Sustainable food systems and nutrition in the 21st century: a report from the 22nd annual Harvard Nutrition Obesity Symposium

A multi-dimensional Sustainable Diet Index (SDI) for Ghanaian adults under transition: the RODAM Study

BACKGROUND

The sustainability of diets consumed by African populations under socio-economic transition remains to be determined. This study developed and characterized a multi-dimensional Sustainable Diet Index (SDI) reflecting healthfulness, climate-friendliness, sociocultural benefits, and financial affordability using individual-level data of adults in rural and urban Ghana and Ghanaian migrants in Europe to identify the role of living environment in dietary sustainability.

METHODS

We used cross-sectional data from the multi-centre Research on Obesity and Diabetes among African Migrants Study (N = 3169; age range: 25-70 years). For the SDI construct (0-16 score points), we used the Diet Quality Index-International, food-related greenhouse gas emission, the ratio of natural to processed foods, and the proportion of food expenditure from income. In linear regression analyses, we estimated the adjusted ß-coefficients and 95% confidence intervals (CIs) for the differences in mean SDI across study sites (using rural Ghana as a reference), accounting for sociodemographic and lifestyle factors.

RESULTS

The overall mean SDI was 8.0 (95% CI: 7.9, 8.1). Participants in the highest SDI-quintile compared to lower quintiles were older, more often women, non-smokers, and alcohol abstainers. The highest mean SDI was seen in London (9.1; 95% CI: 8.9, 9.3), followed by rural Ghana (8.2; 95% CI: 8.0, 8.3), Amsterdam (7.9; 95% CI: 7.7, 8.1), Berlin (7.8; 95% CI: 7.6, 8.0), and urban Ghana (7.7; 95% CI: 7.5, 7.8). Compared to rural Ghana, the differences between study sites were attenuated after accounting for age, gender and energy intake. No further changes were observed after adjustment for lifestyle factors.

CONCLUSION

The multi-dimensional SDI describes four dimensions of dietary sustainability in this Ghanaian population. Our findings suggest that living in Europe improved dietary sustainability, but the opposite seems true for urbanization in Ghana.

Positive impact of nutrition in the prevention of peripheral vascular disease and severe acute respiratory syndrome coronavirus 2: review

Recent research has shown that there is a link between the trend of cardiovascular disease (CVD), chronic symptoms of SARS-CoV-2 (COVID-19), and medical nutrition therapy. Making positive changes to an individual's lifestyle can help to reduce the symptoms that follow exposure to CVD and COVID-19. Sustainable nutrition and lifestyle changes can positively impact an individual's health. Studies have considered the risk factors associated with the disease, medical history, the link between nutrition and peripheral vascular disease (PVD), symptom management, and the interrelationship between nutrition, COVID-19, and PVD. One study has demonstrated that Western Dietary intake can boost the innate immune system while suppressing humoral response, causing chronic inflammation and poor host defense against viruses. However, further investigation is needed to confirm. Patients with PVD and COVID-19 have experienced a reduction in side effects when prescribed a regimen of medical nutrition therapy, heart-healthy diets, and adequate physical activity before and after symptoms of both diseases appear. This approach has proven to be a protective factor during the combination of both illnesses. Our findings indicate that balanced diet and lifestyle are essential in supporting an optimal immune system that can reduce the risk of virus load in individuals at risk of infection and symptoms from COVID-19 and PVD.

Safe Circular Food Systems: A Transdisciplinary Approach to Identify Emergent Risks in Food Waste Nutrient Cycling

With growing awareness of the environmental, economic, and social costs associated with food waste, there is a concerted effort on multiple scales to recover the nutrient value of discarded food. These developments are positive, but the rapid movement toward alternatives and the complexity of solving problems located at the intersection of economic, social, and environmental systems also have the potential to produce unanticipated risks. This paper draws upon long-term stakeholder-engaged research throughout New England, with a focus on Maine, to develop a transdisciplinary, systems-based model of the potential social, economic, and environmental risks of food waste nutrient cycling. Our effort is intended to help inform the creation of safe, functional, and environmentally benign circular food systems.

[Bioactive components of whole grain and their effect on health]

Introduction

Non-communicable diseases represent a global health burden with increasing prevalence. To prevent or improve this type of diseases, dietary strategies based on healthy foods have been suggested. Cereals are the most consumed foods in the world and preventive effects of whole grains on health have been described. The germ and bran of cereals are abundant in bioactive compounds, including phytochemicals, vitamins, minerals and fibers, and these compounds are effective in preventing and improving non-communicable diseases. This review analyzes the content and distribution of the primary components of whole grains (wheat, barley, oats, rice and black wheat) and their fractions, focusing on the mechanisms by which phenolic acids and dietary fiber contribute to reducing the risk of metabolic and cardiovascular diseases and cancer. There is clear evidence of the broad cellular and physiological effects of bioactive compounds in whole grains, supporting the health value of a diet rich in whole grains.

The Urban Environment and Cardiometabolic Health

Urban environments contribute substantially to the rising burden of cardiometabolic diseases worldwide. Cities are complex adaptive systems that continually exchange resources, shaping exposures relevant to human health such as air pollution, noise, and chemical exposures. In addition, urban infrastructure and provisioning systems influence multiple domains of health risk, including behaviors, psychological stress, pollution, and nutrition through various pathways (eg, physical inactivity, air pollution, noise, heat stress, food systems, the availability of green space, and contaminant exposures). Beyond cardiometabolic health, city design may also affect climate change through energy and material consumption that share many of the same drivers with cardiometabolic diseases. Integrated spatial planning focusing on developing sustainable compact cities could simultaneously create heart-healthy and environmentally healthy city designs. This article reviews current evidence on the associations between the urban exposome (totality of exposures a person experiences, including environmental, occupational, lifestyle, social, and psychological factors) and cardiometabolic diseases within a systems science framework, and examines urban planning principles (eg, connectivity, density, diversity of land use, destination accessibility, and distance to transit). We highlight critical knowledge gaps regarding built-environment feature thresholds for optimizing cardiometabolic health outcomes. Last, we discuss emerging models and metrics to align urban development with the dual goals of mitigating cardiometabolic diseases while reducing climate change through cross-sector collaboration, governance, and community engagement. This review demonstrates that cities represent crucial settings for implementing policies and interventions to simultaneously tackle the global epidemics of cardiovascular disease and climate change.

Toward Heart-Healthy and Sustainable Cities: A Policy Statement From the American Heart Association

Nearly 56% of the global population lives in cities, with this number expected to increase to 6.6 billion or >70% of the world's population by 2050. Given that cardiometabolic diseases are the leading causes of morbidity and mortality in people living in urban areas, transforming cities and urban provisioning systems (or urban systems) toward health, equity, and economic productivity can enable the dual attainment of climate and health goals. Seven urban provisioning systems that provide food, energy, mobility-connectivity, housing, green infrastructure, water management, and waste management lie at the core of human health, well-being, and sustainability. These provisioning systems transcend city boundaries (eg, demand for food, water, or energy is met by transboundary supply); thus, transforming the entire system is a larger construct than local urban environments. Poorly designed urban provisioning systems are starkly evident worldwide, resulting in unprecedented exposures to adverse cardiometabolic risk factors, including limited physical activity, lack of access to heart-healthy diets, and reduced access to greenery and beneficial social interactions. Transforming urban systems with a cardiometabolic health-first approach could be accomplished through integrated spatial planning, along with addressing current gaps in key urban provisioning systems. Such an approach will help mitigate undesirable environmental exposures and improve cardiovascular and metabolic health while improving planetary health. The purposes of this American Heart Association policy statement are to present a conceptual framework, summarize the evidence base, and outline policy principles for transforming key urban provisioning systems to heart-health and sustainability outcomes.

Diet strategies for promoting healthy aging and longevity: An epidemiological perspective

In recent decades, global life expectancies have risen significantly, accompanied by a marked increase in chronic diseases and population aging. This narrative review aims to summarize recent findings on the dietary factors influencing chronic diseases and longevity, primarily from large cohort studies. First, maintaining a healthy weight throughout life is pivotal for healthy aging and longevity, mirroring the benefits of lifelong, moderate calorie restriction in today's obesogenic food environment. Second, the specific types or food sources of dietary fat, protein, and carbohydrates are more important in influencing chronic disease risk and mortality than their quantity. Third, some traditional diets (e.g., the Mediterranean, Nordic, and Okinawa) and contemporary dietary patterns, such as healthy plant-based diet index, the DASH (dietary approaches to stop hypertension) diet, and alternate healthy eating index, have been associated with lower mortality and healthy longevity. These patterns share many common components (e.g., a predominance of nutrient-rich plant foods; limited red and processed meats; culinary herbs and spices prevalent in global cuisines) while embracing distinct elements from different cultures. Fourth, combining a healthy diet with other lifestyle factors could extend disease-free life expectancies by 8-10 years. While adhering to core principles of healthy diets, it is crucial to adapt dietary recommendations to individual preferences and cultures as well as nutritional needs of aging populations. Public health strategies should aim to create a healthier food environment where nutritious options are readily accessible, especially in public institutions and care facilities for the elderly. Although further mechanistic studies and human trials are needed to better understand molecular effects of diet on aging, there is a pressing need to establish and maintain long-term cohorts studying diet and aging in culturally diverse populations.

Strengths and weaknesses of food eco-labeling: a review

Food labeling is increasingly expanding and adding more information to the food package. There is strong evidence about nutrition labeling effectiveness in driving food choice, especially if displayed in the front of package (FoP). Despite the growing attention to nutrition and sustainable diets, few countries have implemented sustainable labels or eco-labels that could address economic, social and/or environmental concerns. Implementing new techniques of eco-labeling emerges as a consumer-focused solution. However, evidence of the effectiveness of eco-labeling in driving consumers' choices is heterogeneous and not univocal. Thus, this review aims to summarize the evidence about the effectiveness of FoP eco-labeling in driving food choice and provide a reference framework of the eco-labeling initiatives relative to food package labeling. This narrative review addresses both the potential benefits as well as the main concerns that arise from the use of eco-labels. Although eco-labeling seems to provide a series of sustainability benefits for producers and consumers, the implementation of such policies should take into consideration potential trade-offs and inter-sectorial coordination to obtain bigger impacts, assuming that a policy itself cannot transform the whole food system. Eco-labeling could be encouraged and implemented within a set of policies shaping sustainable food systems.

Impacts of the SARS-CoV-2 pandemic on the dietary practices of university students in Germany

Purpose

The dietary practices (DPs) of university students are influenced by many external factors. Therefore, we investigate how the DPs of students in Germany changed during the SARS-CoV-2 pandemic, what the main motivations were for those changes, and what effect the closure of university catering had on the DPs of students.

Methods

A total of 560 students from two universities in Lübeck (Germany) were surveyed online during a pilot phase. The final online questionnaire was subsequently administered at 10 other German universities (399 respondents). The questionnaire surveyed sociodemographic factors, dietary habits, food consumption frequencies, and the relevance of university catering before and during the SARS-CoV-2 pandemic.

Results

Regarding changes in DPs, similarities to previous studies were found, especially positive eating behaviors and an increasing interest in health- and nutrition-related sustainability. Students prepared meals freshly more often during the pandemic; consumed legumes, plant-based meats and dairy alternatives more often; and reduced their consumption of meat and milk compared to before the pandemic. The consumption frequency of sweets also decreased. It was observed that students consider eating communal in the university canteen to be highly relevant for their social interactions, which was only possible to a limited extent during the pandemic.

Conclusion

In Germany, the DPs of university students as well as criteria regarding health and sustainability changed during the first 2 years of the SARS-CoV-2 pandemic. The social aspect of DPs became evident due to closed university catering. Still, changes in dietary patterns and eating habits were positively related to health and revealed some differences in the cross section of the population.

Pre-Harvest Food Safety Challenges in Food-Animal Production in Low- and Middle-Income Countries

Food safety remains a significant global public health concern, with the risk of unsafe food varying worldwide. The economies of several low- and middle-income countries (LMICs) heavily rely on livestock, posing a challenge to ensuring the production of safe food. This review discusses our understanding of pre-harvest critical issues related to food safety in LMICs, specifically focusing on animal-derived food. In LMICs, food safety regulations are weak and inadequately enforced, primarily concentrating on the formal market despite a substantial portion of the food sector being dominated by informal markets. Key critical issues at the farm level include animal health, a low level of good agriculture practices, and the misuse of antimicrobials. Effectively addressing foodborne diseases requires a comprehensive One Health framework. Unfortunately, the application of the One Health approach to tackle food safety issues is notably limited in LMICs. In conclusion, considering that most animal-source foods from LMICs are marketed through informal channels, food safety legislation and policies need to account for this context. Interventions aimed at reducing foodborne bacterial pathogens at the farm level should be scalable, and there should be strong advocacy for the proper implementation of pre-harvest interventions through a One Health approach.

Corporate interest groups and their implications for global food governance: mapping and analysing the global corporate influence network of the transnational ultra-processed food industry

BACKGROUND

A major challenge to transforming food systems to promote human health and sustainable development is the global rise in the manufacture and consumption of ultra-processed foods (UPFs). A key driver of this dietary transition is the globalization of UPF corporations, and their organized corporate political activity (CPA) intended to counter opposition and block government regulation. UPF industry CPA and the corporate interest groups who lobby on their behalf have been well described at the national level, however, at the global level, this network has not been systematically characterized. This study aims to map, analyse, and describe this network, and discuss the implications for global food policy action on UPFs, global food governance (GFG), and food systems transformation.

METHODS

We conducted a network analysis of the declared interest group memberships of the world's leading UPF corporations, extracted from web sources, company reports, and relevant academic and grey literature. Data on the characteristics of these interest groups were further extracted for analysis, including year founded, level, type, and headquarter location.

RESULTS

We identified 268 interest groups affiliated with the UPF industry. The UPF manufacturers Nestlé (n = 171), The Coca-Cola Company (n = 147), Unilever (n = 142), PepsiCo (n = 138), and Danone (n = 113) had the greatest number of memberships, indicating strong centrality in coordinating the network. We found that this network operates at all levels, yet key actors now predominantly coordinate globally through multistakeholder channels in GFG. The most common interest group types were sustainability/corporate social responsibility/multistakeholder initiatives, followed by branding and advertising, and food manufacturing and retail. Most corporate interest groups are headquartered where they can access powerful government and GFG decision-makers, nearly one-third in Washington DC and Brussels, and the rest in capital cities of major national markets for UPFs.

CONCLUSIONS

The UPF industry, and especially its leading corporations, coordinate a global network of interest groups spanning multiple levels, jurisdictions, and governance spaces. This represents a major structural feature of global food and health governance systems, which arguably poses major challenges for actions to attenuate the harms of UPFs, and to realising of healthy and sustainable food systems.

From Health-in-All-Policies to Climate-in-All-Policies: Using the Synergies between Health Promotion and Climate Protection to Take Action

The climate crisis is developing into a life-changing event on a global level. Health promotion with the aim to increase the health status of individuals, independent of the present health status, has been developed on a scientific basis at least for the last eight decades. There are some basic principles which are prerequisites for both health promotion and climate protection. Those principles include (1) sustainability, (2) orientation on determinants, and (3) requirement of individual as well as community approaches. People are generally aiming to protect their lifestyle habits (e.g., traveling and consumer habits) and personal property (e.g., car and house) with easy solutions and as little effort as possible, and this can affect both health and climate. To reduce the emission of greenhouse gases and to protect our environment, changes towards a sustainable lifestyle have to be embedded into everybody's mind. Examples for domains that need to be addressed in health promotion as well as in climate protection include (health and climate) literacy, physical activity and active mobility, and nutrition and dietary habits. If health promotion fails to tackle those domains, this will continue to drive the climate crisis. And climate change, in turn, will affect health. On the other hand, developing and promoting health resources in the domains mentioned could help to mitigate the health-damaging effects of climate change. Success in the joint efforts to promote health and protect the climate would improve the One Health approach, the health of people and the environment.

Sustainability analysis of the Mediterranean diet: results from the French NutriNet-Santé study

The Mediterranean diet is often proposed as a sustainable diet model. This study aimed to evaluate the associations between adherence to the Mediterranean diet and sustainability domains in a cohort of French adults, using multiple criteria including nutritional quality, environmental pressures, monetary cost and dietary pesticide exposure. Food intakes of 29 210 NutriNet-Santé volunteers were assessed in 2014 using a semi-quantitative FFQ. Adherence to the Mediterranean diet was evaluated using the validated literature-based adherence score (MEDI-LITE). The associations between the MEDI-LITE and various sustainability indicators were examined using ANCOVA models, adjusted for sex, age and energy intake. Higher adherence to the MEDI-LITE was associated with higher nutritional quality scores, better overall nutrient profile as well as reduced environmental impact (land occupation: Q5 v. Q1: -35 %, greenhouse gas emissions: -40 % and cumulative energy demand: -17 %). In turn, monetary cost increased with increasing adherence to the Mediterranean diet (Q5 v. Q1: +15 %), while higher adherents to the Mediterranean diet had overall higher pesticide exposure due to their high plant-based food consumption. In this large cohort of French adults, greater adherence to the Mediterranean diet was associated with nutritional and environmental benefits, but also with higher monetary cost and greater exposure to pesticides, illustrating the necessity to develop large-scale strategies for healthy, safe (pesticide- and contaminant-free) and environmentally sustainable diets for all.

Nutrition quality and food and packaging waste associated with the school food system: A pilot, citizen science study in an Irish secondary school

BACKGROUND

School is an important setting for creating healthy and sustainable food environments. Using participatory methods, this pilot study examined food and packaging waste and nutrition quality within the school food system.

METHODS

One secondary school in Ireland participated in a waste audit. Eleven male students (15-17 years) participated as citizen scientists. Students collected waste over 1 day and documented data on waste categories. Nutrition labels were photographed for analysis. Students created a video and participated in a focus group. Quantitative data were summarised using descriptive frequencies. A Nutrient Profile Model was applied to summarise nutrition quality. The focus group discussion was analysed using content analysis.

RESULTS

Highest weights of waste were organic waste (14.2 kg), paper and cardboard (5.0 kg), and hard plastics (4.1 kg). Materials banned by the European Union Single Use Plastics Directive were found. Recycling bins were contaminated with food waste. Nutrition labels from 132 food packages were analysed, of which 115 items (87%) were low-nutrient, energy dense foods. Confectionary, energy bars and desserts and savoury snacks were the most common packaged food groups. Students were not surprised by the unhealthy food choices; however, they were shocked and saddened at the waste practices. Their proposed solutions mapped across individual, community and organisational levels.

CONCLUSIONS

The methodologies allowed successful engagement with students on this topic. The use of unnecessary plastics to serve food, poor waste separation practices, and the production of avoidable waste from low-nutrient, energy-dense products were key issues identified. Students proposed solutions that are achievable in the short-term.

Consumer attitudes and behaviors toward more sustainable diets: a scoping review

There is an urgent need to move toward more sustainable diets. Although this will require radical and systemic changes across food systems, altering consumer ideologies and practices is essential to garner support for such actions. In this scoping review, the evidence on consumers' attitudes and behaviors toward more sustainable diets is synthesized and a range of factors, considerations, and proposed strategies are presented that can contribute to building the societal-level support for urgent and systems-level changes. The findings suggest that consumers, insofar as they are interested in sustainability and have the capacity to engage with the concept, primarily approach the concept of sustainable diet from a human health perspective. However, the interconnectedness of human health and well-being with environmental health is poorly understood and under-researched in the context of consumer behaviors and attitudes toward sustainable diets. This highlights the need for (1) sustained efforts from public health professionals to encourage a realignment of the term sustainable diet with its multidimensional meaning by championing an ecological public health approach in all efforts aimed at promoting more sustainable consumption, from awareness raising to policy development; (2) a broader research lens focused on the multidimensional concept of sustainability in the literature exploring consumer attitudes and behaviors; and (3) the development of multidisciplinary, clear, and evidence-based sustainable-eating messages, including holistic sustainable dietary guidance, to address knowledge gaps, minimize conflicting narratives, and build consumer agency. The findings contribute to understanding how support can be generated for the necessary structural and system-level changes required to support behavior change.

Food retail environments, extreme weather, and their overlap: Exploratory analysis and recommendations for U.S. food policy

Extreme weather events are increasing in frequency and severity due to climate change, yet many of their impacts on human populations are not well understood. We examine the relationship between prior extreme weather events and food environment characteristics. To do so, we conduct a U.S. county-level analysis that assesses the association between extreme weather events and two common food retail environment dimensions. Overall, we find a relationship between higher levels of historic extreme weather exposure and lower food availability and accessibility. In addition, we find heterogeneity in association across the distribution of the number of extreme weather events and event type. Specifically, we find that more localized extreme weather events are more associated with a reduction of access and availability than broad geographic events. Our findings suggest that as extreme weather events amplify in intensity and increase in frequency, new approaches for mitigating less acute and longer-term impacts are needed to address how extreme weather may interact with and reinforce existing disparities in food environment factors. Furthermore, our research argues that integrated approaches to improving vulnerable food retail environments will become an important component of extreme weather planning and should be a consideration in both disaster- and food-related policy.

Exploring Benefits and Barriers of Plant-Based Diets: Health, Environmental Impact, Food Accessibility and Acceptability

Unhealthy dietary patterns are directly linked to the current Global Syndemic consisting of non-communicable diseases, undernutrition and climate change. The dietary shift towards healthier and more sustainable plant-based diets is essential. However, plant-based diets have wide intra differences; varying from vegan diets that totally exclude meat and animal products to traditional ones such as the Mediterranean diet and the new Nordic diet. It is acknowledged that plant-based diets may contribute simultaneously to improving population health as well as to decreasing the environmental impact of food systems. Evidence from cohort and randomized-controlled trials suggests that plant-based dietary patterns have beneficial effects on bodyweight control, cardiovascular health and diabetes prevention and treatment. On the other hand, micronutrient requirements may not be met, if some plant-based diets are not well-planned. Additionally, studies showed that lower consumption of meat and animal products results in lower environmental impacts. Consequently, plant-based diets could be a key factor to increase diet sustainability. This narrative review addresses the advantages of adherence to plant-based diets on human and planetary health considering strains and barriers to achieve this dietary transition, including cultural acceptability and affordability factors. Finally, potential intervention and policy recommendations are proposed, focusing on the update of current national food-based dietary guidelines.

Synthesis of inventive biphenyl and azabiphenyl derivatives as potential insecticidal agents against the cotton leafworm, Spodoptera littoralis

The emergence of pest resistance of Spodoptera littoralis (order; Lepidoptera, family; Noctuidae) towards the large scale of different classes of insecticides necessitates the development of some new poly-functionalized biphenyl and azabiphenyl with highly anticipated insecticidal bioresponse. Four new biphenyl carboxamidines 4a-d and four aza-analogue picolinamidine derivatives 8a-d were designed and prepared via the treatment of their corresponding carbonitriles with lithium-bis trimethylsilylamide [LiN(TMS)2], followed by hydrolysis with hydrogen chloride. Furthermore, these compounds were elucidated by spectral data, and their toxicity and insecticidal activity were screened against Spodoptera littoralis. Whereby, toxicological and biochemical aspects of the inventively synthesized biphenyl and azabiphenyl derivatives against the cotton leafworm, Spodoptera littoralis were inspected. As regards the indomitable LC50 and LC90 values, biphenyl and aza-analogues 8d, 8a, 4b, and 8b, revealed the furthermost forceful toxic effects with LC50 values of 113.860, 146.265, 216.624, and 289.879 ppm, respectively. Whereby, their LC90 values are 1235.108, 1679.044, 2656.296, and 3381.256 ppm, respectively, and toxicity index being 22.31%, 17.36%, 11.72%, and 8.76%, respectively, comparing with the already recommended, methomyl insecticide, lannate 90% SP (LC50, 25.396 and LC90, 57.860 and toxicity index, 100%). Additionally, electrochemical parameters via DFT studies were carried out for demonstrating and elucidation of structure-activity relationship (SAR) according to highly motived compounds, descriptors, and the in vivo insecticidal activities.

Harnessing the connectivity of climate change, food systems and diets: Taking action to improve human and planetary health☆

With climate change, the COVID-19 pandemic, and ongoing conflicts, food systems and the diets they produce are facing increasing fragility. In a turbulent, hot world, threatened resiliency and sustainability of food systems could make it all the more complicated to nourish a population of 9.7 billion by 2050. Climate change is having adverse impacts across food systems with more frequent and intense extreme events that will challenge food production, storage, and transport, potentially imperiling the global population’s ability to access and afford healthy diets. Inadequate diets will contribute further to detrimental human and planetary health impacts. At the same time, the way food is grown, processed, packaged, and transported is having adverse impacts on the environment and finite natural resources further accelerating climate change, tropical deforestation, and biodiversity loss. This state-of-the-science iterative review covers three areas. The paper's first section presents how climate change is connected to food systems and how dietary trends and foods consumed worldwide impact human health, climate change, and environmental degradation. The second area articulates how food systems affect global dietary trends and the macro forces shaping food systems and diets. The last section highlights how specific food policies and actions related to dietary transitions can contribute to climate adaptation and mitigation responses and, at the same time, improve human and planetary health. While there is significant urgency in acting, it is also critical to move beyond the political inertia and bridge the separatism of food systems and climate change agendas that currently exists among governments and private sector actors. The window is closing and closing fast.

Consideration for Flavonoid-Containing Dietary Supplements to Tackle Deficiency and Optimize Health

Randomized clinical trials (RCT) and observational studies have highlighted the importance of flavonoid consumption for human health. Several studies have associated a high intake of dietary flavonoids with (a) enhanced metabolic and cardiovascular health, (b) enhanced cognitive and vascular endothelial functions, (c) an improved glycemic response in type 2 diabetes mellitus, and (d) a reduced risk of breast cancer in postmenopausal women. Since flavonoids belong to a broad and diverse family of polyphenolic plant molecules-with more than 6000 compounds interspersed in the human diet-researchers are still uncertain whether the intake of single, individual polyphenols or a large combination of them (i.e., synergistic action) can produce the greatest health benefits for humans. Furthermore, studies have reported a poor bioavailability of flavonoid compounds in humans, which presents a major challenge for determining their optimal dosage, recommended intake, and, consequently, their therapeutic value. Especially because of their scarce bioavailability from foods-along with the overall declining food quality and nutrient density in foods-the role of flavonoid supplementation may become increasingly important for human health. Although research shows that dietary supplements can be a highly useful tool to complement diets that lack sufficient amounts of important nutrients, some caution is warranted regarding possible interactions with prescription and non-prescription drugs, especially when taken concurrently. Herein, we discuss the current scientific basis for using flavonoid supplementation to improve health as well as the limitations related to high intakes of dietary flavonoids.

The Alignment of Recommendations of Dietary Guidelines with Sustainability Aspects: Lessons Learned from Italy's Example and Proposals for Future Development

The main objective of this paper is to describe the process of the inclusion of sustainability in the Italian Dietary Guidelines (IDGs). In the IDGs' sustainability chapter, particular emphasis was put on the selection of foods, recommending a plant-based diet with a large quota of vegetable proteins. Advice was also given on the selection of local seasonal products, with low growth input, such as fertilizers, artificial light and heating. Reduction of animal food was recommended, to be substituted with lower impact foods (poultry, milk, eggs and Mediterranean fish including aquaculture). Food waste was largely addressed. Recommendations were made for food purchase planning, food storage and the reuse of leftovers as strategies to reduce waste and save money. The IDGs sustainability recommendations were related to the 16 guiding principles of a sustainable healthy diet and their contribution to the achievement of the Sustainable Developing Goals was provided. The inclusion of sustainability in dietary guidelines requires a multidisciplinary approach to cover the wide range of aspects of a sustainable diet. In the IDGs, it was possible to show that practical recommendations for improving sustainability behavior can be passed on to consumers. Methodological aspects for developing recommendations are not definitive.

Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition-Narrative Review

The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition.

Wild berries and related wild small fruits as traditional healthy foods

The consumption of cultivated berry species (e.g., strawberries, blueberries) has increased dramatically in the last two decades after consumers appreciated them as flavorful, convenient and healthy fruits. Wild berries and similar small wild fruits are traditionally consumed around the world by local people as safe, nutritious, tasty, and versatile foods. These wild fruits have played an important role in the nutrition and bio-cultural aspects of rural communities. Like their commercial counterparts, wild berries contain important nutrients and bioactive compounds that may prevent or delay some chronic diseases attributed to oxidative stress and chronic inflammation. This review provides a comprehensive appraisal of the chemical and bioactive components in wild berry species and their traditional uses as foods around the globe. Presently, wild berries and similar wild small fruits are novel food sources that inspire applications as culinary products, processed foods, and nutraceuticals. Further research is needed to validate the content and action of bioactive components responsible for health claims. Sustainable commercial exploitation of wild berries should consider biocultural, environmental, and socio-economic aspects.

Nutritional Demand and Consumption Pattern: A Case Study of Pakistan

Nutrition problems persist over several decades in most developing countries. Poor and vulnerable households in low-income countries do not have sufficient disposable sources to access adequate and diverse diets. This study analyzes the household nutrition consumption patterns in Pakistan at a provincial level. The log-linear Engel’s curve approach is applied using household-level data comprising 16,340 households from the Pakistan Household Integrated Expenditure survey (HIES) between 2018 and 2019. The results of the estimated income and household size elasticities reveal that any variation in the households’ income brings major changes in their diets, whereas an increase in household size, ceteris paribus (impact of all other factors are held constant), increases the demand for all nutritional intakes except thiamine and cholesterol. Furthermore, the estimated income elasticities for the four provinces provided similarities and differences in the nutritional consumption patterns of households. On the basis of income elasticities, we find the same nutrition pattern in Sindh and Baluchistan and a similar nutrition pattern in Khyber Pakhtunkhwa and Punjab. Finally, the estimated income elasticities show poor nutritional consumption patterns in Sindh and Baluchistan as compared to Punjab and Khyber Pakhtunkhwa. Thus, there is a need to generate nutritional policies in each province, and people should make wise nutrient-dense choices from all food commodities groups. Moreover, this study applies a unique approach to estimate the income elasticities for 17 nutrients using household survey data within the same framework of Engel’s curve. The findings of this study have important implications for public policy aiming at malnutrition alleviation and understanding dietary change in Pakistan.

Health and Sustainable Nutritional Choices from Childhood: Dietary Pattern and Social Models

BACKGROUND

The role of diet in the pediatric age for optimal development, achievement, and maintenance of a healthy status is well recognized. Increasing attention is nowadays also paid to reducing the burden of human nutrition on the planet's health for present and future generations.

SUMMARY

Beyond environmental sustainability, the transition to diets rich in animal and processed foods contributes to an overall unhealthy nutritional status leading to an increased prevalence of obesity- and diet-related noncommunicable diseases. Childhood overweight and obesity are a growing public health crisis worldwide. The aim of this narrative review was to summarize evidence of the nutritional status and dietary habits in children and the link with environmental sustainability.

KEY MESSAGE

Optimizing nutrition in infancy and establishing healthy lifestyles from the preschool years might help to reduce the risk of overweight, and all the disorders related, respecting the sustainability dimension.