A cross-sectional survey of the readiness of consumers to adopt an environmentally sustainable diet

What factors influence sustainable and healthy diet consumption? A review and synthesis of literature within the university setting and beyond

Globally, typical dietary patterns are neither healthy nor sustainable. Recognizing the key role of dietary change in reducing noncommunicable disease risk and addressing environmental degradation, it is crucial to understand how to shift individuals toward a sustainable and healthy diet (SHD). In this literature review, we introduced the concept of a SHD and outlined the dietary behaviors necessary to transition toward SHD consumption; we reviewed the literature on factors that may influence sustainable (and unsustainable) dietary behaviors in adults; and we developed a novel scoring system to rank factors by priority for targeting in future research. Given the significant potential to promote a sustainable and healthy dietary transition on the university campus-where factors that may impact dietary behaviors can be targeted at all levels of influence (i.e., individual, interpersonal, environmental, policy)-we narrowed our focus to this setting throughout. Aided by our novel scoring system, we identified conscious habitual eating, product price, food availability/accessibility, product convenience, self-regulation skills, knowledge of animal ethics/welfare, food promotion, and eating norms as important modifiable factors that may influence university students' dietary behaviors. When scored without consideration for the university population, these factors were also ranked as highest priority, as was modified portion sizes. Our findings offer insight into factors that may warrant attention in future research aimed at promoting SHDs. In particular, the high-priority factors identified from our synthesis of the literature could help guide the development of more personalized dietary behavioral interventions within the university setting and beyond.

The impact of replacing milk with plant-based alternatives on iodine intake: a dietary modelling study

PURPOSE

Cow's milk is the primary source of iodine in the UK, but consumption of plant-based milk alternatives (PBMA) is increasing and these products are often not fortified with iodine. We evaluated the impact that replacing current milk consumption with PBMA would have on iodine intake.

METHODS

We used data from the National Diet and Nutrition Survey (2016-2019) for children (1.5-10 years), girls 11-18 years, and women of reproductive age (WRA). We used a dietary modelling approach with scenarios using brand-level iodine-fortification data (0, 13, 22.5, 27.4 and 45 µg/100 mL). Relative to usual diet, we calculated change in iodine intake, and the proportion with intake below the Lower Reference Nutrient Intake (LRNI) or above the upper limit.

RESULTS

For all groups, replacement with PBMA, either unfortified or fortified at the lowest concentration, resulted in a meaningful decrease in iodine intake, and increased the proportion with intake < LRNI; compared to usual diet, iodine intake reduced by 58% in children 1.5-3 years (127 vs. 53 µg/day) and the proportion with intake < LRNI increased in girls (11-18 years; 20% to 48%) and WRA (13% to 33%) if an unfortified PBMA was used. Replacement of milk with PBMA fortified at 27.4 µg/100 mL had the lowest impact.

CONCLUSION

Replacing milk with commercially available PBMAs has potential to reduce population iodine intake, depending on the fortification level. PBMAs fortified with ≥ 22.5 and < 45 µg iodine/100 mL would be required to minimize the impact on iodine intake. Research is needed on the impact of total dairy replacement.

Effectively implementing healthy and sustainable food practices in out-of-home food service locations: The perspective of the catering staff members

Restaurants, canteens, residential care, hospitals and other out-of-home food service locations can play an important role in improving people's diet quality by offering healthier and more sustainable food choices. However, the effectiveness of implementing sustainable and healthy food practices at these locations is, at least partly, dependent on the extent to which they are accepted and implemented by the staff members. This study aims to assess staff members' motivation, perceived capability, perceived opportunity and their readiness to change their behaviour (i.e., stages of change) in offering more healthy and sustainable food options to their customers or patients. Eleven out-of-home locations that wanted to adjust their assortment towards more healthy and sustainable product offerings participated in this study and were able to distribute a comparable questionnaire among their staff members to assess their perceived readiness to change. Results among 268 participants show that staff members find both a healthy and sustainable food assortment important and also seem to be motivated to improve their food assortment regarding health and sustainability. Perceived opportunity seems to be the largest barrier for staff members, although there is also room for improvement regarding their perceived capability. In addition, personal motivation seems to play the dominant role in staff members' readiness to change the health of the assortment, whereas perceived capability seems to play the dominant role in their perceived readiness to change the sustainability of the assortment. This study shows that taking into account the perspective of the catering staff members may help to effectively implement healthy and sustainable food practices in out-of-home food service locations.

Sustainable diets among youth: Validity and reliability of a questionnaire assessing knowledge, attitudes, practices, and willingness to change

BACKGROUND

In light of the global commitment to promoting sustainable dietary choices and the pivotal role of young adults in the adoption of these choices, it is paramount to understand their perspectives of healthy and sustainable diets. The present study aimed to investigate the validity and reliability of a questionnaire examining the knowledge, attitudes, practices, and willingness to change regarding sustainable diets among young adults in the United Arab Emirates (UAE).

METHODS

Male and female students attending University of Sharjah, UAE (n = 436), completed an online questionnaire consisting of four sections: knowledge, attitudes, practices, and willingness to change with regard to sustainable diets. Of the participants, 106 completed the questionnaire a second time, 1 month later. Factor analysis (FA) (both exploratory and confirmatory), Cronbach-α, interitem correlations, and intra class correlation (ICC) coefficients were used in the data analysis.

RESULTS

Exploratory FA revealed four factors corresponding to the components of the questionnaire. Results of the confirmatory FA indicated a good fit: the χ2 df ratio was < 5 (2.3), root mean squared error of approximation was < 0.08 (0.048) and the comparative fit index was above 0.9 (0.901). Cronbach α and interitem correlations were: knowledge: 0.57 and 0.21; attitude: 0.70 and 0.28; practices: 0.76 and 0.39; willingness to change: 0.69 and 0.27. The ICC coefficients, assessing the reliability of the questionnaire, ranged between 0.48 and 0.92 for the various items.

CONCLUSIONS

The developed questionnaire is a valid and reliable tool that could be used to identify the gaps and opportunities for the development of evidence-based interventions aiming to enhance the uptake of sustainable diets among young adults.

The Gap in Sustainable Food Services in Public Institutions: The Perceptions of Young Consumers from Public Universities in the Madrid Region (Spain)

The agri-food system needs to transition into a more balanced system that takes into account economic, social, and environmental factors. Young people are a key demographic group to consider as they are open to new trends of consumption, including sustainable buying practices. Public universities can play a significant role in promoting sustainable and healthy eating habits among students. In this paper, we focus on the perceptions of young people regarding sustainable food in the Madrid Region. We conducted a survey using a questionnaire-based approach among 1940 students in 2022. The results highlight that young consumers are highly concerned about food sustainability. They perceive sustainability as local and non-processed foods. However, this perception varies among young consumers, and we identified five different consumer profiles. Principal component analysis and cluster analysis provide insights into potential actions that universities can take to promote sustainable and healthy eating habits among students.

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.

Current Perceptions of Sustainable Diets in Ireland and the Outlook of Circular Eating Practices

Encouraging sustainable dietary practices is a positive step towards alleviating the negative impact of increasing food waste. This study explores consumers' perceptions of sustainable diets and factors influencing their adoption of sustainable practices, such as circular eating. Fifteen consumers in Ireland aged 18-65+ years were recruited for a qualitative study exploring their views on sustainable diets and their opinions on the use of peels, trimmings, and other by-products from fruit and vegetables as potential new ingredients or new circular food products. Age, gender, dietary preferences and educational background were important considerations during recruitment. Online interviews were conducted, and the data were analyzed using thematic analysis managed by NVivo 12. The results highlighted two overarching themes impacting circular eating, namely, food choice motives and awareness of food waste. These were linked to the participants' knowledge of and potential adoption of sustainable diets. Daily trade-offs were evident, linked to the product and the person who was also strongly influenced by their micro-environment. Consumer education from credible sources would be required to create awareness of circular eating. Most respondents were positively disposed to the concept of circular eating, as long as food safety concerns and affordability considerations were addressed through industry transparency.

Novel plant-based meat alternatives: future opportunities and health considerations

Present food systems threaten population and environmental health. Evidence suggests reduced meat and increased plant-based food consumption would align with climate change and health promotion priorities. Accelerating this transition requires greater understanding of determinants of plant-based food choice. A thriving plant-based food industry has emerged to meet consumer demand and support dietary shift towards plant-based eating. 'Traditional' plant-based diets are low-energy density, nutrient dense, low in saturated fat and purportedly associated with health benefits. However, fast-paced contemporary lifestyles continue to fuel growing demand for meat-mimicking plant-based convenience foods which are typically ultra-processed. Processing can improve product safety and palatability and enable fortification and enrichment. However, deleterious health consequences have been associated with ultra-processing, though there is a paucity of equivocal evidence regarding the health value of novel plant-based meat alternatives (PBMAs) and their capacity to replicate the nutritional profile of meat-equivalents. Thus, despite the health halo often associated with plant-based eating, there is a strong rationale to improve consumer literacy of PBMAs. Understanding the impact of extensive processing on health effects may help to justify the use of innovative methods designed to maintain health benefits associated with particular foods and ingredients. Furthering knowledge regarding the nutritional value of novel PBMAs will increase consumer awareness and thus support informed choice. Finally, knowledge of factors influencing engagement of target consumer subgroups with such products may facilitate production of desirable, healthier PBMAs. Such evidence-based food manufacturing practice has the potential to positively influence future individual and planetary health.

The FLY-project: study protocol for mixed methods research to explore the complex social dynamics of sustainable food-related lifestyles in youth in practical education

BACKGROUND

The present-day food system is a key driver of climate change and biodiversity loss, making it imperative for populations to shift towards more sustainable diets. The involvement of youth in this transition is vital because they are in a formative period where their identities, values, and norms, including their food behaviours, are being shaped. Special attention should be paid to youth in practical education because they are often overlooked in existing studies, yet evidence suggests they may lack the necessary resources to support dietary changes, resulting in lower levels of pro-environmental food-related behaviours. The aim of the FLY (Food-related Lifestyles in Youth) project is to study how sustainable food-related lifestyles and underlying factors develop in early adolescence, particularly in Dutch youth in practical education, how these spread in social networks, and to develop community-level intervention strategies to support youths' transition to sustainable food-related behaviours.

METHODS/DESIGN

The FLY-project adopts a mixed-method approach. First, two literature reviews are conducted. A systematic review assesses how capabilities, opportunities and motivation are associated with sustainable food behaviours in youth, and how these elements interrelate in determining sustainable food-related lifestyles. A scoping review studies community-level interventions that target sustainable and healthy food-related behaviours. Second, focus groups are conducted to explore the barriers and facilitating factors concerning capabilities, opportunities, and motivations that Dutch youth in practical-level education experience to transition to more sustainable food-related lifestyles. Third, a cohort survey study is conducted to track the dynamic interplay between capabilities, opportunities, motivation, and changes in specific sustainable food behaviours over time, and to assess the diffusion of sustainable food-related lifestyles via social (media) networks. Fourth, an experimental research programme tests promising intervention approaches, some of which are co-created with youth, targeting relevant underlying factors.

DISCUSSION

This paper describes the rationale, conceptual framework, design and methods of the FLY-project. The FLY-project contributes to an understanding of underlying factors of sustainable food-related behaviours in adolescence and results in a multi-component intervention toolkit, with a particular focus on youth in practical education programmes.

Plant-Based Dairy Alternatives Contribute to a Healthy and Sustainable Diet

Plant-based foods are increasing in popularity as more and more people are concerned about personal and planetary health. The consumption of plant-based dairy alternatives (PBDAs) has assumed a more significant dietary role in populations shifting to more sustainable eating habits. Plant-based drinks (PBDs) made from soya and other legumes have ample protein levels. PBDs that are appropriately fortified have adequate levels of important vitamins and minerals comparable to dairy milk. For the PBDs examined, the greenhouse gas emissions were diminished by 59-71% per 250 mL, and the land use and eutrophication impact was markedly less than the levels displayed by dairy milk. The water usage for the oat and soya drinks, but not rice drinks, was substantially lower compared to dairy milk. When one substitutes the 250 mL serving of dairy milk allowed within the EAT Lancet Planetary Health Diet for a fortified plant-based drink, we found that the nutritional status is not compromised but the environmental footprint is reduced. Combining a nutrient density score with an environmental index can easily lead to a misclassification of food when the full nutrition profile is not utilized or only a selection of environmental factors is used. Many PBDAs have been categorized as ultra-processed foods (UPFs). Such a classification, with the implied adverse nutritional and health associations, is inconsistent with current findings regarding the nutritional quality of such products and may discourage people from transitioning to a plant-based diet with its health and environmental advantages.

The Influence of APOE Genotype, DHA, and Flavanol Intervention on Brain DHA and Lipidomics Profile in Aged Transgenic Mice

The apolipoprotein E4 (APOE4) genotype is predictive of Alzheimer's disease (AD). The brain is highly enriched with the omega-3 polyunsaturated fatty acid (n3-PUFA), docosahexaenoic acid (DHA). DHA's metabolism is defective in APOE4 carriers. Flavanol intake can play a role in modulating DHA levels. However, the impact of flavanol co-supplementation with fish oil on brain DHA uptake, status and partitioning, and according to APOE genotype is currently unknown. Here, using a humanised APOE3 and APOE4 targeted replacement transgenic mouse model, the interactive influence of cocoa flavanols (FLAV) and APOE genotype on the blood and subcortical brain PUFA status following the supplementation of a high fat (HF) enriched with DHA from fish oil (FO) was investigated. DHA levels increased in the blood (p < 0.001) and brain (p = 0.001) following supplementation. Compared to APOE3, a higher red blood cell (RBC) DHA (p < 0.001) was evident in APOE4 mice following FO and FLAV supplementation. Although FO did not increase the percentage of brain DHA in APOE4, a 17.1% (p < 0.05) and 20.0% (p < 0.001) higher DHA level in the phosphatidylcholine (PC) fraction in the HF FO and HF FO FLAV groups, and a 14.5% (p < 0.05) higher DHA level in the phosphatidylethanolamine (PE) fraction in the HF FO FLAV group was evident in these animals relative to the HF controls. The addition of FLAV (+/- FO) did not significantly increase the percentage of brain DHA in the group as a whole. However, a higher brain: RBC DHA ratio was evident in APOE3 only (p < 0.05) for HF FLAV versus HF. In conclusion, our data shows only modest effects of FLAV on the brain DHA status, which is limited to APOE3.

Public interest in food sustainability: an infodemiology study of Google trends data in Europe from 2010-2021

Understanding food sustainability and healthy diets public awareness is of utmost importance since consumers are the main drivers of global consumption patterns. Using Google Trends data, from 2010 to 2021, we aim to explore the temporal dynamics of food sustainability public interest across Europe and its association with interest in sustainability, healthy diet, Mediterranean diet (MedDiet), and flexitarianism. Public interest in food sustainability has increased and is positively associated with the interest in the topic of sustainability. With few exceptions, no general association between food sustainability and healthy diet or MedDiet interest were found. Consistent associations between food sustainability and flexitarianism were found across most of the European regions and countries. Despite the growing interest, only flexitarianism seems to be associated with food sustainability. Understanding consumers' interest in food sustainability is crucial for the transition towards healthy and sustainable diets and to define educational and behavioural interventions.

Self-Reported Purchasing Behaviour, Sociodemographic Predictors of Plant-Based Protein Purchasing and Knowledge about Protein in Scotland and England

Plant-based diets are seen as a food-based strategy to address both the impact of dietary patterns on the environment, to reduce climate change impact, and also to reduce rates of diet-related disease. This study investigated self-reported consumer purchasing behaviour of plant-based alternative foods (PBAF) and wholefood plant protein foods (legumes) with a cross-sectional online survey. We identified the sociodemographic factors associated with purchasing behaviour and examined knowledge about protein and plant-based diets. We recruited and obtained consent from n = 1177 adults aged >18 from England and Scotland (mean age (± standard deviation (SD)) 44 (16.4) years), across different areas of social deprivation, based on postcode. Descriptive statistics were conducted, and sociodemographic factors were examined by computing covariate-adjusted models with binary logistic regression analysis. A total of 47.4% (n = 561) consumers purchased PBAF and 88.2% (n = 1038) wholefood plant-proteins. The most frequently purchased PBAF were plant-based burgers, sausages, and mince/meatballs. Individuals from low deprivation areas were significantly more likely than individuals from high deprivation areas to purchase wholefood plant-proteins (odds ratio (OR) 3.46, p = 0.001). People from low deprivation areas were also more likely to recognise lentils as good source of protein (OR 1.94, p = 0.003) and more likely to recognise plant-based diets as healthy (OR 1.79, p = 0.004) than those from high deprived areas. These results support current trends of increasing popularity of PBAF, which is positive for the environment, but also highlights these products as being ultra-processed, which may negatively impact on health. The study also re-enforces the link between deprivation, reduced purchasing of wholefood plant-proteins and knowledge of plant-based protein and diets. Further research is needed to examine healthfulness of PBAF and how sociodemographic factors, especially deprivation, affect both food choice and consumption of wholefood plant-proteins.

Making Healthy, Sustainable Diets Accessible and Achievable: A New Framework for Assessing the Nutrition, Environmental, and Equity Impacts of Packaged Foods

There is a growing global consensus among food system experts that diets and how we source our foods must change. The sustainable nutrition community continues exploring the environmental impact and dietary value of foods. Packaged foods have been largely ignored within the dialogue, and if they are addressed, existing frameworks tend to label them all as "ultraprocessed" and uniformly discourage their consumption. This approach lacks the nuance needed to holistically evaluate packaged foods within recommended dietary patterns. Additionally, there is considerable diversity of opinion within the literature on these topics, especially on how best to improve nutrition security in populations most at risk of diet-related chronic disease. In support of addressing these challenges, 8 sustainability and nutrition experts were convened by Clif Bar & Company for a facilitated discussion on the urgent need to drive adoption of healthy, sustainable diets; the crucial role that certain packaged foods can play in helping make such diets achievable and accessible; and the need for actionable guidance around how to recommend and choose packaged foods that consider human, societal, and planetary health. This article summarizes the meeting discussion, which informed the development of a proposed framework based on guiding principles for defining sustainable, nutritious packaged foods across key nutrition, environmental, economic, and sociocultural well-being indicators. Although additional research is needed to substantiate specific metrics in order to operationalize the framework, it is intended to be a foundation from which to build and refine as science and measurement capabilities advance, and an important step toward broader adoption of healthy, sustainable diets.

The Clean Your Plate Campaign: Resisting Table Food Waste in an Unstable World

The COVID-19 pandemic threatens global food security and has created an urgent need for food conservation. This article presents a review of clean plate campaigns around the world. It aims to fight food waste and reveal the factors that may influence food waste. The Clean Plate Club in the US developed during wartime and relied heavily on political power for compliance, whereas the Clean Plate movement in South Korea was based on religion. China’s Clean Your Plate Campaign (CYPC) has gone through two stages: CYPC I and CYPC II. The latter occurred during the unstable period of the COVID-19 pandemic. It was large-scale and more strongly enforced than CYPC I. In China, CYPC has relied more on personal virtue than on politics or religion. Culture, policy, COVID-19, and behavior are all important social factors that influence food waste. Specifically, two cultural values are drivers of food waste in China: hospitality and face-saving (mianzi). In terms of policy, China’s food waste law mainly relies on persuasion; it lacks any power of enforcement. Laws in France and Italy, by contrast, focus on re-using food and involve both coercion and incentives. COVID-19 may have led to panic purchasing and stockpiling, but, in general, it has resulted in a reduction in food waste.

Italian Consumers' Readiness to Adopt Eggs from Insect-Fed Hens

Simple Summary

An overall increase in food demand is pushing the agri-food sector toward higher food output. In particular, the feeding of laying hens plays a major role, requiring larger quantities of soybean meal for egg production each year. Replacing soybean meal with insect meal has proven to lower the environmental impact compared to traditional feed production, but it may influence consumer acceptance. An online survey was conducted to evaluate the perception and the readiness of Italian consumers to the use of eggs from laying hens fed with insect meal. The results showed a considerable level of willingness of the participants to face this innovative scenario.

Abstract

Demand for eggs from laying hens is increasing as the world population continues to grow. The use of insects as animal feed is a strategic opportunity to find a new innovative, economic and sustainable source of protein. The aim of this study was to evaluate the Italian consumer inclination for eggs produced with the use of insect-fed hens. The investigation on consumers’ readiness to adopt eggs from insect-fed hens was carried out through an online survey conducted on 510 participants. Survey results outlined four different clusters on the basis of the willingness to buy/eat eggs fed with insects: “ready” (40.1%), “environmentalist” (24.3%), “cautious” (21.7%), and “reluctant” (13.9%). “Ready”, “environmentalist”, and “cautious” were quite favorable to the use of insects as feed stuffs and share drivers for product choice: cheap, organic, and with an explicit indication of use of insects. On the other hand, for the “reluctant”, the diet based on insects was the main negative factor influencing product acceptance. This cluster also showed the highest level of neophobia. Italian consumers showed a considerable level of readiness to accept insects as feed material for egg production, which should be reinforced with further information on the origin and the environmental benefit of using insects.

Sustainable Agri-Food Systems: Environment, Economy, Society, and Policy

Agri-food systems (AFS) have been central in the debate on sustainable development. Despite this growing interest in AFS, comprehensive analyses of the scholarly literature are hard to find. Therefore, the present systematic review delineated the contours of this growing research strand and analyzed how it relates to sustainability. A search performed on the Web of Science in January 2020 yielded 1389 documents, and 1289 were selected and underwent bibliometric and topical analyses. The topical analysis was informed by the SAFA (Sustainability Assessment of Food and Agriculture systems) approach of FAO and structured along four dimensions viz. environment, economy, society and culture, and policy and governance. The review shows an increasing interest in AFS with an exponential increase in publications number. However, the study field is north-biased and dominated by researchers and organizations from developed countries. Moreover, the analysis suggests that while environmental aspects are sufficiently addressed, social, economic, and political ones are generally overlooked. The paper ends by providing directions for future research and listing some topics to be integrated into a comprehensive, multidisciplinary agenda addressing the multifaceted (un)sustainability of AFS. It makes the case for adopting a holistic, 4-P (planet, people, profit, policy) approach in agri-food system studies.