to influence food and nutrition policy processes in their favour. A range of measures to minimise industry influence on policy processes should be introduced, to ensure that implemented food and nutrition policies align with best practice recommendations.

A comparative study on the dietary ecological footprint in contemporary China

Food consumption is increasingly impacting environmental sustainability. Building on the latest data of China Statistical Yearbook 2015-2020, this study quantified the dietary ecological footprint per capita (EFP), including animal-based and plant-based EFP, across seven provinces (representing seven regions) and between urban and rural areas of China. We further analyzed the possible correlated factors with the EFP and the strength of these correlations. The results showed that the EFP in southern areas was generally higher than that in northern areas, and the EFP in urban areas was higher than that in rural areas. The EFP was significantly correlated with per capita disposable income (PCDI), food consumption (FC) quantity, urban/rural status, southern/northern areas, and provinces. Moreover, we found geographical locations (i.e., southern/northern areas and provinces) contributed more to the total and animal-based EFP than economic conditions (i.e., urban/rural status and PCDI). Although pork price dramatically influenced the dietary patterns, it did not affect the total or animal-based EFP. These findings provide novel insights for understanding the mechanisms of the relationship between food consumption and environmental sustainability in China. The conclusions are helpful in predicting the future environmental impacts of diets in other countries with similar national conditions.

Changes in terms of risks/benefits of shifting diets towards healthier and more sustainable dietary models

Food production and therefore human diet are identified as important sources of environmental impact. Unhealthy and unsustainable diets with high intake of meat and low intake of plant-based products are predominant worldwide. On the other hand, a balance between health and sustainability is necessary, since diets that are environmentally sustainable could lack essential macro- and micronutrients and result in nutrient deficiencies, non-communicable diseases and malnutrition. The aim of this project was to investigate the nutritional adequacy and environmental impact of adults' diet by comparing current dietary habits and new alternative dietary scenarios. First, a systematic review was conducted following PRISMA guidelines to assess the environmental impact of current diets and sustainable dietary scenarios such as vegan, vegetarian, pescatarian, omnivorous and optimised dietary patterns worldwide. In the second part of the project, an optimisation study was conducted, based on a multi-objective optimisation approach, with the purpose of creating the optimal diet based on nutritional and environmental constraints for the adult Italian population. The dietary scenarios of the optimised models were developed in accordance with the Italian food-based dietary guidelines. Food consumption data was extracted from the INHES study and used as baseline diet. A clear evaluation of the current environmental impact because of diet and potential sustainable dietary scenarios globally is challenging. Finally, national food-based guidelines should be adjusted by suggesting healthy and sustainable dietary recommendations in line with traditional eating habits and local food availability in order the desirable dietary shifts towards sustainability to be feasible.

Strategies used by the soft drink industry to grow and sustain sales: a case-study of The Coca-Cola Company in East Asia

BACKGROUND

The market and non-market activities of the food and beverage industry contribute to unhealthy and unsustainable dietary patterns, increasingly in low-income and middle-income countries (LMICs). We aimed to describe how The Coca-Cola Company (TCCC), as the world market leader in the sugar-sweetened beverage sector, operationalises their activities in LMICs in East Asia, among the world's most highly populated yet under-researched countries, to illustrate the ways in which these activities may negatively influence health outcomes.

METHODS

We adopted a theoretically-guided qualitative research design and documentary analysis method. Data sources included: industry documents and web pages, marketing case studies obtained from the World Advertising Research Centre, media reports, global trade summaries and websites of industry associations. To guide data analysis, we synthesised a conceptual framework from existing commercial determinants of health literature, to describe ways in which the market and non-market activities of TCCC influence health.

RESULTS

TCCC leverages subsidiary companies and investments in international networks to expand its supply chains. The company engages in frequent political activities to minimise the implementation of nutrition policies that may impact profits. The company markets products, particularly on digital and mobile devices, often targeting children, adolescents and mothers, and undertakes public relations activities related to human rights, environmental sustainability and community and economic supports, and these public relations activities are often integrated into marketing campaigns. The identified activities of TCCC are frequently in direct contrast to efforts to improve the healthfulness of population diets in East Asia LMICs.

CONCLUSIONS

A public health analysis of the market and non-market activities of corporations active in unhealthy commodity industries needs to be broad in scope to cover the diverse set of strategies used to increase their market power and influence. Governments should consider a suite of policy options to attenuate these commercial determinants of unhealthy diets.

Targeted policy intervention for reducing red meat consumption: conflicts and trade-offs

BACKGROUND

There are a range of policies and guidelines focused on meat consumption which aim to tackle health and environmental issues. Policies are often siloed in nature and propose universal limits on consumption. Despite this, there will be a number of conflicts and trade-offs between interest groups. This study explores secondary impacts associated with guidelines issued by the World Cancer Research Fund and assesses the utility of a targeted policy intervention strategy for reducing red meat consumption.

METHODS

We used highly detailed consumption data of over 5,000 individuals from the National Diet and Nutrition Survey. We firstly compared individual consumption against the policy guidelines to identify demographic groups most likely to consume above recommended levels. We then synthetically modified the food diary data to investigate the secondary impacts of adherence to the recommendations by all individuals. We assessed changes in overall consumption, nutrient intake (iron, zinc, vitamin B12, vitamin B3, fat and saturated fat) and global warming potential. We also projected future impacts under various population projections.

RESULTS

We found that certain demographic groups are much more likely to exceed the recommendations and would therefore benefit from a targeted intervention approach. Our results provide a baseline for which the impacts of any meat substitute diets can be assessed against. Whilst secondary health benefits may be realised by reducing intake of certain nutrients (e.g. fats), negative impacts may occur due to the reduced intake of other nutrients (e.g. iron, zinc). Reduced overall consumption is likely to have implications for the wider meat industry whilst complementary impacts would occur in terms of reduced greenhouse gas emissions. Impacts will be counteracted or maybe even reversed by any substitute products, highlighting the need to carefully consider the suitability and impacts of meat-replacements.

CONCLUSION

The future structure of the meat industry will depend on how conflicts and trade-offs are addressed and how more holistic policy ideas are implemented. This research provides a framework for using demographic and consumption data to reduce negative trade-offs and improve policy effectiveness.

The complex challenge of governing food systems: The case of South African food policy

International experience reveals that food policy development often occurs in silos and offers few tangible mechanisms to address the interlinked, systemic issues underpinning food and nutrition insecurity. This paper investigated what South African government policies cover in terms of different aspects of the food system, who is responsible for them, and how coordinated they are. Policy objectives were categorized into seven policy domains relevant to food systems: agriculture, environment, social protection, health, land, education, economic development, and rural development. Of the ninety-one policies reviewed from 1947-2017, six were identified as being "overarching" with goals across all the domains. About half of the policies focused on agriculture and the environment, reflecting an emphasis on agricultural production. Policies were formulated and implemented in silos. As a result, learning from implementation, and adjusting to improve impact has been limited. Particularly important is that coordination during implementation, across these complex domains, has been partial. In order to achieve its stated food and nutrition outcomes, including Sustainable Development Goal (SDG) 2, South Africa needs to translate its policies into tangible, practical plans and processes guided by effective coordination and alignment. Key recommendations are practically to align policies to a higher-level "food goal", establish better coordination mechanisms, consolidate an effective monitoring and evaluation approach to address data gaps and encourage learning for adaptive implementation. Actively engaging the existing commitments to the SDGs would draw stated international commitments together to meet the constitutional commitment to food rights into an overarching food and nutrition security law.

Socioeconomic, intrapersonal and food environmental correlates of unhealthy snack consumption in school-going adolescents in Mumbai

Background

Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions.

Methods

A representative sample of 10–12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factors of unhealthy snack consumption in adolescents attending private and public schools.

Results

The mean age of adolescents was 10.9 (1.1) years, 48.2% were girls and 53.9% attended private schools. The most frequently consumed unhealthy snacks were biscuits/ cookies (5.2d/wk) followed by wafers (3.4d/wk) and Indian fried snacks- samosa/ vada pav (2.8 d/wk). Among the public-school adolescents, the odds of unhealthy snack consumption were 0.89 times lower when meals were had frequently at the dinner table and 4.97 times higher when the perceived barriers related to the affordability of healthy snacks were greater. Maternal education (OR 0.78, 95% CI 0.66–0.82, p < 0.001), family income (OR 2.15, 95% CI 1.98–2.32, p < 0.001), availability of unhealthy snacks (OR 2.98, 95% CI 1.36–3.46, p < 0.001) and fruits (OR 0.57, 95% CI 0.49–0.69, p < 0.001) at home, having evening meals together (OR 0.71, 95% CI 0.63–0.81, p 0.031), and perceived parental control during mealtimes (OR 0.67, 95% CI 0.62–0.72, p < 0.001) were associated with unhealthy snack consumption in adolescents attending private schools.

Conclusions

The results highlighted a pervasiveness of unhealthy snacks in adolescents’ food environments. Improving provisions and affordability of fruits and healthy snacks at schools, encouraging family mealtimes, and limiting the availability of unhealthy snacks at home whilst addressing the perceived barriers within food environments, and inculcating self-efficacy skills can improve snacking habits in Indian adolescents, irrespective of socioeconomic backgrounds.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13449-6.

A ciência da Nutrição no “Novo Regime Climático”

Uma das maiores preocupações da humanidade no momento atual, denominado por Bruno Latour de um “Novo Regime Climático, é o impacto negativo produzido pelas mudanças ambientais, uma vez que seus efeitos repercutem em todo o planeta. A deterioração do meio ambiente natural tem sido acompanhada de um correspondente aumento dos problemas de saúde dos indivíduos. Nos encontramos numa fase de crise de paradigma na Ciência da Nutrição, em que a mudança se torna cada vez mais necessária e urgente; o caminho que vem sendo apontado é o da ampliação das noções existentes rumo a uma visão sistêmica e holística para enfrentar os desafios e oportunidades do século XXI. Este ensaio reflexivo teórico tem como base a obra de Bruno Latour, e tem como objetivo identificar as intersecções da Ciência da Nutrição e o exercício profissional do nutricionista com a ideia da reorientação ao vetor que Latour chama de “Terrestre”, como novo ator-político no período do Antropoceno. Torna-se necessário estender o mandato da prática baseada em evidências para adotar modelos mais relacionais de pensamento crítico para a aprendizagem transformacional em nutrição, sendo uma oportunidade de colaboração para todos os profissionais da área apoiarem as pessoas a combinarem uma alimentação saudável com uma alimentação sustentável. O redirecionamento da ciência da Nutrição vai ao encontro das ideias recentes de Latour em relação a uma possível mudança do sistema de produção para o sistema de geração sintonizado com a sustentabilidade

Ten-Year Changes in Global Warming Potential of Dietary Patterns Based on Food Consumption in Ontario, Canada

Many studies have evaluated the life cycle environmental impacts of diets based on a single period, but few studies have considered how environmental impacts of diets change over time, even though dietary patterns (DPs) change due to policy and socio-demographic factors. This study evaluated changes in the global warming potential (GWP) of DPs in the province of Ontario, Canada, using a life cycle assessment. We quantified the farm-to-fork GWP of six DPs (Omnivorous, No Pork, No Beef, No Red Meat, Pescatarian, and Vegetarian), using dietary intake data from a 2014 and 2015 survey. Throughout this period, the biggest decrease in GWP was for DPs containing beef, even though these DPs still have the highest GWP (3203 and 2308 kg CO2e, respectively, based on the annual energy intake of one individual). Across all DPs, plant-based proteins contributed less than 5% to GWP, while meat and fish contributed up to 62% of the total GWP. Ten-year GWP reductions are insufficient to meet climate change and other sustainability goals, and major dietary shifts are needed, particularly substituting animal-based proteins with plant-based proteins. To design effective interventions for shifting towards sustainable diets, research is needed to understand how socio-demographic and regional differences influence individuals’ food choices.

The water footprint and nutritional implications of diet change in Mexico: a principal component analysis

PURPOSE

Nutrition transition (NT) has modified the way that the Mexican population eats, while their body composition has also been modified. These changes have been linked with environmental impacts; however, little is known regarding water footprint (WF). The objective of this paper was to analyze the NT process in Mexico and evaluate its impact on WF using principal component analysis (PCA).

METHODS

A validated Food Consumption Frequency Questionnaire (FCFQ) was modified and applied to 400 adults from the Metropolitan Zone of Guadalajara, Mexico. The WF was calculated according to the WF Assessment Method. PCA and tertiles analysis was carried out to define dietary patterns WFs (DPWF). Questions covering sociodemographic and socioeconomic factors, as well as body composition data and physical activity levels were measured.

RESULTS

The average DPWF was 6619.58 ± 3182.62 L per person per day (L p^-1d^-1). We found three DPWF by PCA: Medium NT (55% from the total sample), Healthy plant-based (28%), and High in animal protein (17%). The highest energy consumption, western and Mexican foods intake, and dietary WF were found in Medium NT DPWF, as well as obesity prevalence. Fruits and vegetable consumption was higher in Healthy plant-based DPWF. Muscle mass percentage was higher in the High in animal protein DPWF.

CONCLUSIONS

Although most of the population is currently on Medium NT, new dietary patterns have emerged, where there was found a trend to plant-based diets but also diets high in animal food sources that can influence nutritional status.

Mobilising evidence, data, and resources to achieve global maternal and child undernutrition targets and the Sustainable Development Goals: an agenda for action

As the world counts down to the 2025 World Health Assembly nutrition targets and the 2030 Sustainable Development Goals, millions of women, children, and adolescents worldwide remain undernourished (underweight, stunted, and deficient in micronutrients), despite evidence on effective interventions and increasing political commitment to, and financial investment in, nutrition. The COVID-19 pandemic has crippled health systems, exacerbated household food insecurity, and reversed economic growth, which together could set back improvements in undernutrition across low-income and middle-income countries. This paper highlights how the evidence base for nutrition, health, food systems, social protection, and water, sanitation, and hygiene interventions has evolved since the 2013 Lancet Series on maternal and child nutrition and identifies the priority actions needed to regain and accelerate progress within the next decade. Policies and interventions targeting the first 1000 days of life, including some newly identified since 2013, require renewed commitment, implementation research, and increased funding from both domestic and global actors. A new body of evidence from national and state-level success stories in stunting reduction reinforces the crucial importance of multisectoral actions to address the underlying determinants of undernutrition and identifies key features of enabling political environments. To support these actions, well-resourced nutrition data and information systems are essential. The paper concludes with a call to action for the 2021 Nutrition for Growth Summit to unite global and national nutrition stakeholders around common priorities to tackle a large, unfinished undernutrition agenda-now amplified by the COVID-19 crisis.

Vegan Diet Health Benefits in Metabolic Syndrome

Plant-based diets (PBDs) are increasingly consumed by the Italian population and around the world. In particular, among PBDs, the vegan diet is a food pattern characterized by the exclusion of all animal-origin foods. What drives people to adopt this model are mainly ethical, health and environmental reasons. A vegan diet, if well-balanced and varied, can help in achieving and maintaining an optimal state of health. However, this nutritional approach, if not well-balanced, can cause deficiencies in proteins, ω-3 fatty acids, iron, vitamin D and calcium, zinc, iodine and, above all, vitamin B12. Oral food supplements especially fortified foods are recommended in these cases to restore the nutritional deficiencies. A vegan diet generally reduces the risk of developing chronic non-communicable degenerative diseases, such as metabolic syndrome (MetS) and, in addition, requires fewer natural resources for food production than an omnivorous diet. The aim of this review is to analyze the possible impact of the vegan diet on MetS onset and its treatment.

Factors influencing dietary practices in a transitioning food environment: a cross-sectional exploration of four dietary typologies among rural and urban Ugandan women using Photovoice

BACKGROUND

Healthy and sustainable dietary practices offer a possible solution to competing tensions between health and environmental sustainability, particularly as global food systems transition. To encourage such dietary practices, it is imperative to understand existing dietary practices and factors influencing these dietary practices. The aim of this study was to identify multi-level factors in lived rural and urban Ugandan food environments that influence existing dietary practices among women of reproductive age (WRA).

METHODS

A mixed methods study was conducted. Multiple correspondence analysis followed by hierarchical cluster analysis were performed on dietary data collected among a sample (n = 73) of Ugandan WRA in Kampala (urban) and Wakiso (rural) districts to elicit dietary clusters. Dietary clusters, which were labelled as dietary typologies based on environmental impact and nutrition transition considerations, were reflective of dietary practices. Following this, a smaller sample of WRA (n = 18) participated in a Photovoice exercise and in-depth interviews to identify factors in their social, physical, socio-cultural and macro-level environments influencing their enactment of the identified dietary typologies, and therefore dietary practices.

RESULTS

Four dietary typologies emerged: 'urban, low-impact, early-stage transitioners', 'urban, medium-impact, mid-stage transitioners', 'rural, low-impact, early-stage transitioners' and 'rural, low-impact, traditionalists'. Although experienced somewhat differently, the physical environment (access, availability and cost), social networks (parents, other family members and friends) and socio-cultural environment (dietary norms) were cross-cutting influences among both urban and rural dietary typologies. Seasonality (macro-environment) directly influenced consumption of healthier and lower environmental impact, plant-based foods among the two rural dietary typology participants, while seasonality and transportation intersected to influence consumption of healthier and lower environmental impact, plant-based foods among participants in the two urban dietary typologies.

CONCLUSION

Participants displayed a range of dietary typologies, and therefore dietary practices. Family provides an avenue through which interventions aimed at encouraging healthier and lower environmental impact dietary practices can be targeted. Home gardens, urban farming and improved transportation could address challenges in availability and access to healthier, lower environmental impact plant-based foods among urban WRA.

The Future of Smallholder Farming in India: Some Sustainability Considerations

The biodiverse, predominantly crop-livestock mixed-farming in India is key to ensuring resilience to climate change and sustainability of smallholder farming agroecologies. Farmers traditionally grow diverse crops as polyculture, and agriculture is mainly organic/biodynamic with spirituality in food systems deeply ingrained. Job-driven out-migration of rural youths, the family labor force, and globalization of contemporary food choices under corporate industrial agriculture both adversely affect sustainability of traditional farming landscapes and compromise the nutrition and health of rural farming communities. Besides documenting information on general agri-food system policy inputs, our paper presents the results of an exploratory study of four crucial community-level initiatives conducted in four distinct agroecological landscapes of India, aimed at bringing sustainability to traditional farming and food systems. The driving force for fundamental change in agri-food system, and in society, is the question of sustainability. The organic and local food movements are but specific phases of the larger, more fundamental sustainable agri-food movement. While it is very critical to increase farmer livelihood, it is even more important to increase overall rural economy. It was found that four important interventions viz. linking organic agriculture to community-supported agriculture (CSA) initiatives; linking small-holder farming to school meal (MDM) programmes; enhanced market access and value chain development for local agricultural produce; and creation of employment opportunities at community level for rural youths and reducing over-dependence of rural population on agriculture as source of income can make traditional farming more profitable and sustainable. The transition to more sustainable methods of farming by selling the farm produce “locally” helps both consumers and farmers alike and is considered a future strength of smallholder Indian agriculture.

Hábitos alimentares, atividade física e comportamento sedentário entre escolares brasileiros: Pesquisa Nacional de Saúde do Escolar, 2015

RESUMO: Introdução: A urbanização e a industrialização colaboraram para a alteração nos padrões de alimentação, bem como para o surgimento de comportamentos sedentários e a redução da atividade física. Objetivos: Identificar e descrever a prevalência de hábitos alimentares, prática de atividade física e comportamento sedentário em escolares brasileiros e analisar sua associação com as características sociodemográficas. Métodos: Foram utilizados dados da Pesquisa Nacional de Saúde do Escolar de 2015. Foram calculadas prevalências, razões de prevalências e intervalos de 95% de confiança (IC95%). As análises foram ajustadas para idade escolaridade materna. Resultados: A maioria consumia feijão (65,1%) e guloseimas (52,3%), teve mais de três dias de aula de Educação Física escolar (50,7%), realizava atividade física fora da escola por mais de três dias (55,4%), tinha comportamento sedentário (73,3%) e realizava atividade física durante 60 min/dia por menos de quatro dias na semana (72,7%). Em geral, as meninas estavam mais expostas a práticas alimentares não desejáveis e ao comportamento sedentário, e o melhor nível socioeconômico associou-se a maiores prevalências dos indicadores estudados. Elevado consumo de alimentos não saudáveis, aumento do comportamento sedentário e redução na prática de atividade física. Conclusão: Observou-se associação de atitudes não saudáveis com características sociodemográficas entre os escolares. Estratégias que foquem na redução desses comportamentos irão contribuir para ações de promoção da saúde nos ambientes escolar e familiar.

Review of Methodologies for Assessing Sustainable Diets and Potential for Development of Harmonised Indicators

The underlying values and priorities that drive policy responses depend largely on the constructs that researchers and decision makers select to measure and the metrics used. Despite much recent attention being given to sustainable diets and food systems and to the importance of clearly measuring sustainability to meet targets, to achieve goals, and to appraise dietary and environmental policies, it is not commonly agreed how the different indicators of sustainable diets are assessed. The evidence base for assessment of these indicators are frequently weak, fragmented, and arbitrary. The aim of this paper was to compare a range of published methods and indicators for assessing sustainable diets and food systems in order to harmonise them. Keyword and reference searches were performed in PubMed, Scopus, CAB Abstracts, and Web of Knowledge. Fifty-two studies (21 proposed methods and 31 used methods) that combined environment, nutrition and health, and socioeconomic aspects of sustainable diets were reviewed. The majority (over 90%) of the studies focused on high-income countries. Twenty-eight studies assessed the environmental effects of different dietary practices, eight of the studies examined the nutrition and health indicators used for assessing sustainable food systems, and seven studies assessed the social and economic costs of diets. A classification of the elements was developed, and common elements are proposed for standardizing. These elements were categorized into nutrition and health indicators, environment indicators, and socioeconomic indicators. Standardized or harmonized indicators can be used for consistency and applicability purposes and to support, implement, and monitor relevant policies.

What Can Dietary Patterns Tell Us about the Nutrition Transition and Environmental Sustainability of Diets in Uganda?

Uganda is undergoing dietary transition, with possible environmental sustainability and health implications, particularly for women. To explore evidence for dietary transitions and identify how environmentally sustainable women's dietary patterns are, principal component analysis was performed on dietary data collected using a 24 h recall during the Uganda Food Consumption Survey (n = 957). Four dietary patterns explained 23.6% of the variance. The "traditional, high-fat, medium environmental impact" pattern was characterized by high intakes of nuts/seeds, fats, oils and spreads, fish and boiled vegetables. High intakes of bread and buns, rice and pasta, tea and sugar characterized the "transitioning, processed, low environmental impact' pattern. The 'plant-based, low environmental impact" pattern was associated with high intakes of legumes, boiled roots/tubers, boiled traditional vegetables, fresh fruit and fried traditional cereals. High intakes of red/organ meats, chicken, and soups characterized the "animal-based high environmental impact" pattern. Urban residence was positively associated with "transitioning, processed, low environmental impact" (β = 1.19; 1.06, 1.32) and "animal-based high environmental impact" (β = 0.45; 0.28, 0.61) patterns; but negatively associated with the "plant-based low environmental impact" pattern (β= -0.49; -0.62, -0.37). A traditional, high-fat dietary pattern with medium environmental impact persists in both contexts. These findings provide some evidence that urban women's diets are transitioning.

Fruit and Vegetable Consumption among Immigrants in Portugal: A Nationwide Cross-Sectional Study

This study aims to compare adequate fruit and vegetable (F&V) intake between immigrants and natives in Portugal, and to analyse factors associated with consumption of F&V among immigrants. Data from a population based cross-sectional study (2014) was used. The final sample comprised 17,410 participants (≥20 years old), of whom 7.4% were immigrants. Chi-squared tests and logistic regression models were conducted to investigate the association between adequate F&V intake, sociodemographic, anthropometric, and lifestyle characteristics. Adequate F&V intake was more prevalent among immigrants (21.1% (95% CI: 19.0–23.4)) than natives (18.5% (95% CI: 17.9–19.1)), (p = 0.000). Association between migrant status and adequate F&V intake was only evident for men: immigrants were less likely to achieve an adequate F&V intake (OR = 0.67, 95% CI = 0.66–0.68) when compared to Portuguese. Among immigrants, being female, older, with a higher education, and living in a low urbanisation area increased the odds of having F&V consumption closer to the recommendations. Adjusting for other factors, length of residence appears as a risk factor (15 or more years vs. 0–9 years: OR = 0.52, 95% CI = 0.50–0.53), (p = 0.000) for adequate F&V intake. Policies aiming to promote adequate F&V consumption should consider both populations groups, and gender-based strategies should address proper sociodemographic, anthropometric, and lifestyle determinants.

Relationship between food waste, diet quality, and environmental sustainability

Improving diet quality while simultaneously reducing environmental impact is a critical focus globally. Metrics linking diet quality and sustainability have typically focused on a limited suite of indicators, and have not included food waste. To address this important research gap, we examine the relationship between food waste, diet quality, nutrient waste, and multiple measures of sustainability: use of cropland, irrigation water, pesticides, and fertilizers. Data on food intake, food waste, and application rates of agricultural amendments were collected from diverse US government sources. Diet quality was assessed using the Healthy Eating Index-2015. A biophysical simulation model was used to estimate the amount of cropland associated with wasted food. This analysis finds that US consumers wasted 422g of food per person daily, with 30 million acres of cropland used to produce this food every year. This accounts for 30% of daily calories available for consumption, one-quarter of daily food (by weight) available for consumption, and 7% of annual cropland acreage. Higher quality diets were associated with greater amounts of food waste and greater amounts of wasted irrigation water and pesticides, but less cropland waste. This is largely due to fruits and vegetables, which are health-promoting and require small amounts of cropland, but require substantial amounts of agricultural inputs. These results suggest that simultaneous efforts to improve diet quality and reduce food waste are necessary. Increasing consumers’ knowledge about how to prepare and store fruits and vegetables will be one of the practical solutions to reducing food waste.

Sustainable food systems-a health perspective

Malnutrition in all forms, ranging from undernourishment to obesity and associated diet-related diseases, is one of the leading causes of death worldwide, while food systems often have major environmental impacts. Rapid global population growth and increases in demands for food and changes in dietary habits create challenges to provide universal access to healthy food without creating negative environmental, economic, and social impacts. This article discusses opportunities for and challenges to sustainable food systems from a human health perspective by making the case for avoiding the transition to unhealthy less sustainable diets (using India as an exemplar), reducing food waste by changing consumer behaviour (with examples from Japan), and using innovations and new technologies to reduce the environmental impact of healthy food production. The article touches upon two of the challenges to achieving healthy sustainable diets for a global population, i.e., reduction on the yield and nutritional quality of crops (in particular vegetables and fruits) due to climate change; and trade-offs between food production and industrial crops. There is an urgent need to develop and implement policies and practices that provide universal access to healthy food choices for a growing world population, whilst reducing the environmental footprint of the global food system.

Environmental and economic risks assessment under climate changes for three land uses scenarios analysis across Teshio watershed, northernmost of Japan

Land use and climate changes affect on the economy and environment with different patterns and magnitudes in the watershed. This study used risk analysis model stochastic efficiency with respect to a function (SERF) to evaluate economic and environmental risks caused by four climate change scenarios (baseline, small-, mid- and large changes) and three land uses (paddy dominated, paddy-farmland mixture and farmland dominated for agriculture) in Teshio watershed in northern Hokkaido, Japan. Under the baseline climate conditions, the lower ranking of economic income of crop yield and higher ranking of pollutant load from agricultural land were both predicted in paddy dominated for agriculture, suggesting that the paddy dominated system caused higher risks of economic and environmental variables compared to other two land uses. Increase of temperature and precipitation increased crop yields under all three climate changes which resulted in increase of the ranking of economic income, indicating that those climate changes could reduce economic risk. The increased temperature and precipitation also accelerated mineralization of organic nutrient and nutrient leaching to river course of Teshio which resulted in increase of the ranking of pollutant load, suggesting that those climate changes could lead to more environmental risk. The rankings of economic income in mid- and large changes of climate were lower than that in small change of climate under paddy-farmland mixture and farmland dominated systems due to decrease of crop yield, suggesting that climate change led to more economic risk. In summary, the results suggested that increase in temperature and precipitation caused higher risks of both economic and environmental perspectives, and the impacts was higher than those of land use changes in the studied watershed. Those findings would help producers and watershed managers to measure the tradeoffs between environmental protection and agricultural economic development for making decision under land use and climate changes.

Sustainable diets within sustainable food systems

Sustainable diets and sustainable food systems are increasingly explored by diverse scientific disciplines. They are also recognised by the international community and called upon to orient action towards the eradication of hunger and malnutrition and the fulfilment of sustainable development goals. The aim of the present paper is to briefly consider some of the links between these two notions in order to facilitate the operationalisation of the concept of sustainable diet. The concept of sustainable diet was defined in 2010 combining two totally different perspectives: a nutrition perspective, focused on individuals, and a global sustainability perspective, in all its dimensions: environmental, economic and social. The nutrition perspective can be easily related to health outcomes. The global sustainability perspective is more difficult to analyse directly. We propose that it be measured as the contribution of a diet to the sustainability of food systems. Such an approach, covering the three dimensions of sustainability, enables identification of interactions and interrelations between food systems and diets. It provides opportunities to find levers of change towards sustainability. Diets are both the results and the drivers of food systems. The drivers of change for those variously involved, consumers and private individuals, are different, and can be triggered by different dimensions (heath, environment, social and cultural). Combining different dimensions and reasons for change can help facilitate the transition to sustainable diets, recognising the food system's specificities. The adoption of sustainable diets can be facilitated and enabled by food systems, and by appropriate policies and incentives.

Diet Quality and Satisfaction with Life, Family Life, and Food-Related Life across Families: A Cross-Sectional Pilot Study with Mother-Father-Adolescent Triads

Family is a major determinant of children's and adolescents' eating behavior. The objectives of the present study were to assess diet quality, eating habits, satisfaction with life, family life, and food-related life in mother-father-adolescent triads, and to identify profiles of families according to family members' diet quality. Questionnaires were administered to a sample of 300 two-parent families with one child over the age of 10 in the city of Temuco (Chile), including the Adapted Healthy Eating Index (AHEI), Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life (SWFoL) scale, Satisfaction with Family Life (SWFaL) scales, and questions relating to their eating habits. Positive relationships were found between the diet quality of the family members, particularly between mothers and adolescents. Three family profiles with different diet qualities were identified: "families with an unhealthy diet" (39.3%), "families in which mothers and adolescents have healthy diets, but the fathers' diets require changes" (14.3%), and "families that require changes in their diet" (46.4%). These findings stress the key role of mothers in determining family diet quality and suggest a positive relationship between diet quality and satisfaction with life.

Padrões alimentares de escolares: existem diferenças entre crianças e adolescentes?

Resumo Objetivo Identificar padrões alimentares de crianças e adolescentes de escolas públicas e verificar a associação destes com a faixa etária, o sexo, o município de residência e a classe econômica. Método Estudo transversal com escolares de cinco a 19 anos, de 10 escolas públicas. Aplicou-se o Formulário de Marcadores do Consumo Alimentar do Sistema de Vigilância Alimentar e Nutricional e a partir deste identificaram-se os padrões alimentares utilizando-se análise de cluster. Na análise estatística, verificou-se a associação dos padrões com faixa etária, sexo, classe econômica e município de residência (teste qui-quadrado de Pearson). Consideraram-se significativos valores de p ≤ 0,05. Resultados A amostra final foi de 631 escolares. Identificaram-se cinco padrões alimentares: “feijão/leite/iogurte” representou o consumo de 23,3% (n = 147); “restrito” representou o de 22,7% (n = 143); “saudável” representou o de 22,0% (n = 139); “industrializado brasileiro” representou o de 17,4% (n = 110) dos escolares; e “misto” representou o de 14,5% (n = 92). Os padrões não se associaram às demais variáveis. Conclusões Identificaram-se cinco padrões alimentares, sendo o saudável associado às crianças e o restrito aos adolescentes.

Quantifying and managing food-sourced nutrient metabolism in Chinese cities

Food supply and consumption are critical for sustaining urban system functions, and are key determinants of the quantity and pathways of nutrient flow in cities. Nutrient elements from urban food consumption are becoming major pollutant sources in urban environments. Therefore, understanding flow magnitude and pathways, the role of a growing population, and changing dietary structure and technology in future nutrient metabolism are essential to understand cities as ecosystems and urban environmental management. Taking the city of Xiamen, a rapid urbanizing area of Southeast China as a case study, we simulated urban metabolism of three major food-sourced nutrient elements (carbon, nitrogen, and phosphorus or CNP) over 1991-2010 and environmental emissions. Impacts of future population growth, dietary habit change, and waste treatment improvement on various environments were forecast by scenario analysis. A sensitivity analysis was conducted to test how different waste treatment technologies affect environmental emissions from food-sourced nutrients. Our results show that the food-sourced CNP had various metabolic fluxes through urban systems, with carbon mostly emitted into the air and nitrogen and phosphorus mostly discharged into landfills and water. Population growth and dietary structure change will accelerate increases of nutrient emissions to the environment, whereas enhancing current waste treatment technology can just alter emissions to different environments. Based on the results, we discuss how food-sourced nutrient metabolism can be better managed, to enhance connectivity between cities and their hinterlands and maintain environmental emissions within the carrying capacity of the cities.