Eating patterns and food systems: critical knowledge requirements for policy design and implementation

Eating patterns in Korean adults, 1998-2018: increased energy contribution of ultra-processed foods in main meals and snacks

PURPOSE

Unfavorable changes in eating patterns over time may contribute to upward trends in chronic diseases, such as obesity. We examined 20-year trends in the percentage of energy from main meals and snacks and the food sources of each eating occasion among Korean adults.

METHODS

This study used nationally representative data from the 1st, 4th, and 7th Korea National Health and Nutrition Examination Surveys (1998, 2007-2009, and 2016-2018) among adults aged 20-69 years (n = 29,389). Each eating occasion (breakfast, lunch, dinner, and snacks) was defined by respondents during a 24-h dietary recall interview. To identify the food sources of each eating occasion, we used the NOVA system. The percentage of energy at each eating occasion and that from each NOVA group across survey cycles were estimated, and tests for linear trends were conducted using orthogonal polynomial contrasts in linear regression models. All analyses accounted for the complex survey design.

RESULTS

After adjusting for age and sex, the percentage of energy from breakfast decreased from 25.0% in 1998 to 16.7% in 2018 (difference, - 8.2%; standard error [SE], 0.3), whereas that from dinner and snacks increased from 31.1 to 33.8% (difference, + 2.7%; SE, 0.4) and from 14.0 to 19.0% (difference, + 5.0%; SE, 0.5), respectively (all P < 0.001). At all eating occasions, the percentage of energy from minimally processed foods declined (difference, - 18.6% for breakfast; - 13.1% for lunch; - 21.1% for dinner; - 20.7% for snacks), while that from ultra-processed foods increased (difference, + 17.0% for breakfast; + 11.3% for lunch; + 18.0% for dinner; + 30.7% for snacks). When stratified by age, the given trends were shown to a greater extent in younger adults (< 50 years old) than in older adults (≥ 50 years old).

CONCLUSIONS

The eating patterns of Korean adults changed from 1998 to 2018, with the greatest decrease in energy intake from breakfast and the greatest increase from snacking. At all eating occasions, the contribution of minimally processed foods declined, while that of ultra-processed foods increased, especially among younger adults.

Sociodemographic determinants of eating patterns in two Latin American populations

BACKGROUND

The present study aimed to describe the dietary patterns of a population from Brazil and another from Colombia with respect to understanding their determinants, similarities and differences.

METHODS

An analytical cross-sectional study was conducted based on secondary data. The dietary patterns of the adult population of Pernambuco, Brazil, as well as those of the adult population of Antioquia, Colombia, were analysed using principal component analysis method with orthogonal varimax rotation, and a Poisson regression with robust variance was used to verify the association between eating patterns and socio-economic variables.

RESULTS

In each population, three eating patterns were identified. One of them related to healthy eating, named "Prudent", was identified in the two populations analysed. In Pernambuco, a food pattern consisting exclusively of foods with some degree of processing was verified, entitled "Processed". The food culture was reflected in the pattern called "Traditional-Regional" in Pernambuco and the "Traditional" and "Regional" patterns in Antioquia.

CONCLUSIONS

Income, education, age, family size, food security status and area of residence were presented as determinants of dietary patterns in both populations. Elements of the food transition were found, which seems to have happened more rapidly in Pernambuco. The food groups that make up the dietary patterns of each population are similar, but the foods that constitute them present differences due to their availability depending on aspects such as climate, soil quality, access to water, local culture and food tradition.

European dietitians as key agents of the green transition: An exploratory study of their knowledge, attitudes, practices, and training

Introduction

How food systems are currently provisioning food to the population is a matter of debate worldwide. Food systems, driven by widespread and increasing adherence to a westernized dietary pattern, are failing to meet people's basic needs and are draining natural resources. There is a push to make food systems more healthy, fair, and sustainable. To this end, action from all players is needed to meet the international agenda. In this regard, dietitians play a crucial role, as they can provide advice and promote actions that foster the adoption of more sustainable dietary patterns (SDP) as well as the promotion of sustainable food systems. As an emerging requirement in their training, it is crucial to know what dietitians know about SDP as well as their attitudes and current practices in this field in order to strengthen their competences and be key agents for the green transition. For this reason, the aim of the present study is to explore the knowledge, attitudes, practices, and training (KAPT) of European dietitians on SDP by administering an online survey.

Methods

Cross-sectional survey administered between April-August 2021 to dietitians based in the European countries with National Dietetic Associations or Education Associate Members affiliated to the European Federation of Associations of Dietitians (EFAD). Results were analyzed based on European region of professional practice (Northern/Southern/Western/South-East Europe), area of expertise and years of experience.

Results

Responses from 2211 dietitians from 25 countries were received, although the analysis was based on those that responded at least 90% of the survey (n=208). European dietitians are lacking training on SDP but are willing to learn more about it. Most dietitians perceive themselves as able to define an SDP, although aspects concerning social and economic sustainability were underestimated. Dietitians concur that barriers exist to the promotion of SDP, such as the lack of updated national food-based dietary guidelines and the absence of support from peers and managers. The country of professional activity seemed to be key to influencing dietitians' KAPT.

Discussion

These results emphasize the need to strengthen European dietitians' training in SDP and increase public/private commitment to consider dietitians as key professionals for the transition towards SDP.

Opportunities and challenges of food policy councils in pursuit of food system sustainability and food democracy–a comparative case study from the Upper-Rhine region

Conventional food systems continue to jeopardize the health and well-being of people and the environment, with a number of related Sustainable Development Goals (SDGs) still far from being reached. Food Policy Councils (FPCs)—since several decades in North America, and more recently in Europe—have begun to facilitate sustainable food system governance activities among various stakeholders as an explicit alternative to the shaping of food systems by multinational food corporations and their governmental allies. In contrast to the former, FPCs pursue the goals of food system sustainability through broad democratic processes. Yet, at least in Europe, the agenda of FPCs is more an open promise than a firm reality (yet); and thus, it is widely unknown to what extent FPCs actually contribute to food system sustainability and do so with democratic processes. At this early stage, we offer a comparative case study across four FPCs from the Upper-Rhine Region (Freiburg, Basel, Mulhouse, Strasbourg)—all formed and founded within the past 5 years—to explore how successful different types of FPCs are in terms of contributing to food system sustainability and adhering to democratic and good governance principles. Our findings indicate mixed results, with the FPCs mostly preparing the ground for more significant efforts at later stages and struggling with a number of challenges in adhering to principles of democracy and good governance. Our study contributes to the theory of sustainable food systems and food democracy with the focus on the role of FPCs, and offers procedural insights on how to evaluate them regarding sustainable outcomes and democratic processes. The study also offers practical insights relevant to these four and other FPCs in Europe, supporting their efforts to achieve food system sustainability with democratic processes.

How Does Adolescents' Usage of Social Media Affect Their Dietary Satisfaction?

In order to improve the health status of adolescents, studies are needed to illuminate the essence of their general and dietary lifestyle. Thus, we conducted this study to verify meaningful relationships between adolescent usage of social media (USM), which plays an important role in their life, their food consumption behavior (FCB), and their dietary satisfaction. This study used two analysis methods: t-tests and structural equation modeling (SEM). This study verified whether there was a significant difference in adolescent FCB depending on their USM using t-tests. This study proposes that the following FCBs showed significant differences between users and non-users of social media in adolescents: a tendency to try new types of food (t = 2.134, p < 0.05), a tendency to avoid foods with harmful risks such as suspected spoilage (t = 3.513, p < 0.001), a tendency to eat bread or fruit for a simple breakfast (t = −3.893, p < 0.001), and a tendency to often use home meal replacements (HMR), eat out or have food delivered (t = −3.245, p < 0.01). Furthermore, this study used SEM to verify the causal relationship between adolescent USM and their dietary satisfaction. According to the results of SEM, adolescents’ USM mediated by the FCB of preferring convenience fully mediates the negative relationship between adolescent USM and their dietary satisfaction (p < 0.01). It is necessary to reverse the situation in which adolescent dietary satisfaction decreases as their FCB of preferring convenience increases. Government regulations for food companies and autonomous efforts for quality improvements on their part are needed.

A Generation Shift in Mediterranean Diet Adherence and Its Association with Biological Markers and Health in Dalmatia, Croatia

Previous studies have confirmed the beneficial effect of a Mediterranean diet in mitigating health issues related to cardiovascular disease, diabetes and obesity. However, rapid changes in the traditional way of life and the “westernization” of the diet in Mediterranean populations, especially in younger generations, has led to progressive abandonment of healthy dietary patterns. In order to investigate the generation shift in dietary patterns and lifestyle habits in the Mediterranean part of Croatia, we compared two cohorts of 610 women (266 pregnant and 344 non-pregnant) from the same region, but from different age groups. The MDSS score was derived from food frequency questionnaires. The results showed that the young, reproductively active generation (pregnant women) in Dalmatia, Croatia, although having a higher education and socioeconomic status, exhibits a more adverse eating behaviour (lower adherence to the Mediterranean diet) and lifestyle (excessive smoking in pregnancy) than the older population from the same region. Lower MDSS scores across aggregated age groups in both cohorts showed significant association with higher blood lipid levels and higher smoking frequency. In conclusion, Mediterranean diet adherence is associated with biological markers (age, lipid profile) and lifestyle (smoking) in our study, with a more adverse trend observed in the younger generation.

Using Word Embeddings to Learn a Better Food Ontology

Food ontologies require significant effort to create and maintain as they involve manual and time-consuming tasks, often with limited alignment to the underlying food science knowledge. We propose a semi-supervised framework for the automated ontology population from an existing ontology scaffold by using word embeddings. Having applied this on the domain of food and subsequent evaluation against an expert-curated ontology, FoodOn, we observe that the food word embeddings capture the latent relationships and characteristics of foods. The resulting ontology, which utilizes word embeddings trained from the Wikipedia corpus, has an improvement of 89.7% in precision when compared to the expert-curated ontology FoodOn (0.34 vs. 0.18, respectively, p value = 2.6 × 10^–138), and it has a 43.6% shorter path distance (hops) between predicted and actual food instances (2.91 vs. 5.16, respectively, p value = 4.7 × 10^–84) when compared to other methods. This work demonstrates how high-dimensional representations of food can be used to populate ontologies and paves the way for learning ontologies that integrate contextual information from a variety of sources and types.

An Italian Innovative Small-Scale Approach to Promote the Conscious Consumption of Healthy Food

An unhealthy diet is considered to be one of the main causes for increases in obesity and chronic diseases. Food choices are frequently influenced by food systems and environments along with the availability and affordability of healthy and sustainable food. In this context, a major contemporary challenge lies in improving these aspects in order to support healthy dietary choices. Hence, to address this issue, here, we propose a small-scale approach called SANI (Italian for “healthy”) which involves experts in science and marketing. Two typical agri-foods of the Abruzzo area (center of Italy), tomato sauce and extra virgin olive oil, are characterized as high-quality products in terms of their nutrient content, absence of chemical contaminants (chromatographic, spectrophotometric, and magnetic resonance techniques), and ecological footprint (lifecycle assessment and carbon footprint). Hence, their consumption is promoted, with strict attention being paid to several aspects of the food system, such as production, processing, distribution, labeling, and promotion, as well as marketing strategies and dissemination activities. Overall, these SANI actions, especially labeling and dissemination, have proven to be a valuable learning tool for consumers moving toward more conscious consumption, which can be extended and applied to additional food products. Future applications of similar research strategies in a wider context could positively affect human and environmental health.

Demand-Side Food Policies for Public and Planetary Health

Background: The current food system has major consequences for the environment and for human health. Alignment of the food policy areas of mitigating climate change and public health will ensure coherent and effective policy interventions for sustaining human health and the environment. This paper explores literature on demand-side policies that aim to reduce consumption of animal-based foods, increase plant-based foods, and reduce overconsumption. Methods: We searched for publications, published between January 2000 and December 2019, considering the above policy domains. Articles were distinguished for type of policy instrument, for topic via keywords and examples were given. Results: The majority of demand-side policies focus on preventing overweight and obesity, using all types of policy instruments including more forceful market-based policies. Hardly any examples of public policies explicitly aiming to lower animal-based foods consumption were found. Policies combining health and sustainability objectives are few and mainly of the information type. Discussion: Moving towards environmentally sustainable and healthy diets is challenging as the implemented demand-side policies focus largely on human health, and not yet on environmental outcomes, or on win-wins. Policies targeting foods from the health perspective can contribute to lower environmental impacts, by indicating suitable animal-based food replacers, and aiming at avoiding overconsumption of energy dense-nutrient poor foods. Preferred policies include a variety of instruments, including strong measures. Conclusions: Working solutions are available to ensure coherent and effective demand side food policies aligning public health and environmental aims. Implementation of aligned and effective policy packages is urgent and needed.

Agri-Food Markets towards Sustainable Patterns

In recent decades, the confluence of different global and domestic drivers has led to progressive and unpredictable changes in the functioning and structure of agri-food markets worldwide. Given the unsustainability of the current agri-food production, processing, distribution and consumption patterns, and the inadequate governance of the whole food system, the transition to sustainable agriculture and food systems has become crucial to effectively manage a global agri-food market able in supporting expected population growth and ensuring universal access to sufficient, safe, and nutritious food for all. Based on a critical review of the existing international literature, the paper seeks to understand the evolutionary paths of sustainability issues within agri-food markets by analyzing their drivers and trends. An extensive analysis was conducted highlighting the development and importance of the body of knowledge on the most important sustainability transition frameworks, focusing mainly on the relationship between markets, trade, food and nutrition security, and other emerging issues within agri-food markets. Finally, the study makes suggestions to extend the research in order to improve basic knowledge and to identify opportunities to design meaningful actions that can shape agri-food markets and foster their transition to sustainability.

Invited review: Resource inputs and land, water and carbon footprints from the production of edible protein of animal origin

Abstract. The objective of this review is to analyze crucial factors in the output from the production of proteins in food of animal origin, such as milk, meat and eggs. We then consider inputs such as land, water, fuel, minerals and feed, as well as characterize emissions. Finally, we estimate footprints for land (land footprint, LF), water (water footprint, WF) and greenhouse gas emissions (i.e., carbon footprint, CF) during the production process. The wide range of different land and water inputs per unit feed between various studies largely influences the results. Further influencing factors are species and categories of animals that produce edible protein, their yields and the feeding of animals. Coproducts with no or low humanly edible fractions and grassland as feed contribute to a lower need for arable land and lower LF, WF and CF. The most efficient land use or the lowest LF per kilogram of edible protein was estimated for higher milk and egg yields; the highest LF values were calculated for beef, followed by pork. The lowest WF and CF were calculated for edible protein of chicken meat and eggs. Edible protein from ruminants is mostly characterized by a higher CF because of the high greenhouse gas potential of methane produced in the rumen. A key prerequisite for further progress in this field is the harmonization of data collection and calculation methods. Alternatives to partial or complete replacement of protein of terrestrial animals, such as marine animals, insects, cell cultures, single-cell proteins or “simulated animal products” from plants, as well as changing eating patterns and reducing food losses are mentioned as further potential ways for more efficient feed production. For all those dealing with plant or animal breeding and cultivation and all those who are working along the whole food production chain, it is a major challenge to enhance the production of more food for more people with, at the same time, less, limited resources and lower emissions.

Land Use for Edible Protein of Animal Origin-A Review

The present period is characterized by a growing world population and a higher demand for more and better quality food, as well as other products for an improved standard of living. In the future, there will be increasingly strong competition for arable land and non-renewable resources such as fossil carbon-sources, water, and some minerals, as well as between food, feed, fuel, fiber, flowers, and fun (6 F's). Proteins of animal origin like milk, meat, fish, eggs and, probably, insects are very valuable sources of essential amino acids, minerals and vitamins, but their production consumes some non-renewable resources including arable land and causes considerable emissions. Therefore, this study´s objective was to calculate some examples of the land use (arable land and grassland) for production of edible animal protein taking into consideration important animal species/categories, levels of plant and animal yields, the latter estimated with and without co-products from agriculture, and the food/biofuel industry in animal feeding. There are large differences between animal species/categories and their potential to produce edible protein depending on many influencing variables. The highest amounts per kilogram body weight are produced by growing broiler chicken followed by laying hens and dairy cows; the lowest yields in edible protein and the highest land need were observed for beef cattle. This review clearly indicates that the production of food of animal origin is a very complex process, and selective considerations, i.e., focusing on single factors, do not provide an assessment that reflects the complexity of the subject.