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Álvarez-Álvarez L, Vitelli-Storelli F, Rubín-García M, Martín-Sánchez V, García Fernández C, Carvalho C, Araújo J, Ramos E. Environmental impact of the diet of young Portuguese and its relationship with adherence to the Mediterranean Diet. Eur J Nutr 2024; 63:2307-2315. [PMID: 38763928 PMCID: PMC11377495 DOI: 10.1007/s00394-024-03396-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/16/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVE To estimate, in a cohort of young Portuguese adults, the environmental impact (greenhouse gas (GHG) emissions, land use, energy used, acidification and potential eutrophication) of diet according to adherence to the Mediterranean Diet (MD). METHODS Data from 1554 participants of the Epidemiologic Health Investigation of Teenagers in Porto (EPITeen) were analysed. Food intake and MD adherence were determined using validated questionnaires. The environmental impact was evaluated with the EAT-Lancet Commission tables, and the link between MD adherence and environmental impact was calculated using adjusted multivariate linear regression models. RESULTS Higher adherence (high vs. low) to the MD was associated with lower environmental impact in terms of land use (7.8 vs. 8.5 m2, p = 0.002), potential acidification (57.8 vs. 62.4 g SO2-eq, p = 0.001) and eutrophication (21.7 vs. 23.5 g PO4-eq, p < 0.001). Energy use decreased only in the calorie-adjusted model (9689.5 vs. 10,265.9 kJ, p < 0.001), and GHG emissions were reduced only in a complementary model where fish consumption was eliminated (3035.3 vs. 3281.2 g CO2-eq, p < 0.001). Meat products had the greatest environmental impact for all five environmental factors analysed: 35.7% in GHG emissions, 60.9% in energy use, 72.8% in land use, 70% in acidification and 61.8% in eutrophication. CONCLUSIONS Higher adherence to the MD is associated with lower environmental impact, particularly in terms of acidification, eutrophication, and land use. Reducing meat consumption can contribute to greater environmental sustainability.
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Affiliation(s)
- Laura Álvarez-Álvarez
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Facundo Vitelli-Storelli
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - María Rubín-García
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Vicente Martín-Sánchez
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Camino García Fernández
- Department of Food Hygiene and Technology, Veterinary Faculty, University of León, León, Spain
| | - Catarina Carvalho
- Department of Public Health and Forensic Sciences, EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Medical School, University of Porto, Porto, Portugal
| | - Joana Araújo
- Department of Public Health and Forensic Sciences, EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Medical School, University of Porto, Porto, Portugal
| | - Elisabete Ramos
- Department of Public Health and Forensic Sciences, EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal.
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal.
- Medical School, University of Porto, Porto, Portugal.
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Biggi C, Biasini B, Ogrinc N, Strojnik L, Endrizzi I, Menghi L, Khémiri I, Mankai A, Slama FB, Jamoussi H, Riviou K, Elfazazi K, Rehman N, Scazzina F, Menozzi D. Drivers and Barriers Influencing Adherence to the Mediterranean Diet: A Comparative Study across Five Countries. Nutrients 2024; 16:2405. [PMID: 39125289 PMCID: PMC11313691 DOI: 10.3390/nu16152405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 07/15/2024] [Accepted: 07/19/2024] [Indexed: 08/12/2024] Open
Abstract
Given the global decline in adherence to the Mediterranean Diet (MD), even within its native region, it is key to identify the factors influencing this trend to mitigate the negative health outcomes associated with westernized diets. To this end, 4025 individuals (49.6% women, 42.6 ± 14.2 y/o) from Greece, Italy, Morocco, Slovenia, and Tunisia remotely completed a series of measures assessing motives, attitudes, and psychosocial factors related to MD adherence, which was evaluated using the MEDAS questionnaire. The results suggested medium-to-low adherence across all countries, with the highest adherence in Italy and Morocco and the lowest in Slovenia. Structural equation modeling revealed that positive attitudes toward the healthiness of food were the strongest predictors of adherence, whereas picky eating was a significant negative predictor in all countries except Greece. Adherence to the MD was positively influenced by health motivations in Morocco and weight control in Slovenia and Greece, while sensory appeal negatively influenced adherence in Italy. Additionally, price and convenience were significant barriers in Tunisia and Greece, whereas a preference for local and seasonal foods promoted adherence in Morocco and Greece. Overall, our findings underscore the need for country-specific interventions and policies that address distinct local factors and motivations to ease favorable shifts in dietary patterns toward MD principles.
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Affiliation(s)
- Chiara Biggi
- Department of Food and Drug, University of Parma, Parco Area delle Scienze, 27/A, 43124 Parma, Italy; (C.B.); (B.B.); (F.S.)
| | - Beatrice Biasini
- Department of Food and Drug, University of Parma, Parco Area delle Scienze, 27/A, 43124 Parma, Italy; (C.B.); (B.B.); (F.S.)
| | - Nives Ogrinc
- Jožef Stefan Institute (JSI), Jamova 39, 1000 Ljubljana, Slovenia; (N.O.); (L.S.)
| | - Lidija Strojnik
- Jožef Stefan Institute (JSI), Jamova 39, 1000 Ljubljana, Slovenia; (N.O.); (L.S.)
| | - Isabella Endrizzi
- Research and Innovation Center, Edmund Mach Foundation, Via Edmund Mach 1, 38098 San Michele all’Adige, Italy;
| | - Leonardo Menghi
- Center Agriculture Food Environment, University of Trento, Via Edmund Mach 1, 38098 San Michele all’Adige, Italy;
| | - Ikram Khémiri
- Tunisian Association of Nutritional Sciences, National Institute of Nutrition and Food Technology, 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia; (I.K.); (A.M.); (F.B.S.); (H.J.)
- Laboratory of Mycology, Pathologies and Biomarkers (LR16/ES05), Faculty of Sciences of Tunis, University of Tunis El Manar, Campus Universitaire, Tunis 2092, Tunisia
| | - Amani Mankai
- Tunisian Association of Nutritional Sciences, National Institute of Nutrition and Food Technology, 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia; (I.K.); (A.M.); (F.B.S.); (H.J.)
- Higher School of Health Sciences and Techniques, University of Tunis El Manar, B.P. 176–Bab Souika, Tunis 1007, Tunisia
| | - Fethi Ben Slama
- Tunisian Association of Nutritional Sciences, National Institute of Nutrition and Food Technology, 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia; (I.K.); (A.M.); (F.B.S.); (H.J.)
- Higher School of Health Sciences and Techniques, University of Tunis El Manar, B.P. 176–Bab Souika, Tunis 1007, Tunisia
| | - Henda Jamoussi
- Tunisian Association of Nutritional Sciences, National Institute of Nutrition and Food Technology, 11 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia; (I.K.); (A.M.); (F.B.S.); (H.J.)
- Research Unit “Obesity: Etiopathology and Treatment, UR18ES01”, Faculty of Medicine, University of Tunis El Manar, 15 Rue Jebel Lakhdar, Bab Saadoun, Tunis 1007, Tunisia
| | - Katerina Riviou
- Ellinogermaniki Agogi Scholi Panagea Savva AE (EA), Dimitriou Panagea Str., 15351 Pallini, Greece;
| | - Kaoutar Elfazazi
- Agri-Food Technology and Quality Laboratory, Regional Center of Agricultural Research of Tadla, National Institute of Agricultural Research, Morocco (INRA), Avenue de la Victoire, B.P. 415 RP, Rabat 10090, Morocco;
| | - Nayyer Rehman
- WRG Europe Ltd., 26-28 Southernhay East, Exeter EX1 1NS, UK;
| | - Francesca Scazzina
- Department of Food and Drug, University of Parma, Parco Area delle Scienze, 27/A, 43124 Parma, Italy; (C.B.); (B.B.); (F.S.)
| | - Davide Menozzi
- Department of Food and Drug, University of Parma, Parco Area delle Scienze, 27/A, 43124 Parma, Italy; (C.B.); (B.B.); (F.S.)
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Álvarez-Álvarez L, Rubín-García M, Vitelli-Storelli F, García S, Bouzas C, Martínez-González MÁ, Corella D, Salas-Salvadó J, Malcampo M, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Bueno-Cavanillas A, García Fernández C, Pintó X, Delgado-Rodríguez M, Matía-Martín P, Vidal J, Vázquez C, Daimiel L, Ros E, García-Arellano A, Martínez MÁ, Sorlí JV, Zomeño MD, García-Rios A, González-Palacios S, Monserrat-Mesquida M, Abete I, Colom Fernández A, Casas R, Cano Ibáñez N, Ugarriza L, Bernal-López MR, Bes-Rastrollo M, Paz-Graniel I, Asensio EM, Fitó M, Arenas Larriva AP, Oncina-Cánovas A, Vázquez Z, Fernández de la Puente M, Pérez-Vega A, Tur JA, Martín-Sánchez V. Effect of a nutritional intervention based on an energy-reduced Mediterranean diet on environmental impact. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 928:172610. [PMID: 38642762 DOI: 10.1016/j.scitotenv.2024.172610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE To estimate the environmental impact of a dietary intervention based on an energy-reduced Mediterranean diet (MedDiet) after one year of follow-up. METHODS Baseline and 1-year follow-up data were used for 5800 participants aged 55-75 years with metabolic syndrome in the PREDIMED-Plus study. Food intake was estimated through a validated semiquantitative food consumption frequency questionnaire, and adherence to the MedDiet was estimated through the Diet Score. Using the EAT-Lancet Commission tables we assessed the influence of dietary intake on environmental impact (through five indicators: greenhouse gas emissions (GHG), land use, energy used, acidification and potential eutrophication). Using multivariable linear regression models, the association between the intervention and changes in each of the environmental factors was assessed. Mediation analyses were carried out to estimate to what extent changes in each of 2 components of the intervention, namely adherence to the MedDiet and caloric reduction, were responsible for the observed reductions in environmental impact. RESULTS We observed a significant reduction in the intervention group compared to the control group in acidification levels (-13.3 vs. -9.9 g SO2-eq), eutrophication (-5.4 vs. -4.0 g PO4-eq) and land use (-2.7 vs. -1.8 m2). Adherence to the MedDiet partially mediated the association between intervention and reduction of acidification by 15 %, eutrophication by 10 % and land use by 10 %. Caloric reduction partially mediated the association with the same factors by 55 %, 51 % and 38 % respectively. In addition, adherence to the MedDiet fully mediated the association between intervention and reduction in GHG emissions by 56 % and energy use by 53 %. CONCLUSIONS A nutritional intervention based on consumption of an energy-reduced MedDiet for one year was associated with an improvement in different environmental quality parameters.
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Affiliation(s)
- Laura Álvarez-Álvarez
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - María Rubín-García
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Facundo Vitelli-Storelli
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain.
| | - Silvia García
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, Guillem Colom Bldg, Campus, E-07122, Palma de Mallorca, Spain
| | - Cristina Bouzas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, Guillem Colom Bldg, Campus, E-07122, Palma de Mallorca, Spain
| | - Miguel Ángel Martínez-González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició, Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain
| | - Mireia Malcampo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - J Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain; Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Ángel M Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Jesús Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Lluís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
| | - Aurora Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria, IBS-Granada, Spain
| | - Camino García Fernández
- Department of Food Hygiene and Technology, Veterinary Faculty, University of León, León, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain; Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía-Martín
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, Institut d` Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Clotilde Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autonoma, Madrid, Spain
| | - Lidia Daimiel
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain; Departamento de Ciencias Farmacéuticas y de la Salud, Faculty de Farmacia, Universidad San Pablo-CEU, CEU Universities, Boadilla del Monte, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Ana García-Arellano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - María Ángeles Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició, Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain
| | - José V Sorlí
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - María Dolores Zomeño
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain; School of Health Sciences, Blanquerna-Ramon Llull University, 08022 Barcelona, Spain
| | - Antonio García-Rios
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Sandra González-Palacios
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
| | - Margalida Monserrat-Mesquida
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, Guillem Colom Bldg, Campus, E-07122, Palma de Mallorca, Spain
| | - Itziar Abete
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Antoni Colom Fernández
- Department of Nursing, University of Málaga, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain; Interdisciplinary Observatory of Mobility, University of the Balearic Islands, 07122 Palma, Spain
| | - Rosa Casas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Naomi Cano Ibáñez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria, IBS-Granada, Spain
| | - Lucía Ugarriza
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, Guillem Colom Bldg, Campus, E-07122, Palma de Mallorca, Spain
| | - M Rosa Bernal-López
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Málaga, Spain
| | - Maira Bes-Rastrollo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - Indira Paz-Graniel
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició, Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain
| | - Eva M Asensio
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Montse Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Antonio P Arenas Larriva
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Alejandro Oncina-Cánovas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
| | - Zenaida Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - María Fernández de la Puente
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentaciò, Nutrició, Desenvolupament i Salut Mental ANUT-DSM, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain
| | - Alejandra Pérez-Vega
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - Josep A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, Guillem Colom Bldg, Campus, E-07122, Palma de Mallorca, Spain
| | - Vicente Martín-Sánchez
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Alves R, Perelman J, Chang K, Millett C. Environmental impact of dietary patterns in 10 European countries; a cross-sectional analysis of nationally representative dietary surveys. Eur J Public Health 2024:ckae088. [PMID: 38776529 DOI: 10.1093/eurpub/ckae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Changing dietary patterns is essential to reducing the substantial environment impact of agriculture and food production systems. We performed a cross-country comparison of dietary patterns and their associated environmental impact in Europe, including by sociodemographic factors. METHODS We analyzed pooled cross-sectional dietary records collected during 2010-18 from 10 European countries using the European Food Safety Authority (EFSA) Comprehensive European Food Database (16 508 adults; aged 18-79 years). Each food consumed was mapped to the corresponding environmental impact data using the SHARP Indicators Database, which provides greenhouse gas emission (GHGE) and land use (LU) values of approximately 900 foods. Total diet-associated environmental impact was calculated for each person and averaged across multiple days. Multivariable linear regression models were used to compare diet-associated GHGE and LU between population subgroups (gender, age, education and diet type) with country-level fixed effects. RESULTS The mean dietary GHGE and LU per capita ranged from 4.0 kgCO2/day and 5.0 m2*year/day in Spain to 6.5 kgCO2eq/day and 8.2 m2*year/day in France. Diet-related GHGE and LU (per kg/food) were lower among females (2.6 kgCO2eq/day, B = -0.08, P < 0.01; 3.2 m2*year/day, B = -0.11, P < 0.01), older population aged 66-79 (2.6 kgCO2eq/day, B = -0.03, P < 0.01; 3.4 m2*year/day, B = -0.4, P < 0.01), people following vegetarian diets (1.7 kgCO2eq/day, B = -0.07, P < 0.01; 2.0 m2*year/day, B = -0.07, P < 0.01), and higher among individuals with secondary education (2.7 kgCO2eq/day, B = 0.05, P < 0.01; 3.6 m2*year/day, B = -0.05, P < 0.01). CONCLUSIONS Environmental footprints vary substantially across countries, dietary patterns and between different sociodemographic groups in Europe. These findings are crucial for the development of country-specific food policies aimed at promoting environmentally sustainable diets.
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Affiliation(s)
- Ricardo Alves
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Julian Perelman
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
| | - Kiara Chang
- School of Public Health, Imperial College London, Public Health Policy Evaluation Unit, London, UK
| | - Christopher Millett
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
- School of Public Health, Imperial College London, Public Health Policy Evaluation Unit, London, UK
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5
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Álvarez-Álvarez L, Vitelli-Storelli F, Rubín-García M, García S, Bouzas C, Ruíz-Canela M, Corella D, Salas-Salvadó J, Fitó M, Martínez JA, Tojal-Sierra L, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Santos-Lozano JM, Serra-Majem L, Bueno-Cavanillas A, García-Fernández C, Esteve-Luque V, Delgado-Rodríguez M, Torrego-Ellacuría M, Vidal J, Prieto L, Daimiel L, Casas R, García Arellano A, Shyam S, González JI, Castañer O, García-Rios A, Ortiz Díaz F, Fernández AC, Sánchez-Villegas A, Morey M, Cano-Ibañez N, Sorto-Sánchez C, Bernal-López MR, Bes-Rastrollo M, Nishi SK, Coltell O, Zomeño MD, Peña-Orihuela PJ, Aparicio DV, Zulet MA, Vázquez Z, Babio N, Pérez KA, Tur JA, Martín-Sánchez V. Impact of mediterranean diet promotion on environmental sustainability: a longitudinal analysis. Public Health 2024; 230:12-20. [PMID: 38479163 DOI: 10.1016/j.puhe.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE This article aims to estimate the differences in environmental impact (greenhouse gas [GHG] emissions, land use, energy used, acidification and potential eutrophication) after one year of promoting a Mediterranean diet (MD). METHODS Baseline and 1-year follow-up data from 5800 participants in the PREDIMED-Plus study were used. Each participant's food intake was estimated using validated semi-quantitative food frequency questionnaires, and the adherence to MD using the Dietary Score. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The influence of diet on environmental impact was assessed through the EAT-Lancet Commission tables. The association between MD adherence and its environmental impact was calculated using adjusted multivariate linear regression models. RESULTS After one year of intervention, the kcal/day consumed was significantly reduced (-125,1 kcal/day), adherence to a MD pattern was improved (+0,9) and the environmental impact due to the diet was significantly reduced (GHG: -361 g/CO2-eq; Acidification:-11,5 g SO2-eq; Eutrophication:-4,7 g PO4-eq; Energy use:-842,7 kJ; and Land use:-2,2 m2). Higher adherence to MD (high vs. low) was significantly associated with lower environmental impact both at baseline and one year follow-up. Meat products had the greatest environmental impact in all the factors analysed, both at baseline and at one-year follow-up, in spite of the reduction observed in their consumption. CONCLUSIONS A program promoting a MD, after one year of intervention, significantly reduced the environmental impact in all the factors analysed. Meat products had the greatest environmental impact in all the dimensions analysed.
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Affiliation(s)
- L Álvarez-Álvarez
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - F Vitelli-Storelli
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - M Rubín-García
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain.
| | - S García
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, Guillem Colom Bldg, Campus, E-07122, Palma de Mallorca, Spain
| | - C Bouzas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands-IUNICS, Guillem Colom Bldg, Campus, E-07122, Palma de Mallorca, Spain
| | - M Ruíz-Canela
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - D Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - J Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - M Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - J A Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain; Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - L Tojal-Sierra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - J Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; EpiPHAAN research group, School of Health Sciences, University of Málaga - Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain
| | - J Vioque
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante. Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain
| | - D Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - J López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - R Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - F J Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - J M Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - L Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain
| | - A Bueno-Cavanillas
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Instituto de Investigación Biosanitarias Granada (IBS-Granada), Granada, Spain
| | - C García-Fernández
- Department of Food Hygiene and Technology, Veterinary Faculty, University of León, León, Spain
| | - V Esteve-Luque
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona Spain
| | - M Delgado-Rodríguez
- Precision Nutrition and Cardiometabolic Health Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain; Division of Preventive Medicine, Faculty of Medicine, University of Jaén, Jaén, Spain
| | - M Torrego-Ellacuría
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - J Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Endocrinology, Institut d' Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - L Prieto
- Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz. Instituto de Investigaciones Biomédicas IISFJD. University Autonoma, Madrid, Spain
| | - L Daimiel
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Nutritional Control of the Epigenome Group. Precision Nutrition and Obesity Program. IMDEA Food, CEI UAM + CSIC, Madrid, Spain; Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - R Casas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - A García Arellano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - S Shyam
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centre for Translational Research, IMU Institute for Research and Development (IRDI), International Medical University (IMU), Kuala Lumpur 57000, Malaysia
| | - J I González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - O Castañer
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - A García-Rios
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - F Ortiz Díaz
- Centro Salud San Vicente del Raspeig, Alicante, Spain
| | - A C Fernández
- EpiPHAAN research group, School of Health Sciences, University of Málaga - Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain; Departament de Geografia, Universitat de les Illes Balears, Palma, Spain
| | - A Sánchez-Villegas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - M Morey
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - N Cano-Ibañez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Instituto de Investigación Biosanitarias Granada (IBS-Granada), Granada, Spain
| | - C Sorto-Sánchez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - M R Bernal-López
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Internal Medicine Department, Regional University Hospital of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA-Plataforma Bionand), University of Málaga, Málaga, Spain
| | - M Bes-Rastrollo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - S K Nishi
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - O Coltell
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Computer Languages and Systems, Jaume I University, Castellón, Spain
| | - M D Zomeño
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain; Blanquerna-Ramon Llull University, 08022, Barcelona, Spain
| | - P J Peña-Orihuela
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - D V Aparicio
- Centro Salud San Vicente del Raspeig, Alicante, Spain
| | - M A Zulet
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Z Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, IDISNA, Pamplona, Spain
| | - N Babio
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - K A Pérez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Médica (IMIM), Barcelona, Spain
| | - J A Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain; Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - V Martín-Sánchez
- Group of Investigation in Interactions Gene-Environment and Health (GIIGAS), Institute of Biomedicine (IBIOMED), University of León, León, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Nucci D, Sommariva A, Degoni LM, Gallo G, Mancarella M, Natarelli F, Savoia A, Catalini A, Ferranti R, Pregliasco FE, Castaldi S, Gianfredi V. Association between Mediterranean diet and dementia and Alzheimer disease: a systematic review with meta-analysis. Aging Clin Exp Res 2024; 36:77. [PMID: 38519775 PMCID: PMC10959819 DOI: 10.1007/s40520-024-02718-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/01/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Dementia affects 5-8% of the population aged over 65 years (~50 million worldwide). Several factors are associated with increased risk, including diet. The Mediterranean diet (MedDiet) has shown potential protective effects against several chronic diseases. AIMS This systematic review with meta-analysis aim was to assess the association between adherence to the MedDiet and the risk of dementia in the elderly. METHODS PRISMA-2020 guidelines were followed. PubMed/MEDLINE and Scopus were searched on 17 July 2023. The Newcastle-Ottawa Scale tool was used to assess the risk of bias. The protocol was pre-registered in PROSPERO (registration number: CRD 42023444368). Heterogeneity was assessed using the I2 test. Publication bias was assessed by visual inspection of the funnel plot and by Egger's regression asymmetry test. The final effect size was reported as OR or HR, depending on the study design of the included studies. RESULTS Out of 682 records, 21 were included in the analysis. The pooled OR was 0.89 (95% CI = 0.84-0.94) based on 65,955 participants (I2 = 69.94). When only cohort studies were included, HR was 0.84 (95% CI = 0.76-0.94) based on 55,205 participants (I2 = 89.70). When only Alzheimer Disease was considered OR was 0.73 (95% CI = 0.62-0.85) based on 38,292 participants (I2 = 63.85). DISCUSSION Despite the relatively low risk reduction associated with higher adherence to MedDiet among elderly, it should be considered that this population is the most affected. CONCLUSIONS Adherence to MedDiet could be an effective non-pharmacological measure to reduce the burden of dementia, even among elderly.
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Affiliation(s)
- Daniele Nucci
- Struttura Semplice Dipartimentale Igiene Alimenti E Nutrizione, Dipartimento Di Igiene E Prevenzione Sanitaria, Azienda Di Tutela Della Salute (ATS) Brescia, Via Duca Degli Abruzzi, 15, 25124, Brescia, Italy
| | - Andrea Sommariva
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Luca Mario Degoni
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Giulia Gallo
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Matteo Mancarella
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Federica Natarelli
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Antonella Savoia
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
| | - Alessandro Catalini
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, Via Tronto 10/a, 60100, Ancona, Italy
| | - Roberta Ferranti
- Struttura Semplice Dipartimentale Igiene Alimenti E Nutrizione, Dipartimento Di Igiene E Prevenzione Sanitaria, Azienda Di Tutela Della Salute (ATS) Brescia, Via Duca Degli Abruzzi, 15, 25124, Brescia, Italy
| | | | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133, Milan, Italy.
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Cardamone E, Iacoponi F, Di Benedetto R, Lorenzoni G, Di Nucci A, Zobec F, Gregori D, Silano M. Adherence to Mediterranean Diet and its main determinants in a sample of Italian adults: results from the ARIANNA cross-sectional survey. Front Nutr 2024; 11:1346455. [PMID: 38476598 PMCID: PMC10927747 DOI: 10.3389/fnut.2024.1346455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/08/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Over the last years, many Mediterranean countries, including Italy, have witnessed a shift away from the Mediterranean Diet, thus contributing to the high rates of overweight and obesity. The survey "Adherence to Mediterranean Diet in Italy (ARIANNA)" aimed to evaluate the Adherence to Mediterranean Diet (AMD) and its main determinants in the Italian population. Materials and methods This study started on March 2023 and was addressed to adults aged ≥17 years, born and resident in Italy, proficient in Italian. Data are collected electronically through a voluntary, anonymous and self-administered questionnaire on the project website. Univariate and then multivariate logistic regressions were performed to evaluate associations between AMD and demographic characteristics, socio-economic status, health status, and lifestyle. Results On a total of 3,732 completed questionnaires, the 87.70% of the respondents was female and the 71.28% was 17-40 years old. The 83.82% of the respondents had medium AMD, 11.33% low and only 4.85% high. The multivariate analysis revealed that being male (p < 0.001), aged >40 years (p < 0.05), workers (p ≤ 0.001), and unemployed (p < 0.05), determined the probability of having a lower AMD. Vegans and vegetarian's diets positively contributed to a higher AMD (p < 0.001). Discussion These results highlighted a medium AMD in the Italian adult participants and suggested the necessity to implement tailored public health intervention strategies to improve food habits.
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Affiliation(s)
- Erica Cardamone
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
- Department of Medicine—DMED, Università degli Studi di Udine, Udine, Italy
| | - Francesca Iacoponi
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Rita Di Benedetto
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Annalisa Di Nucci
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
| | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Marco Silano
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanità, Rome, Italy
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8
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Cacau LT, Hanley-Cook GT, Huybrechts I, De Henauw S, Kersting M, Gonzalez-Gross M, Gottrand F, Ferrari M, Nova E, Castillo MJ, Molnár D, Widhalm K, Androutsos O, Manios Y, Stehle P, Lachat C, Marchioni DM, Moreno LA. Relative validity of the Planetary Health Diet Index by comparison with usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet among European adolescents: the HELENA study. Eur J Nutr 2023; 62:2527-2539. [PMID: 37171585 DOI: 10.1007/s00394-023-03171-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/04/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE The EAT-Lancet Commission proposed an evidence-based global reference diet to improve human health within planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) was developed based on the EAT-Lancet recommendations and validated among Brazilian adults. However, the relative validity of the PHDI in adolescents has yet to be assessed. Thus, we aimed to evaluate the relative validity of the PHDI in European adolescents. METHODS We used cross-sectional data from 1804 adolescents (12.5-17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. The PHDI (0-150 points) was calculated based on dietary intake data from two non-consecutive 24-h dietary recalls. Associations between the PHDI and usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet were evaluated using multivariable-adjusted mixed-effects linear regression models. RESULTS Higher PHDI score was associated with greater intakes of nutrients predominantly from plant-source foods, such as vegetable protein, vitamin E, and folate and with lower intake of nutrients predominately from animal-source foods, such as total and saturated fat, cholesterol, and animal protein. Furthermore, a higher PHDI score was also positively associated with plasma β-carotene, vitamin C, vitamin D, folate, and ferritin concentrations, while negatively associated with trans-fatty acids concentration. Moreover, higher PHDI was related to a greater adherence to the Mediterranean dietary pattern. CONCLUSIONS The PHDI showed good relative validity among adolescents in the HELENA study. Hence, future research should assess adherence to the PHDI and long-term health outcomes.
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Affiliation(s)
- Leandro Teixeira Cacau
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de La Salud, Universidad de Zaragoza, Zaragoza, Spain.
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, 01246-904, Brazil.
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Giles T Hanley-Cook
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Inge Huybrechts
- Nutritional Epidemiology Group, Nutrition and Metabolism Section, International Agency for Research on Cancer, World Health Organization (IARC/WHO), Lyon, France
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Mathilde Kersting
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Marcela Gonzalez-Gross
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Frederic Gottrand
- Institute for Translational Research in Inflammation (INFINITE), University Lille, Lille, France
| | - Marika Ferrari
- Council for Agricultural Research and Economics, Research Center for Food and Nutrition, Rome, Italy
| | - Esther Nova
- Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain
| | - Manuel J Castillo
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Kurt Widhalm
- Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Department of Nutrition and Dietetics, University of Thessaly, Trikala, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, Cerqueira César, São Paulo, SP, 01246-904, Brazil
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Facultad de Ciencias de La Salud, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Instituto Agroalimentario de Aragon (IA2), Zaragoza, Spain
- Instituto de Investigacion Sanitaria Aragon (IIS Aragon), Zaragoza, Spain
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9
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Colombo GE, Pirotta S, Sabag A. Diet and Exercise in the Management of Polycystic Ovary Syndrome: Practical Considerations for Person-Centered Care. Semin Reprod Med 2023; 41:26-36. [PMID: 38040023 DOI: 10.1055/s-0043-1777116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a complex multisystem condition associated with life-long reproductive, metabolic, and psychological symptoms. Individuals with PCOS are at an increased risk of cardiovascular disease and type 2 diabetes, with approximately 70% of all PCOS cases presenting with insulin resistance. Lifestyle interventions have historically been recommended as first-line therapies for the management of PCOS-related cardiometabolic disorders. The term "lifestyle management" incorporates a multifaceted approach to dietary, exercise, and behavioral strategies, aiming to promote a healthy lifestyle. This approach has been commonly employed in practice, in particular through exercise and dietary modulation, due to its effect on cardiometabolic outcomes as well as its tolerability. Furthermore, there is evidence to suggest that combining dietary change with exercise may yield the greatest improvements in clinical outcomes. However, such practices require careful consideration and coordination, as there are instances where certain exercise and/or dietary prescriptions may compromise the effectiveness of the respective interventions. Thus, this review aims to provide practical guidance on diet and exercise planning in the routine care of PCOS. Such recommendations include emphasizing realistic and achievable goals, as well as minimizing barriers to lifestyle changes in order to increase the long-term sustainability of this treatment strategy.
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Affiliation(s)
- Giorgia E Colombo
- Department of Obstetrics and Gynecology, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Stephanie Pirotta
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Angelo Sabag
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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10
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Çıtar Dazıroğlu ME, Acar Tek N. The Effect on Inflammation of Adherence to the Mediterranean Diet in Polycystic Ovary Syndrome. Curr Nutr Rep 2023; 12:191-202. [PMID: 36719550 DOI: 10.1007/s13668-023-00451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW Polycystic ovary syndrome (PCOS), which is common in women of reproductive age worldwide, is a syndrome that reduces the lifelong quality of life and poses a significant risk for various diseases. PCOS is a combination of symptoms of hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology (PCOM). In PCOS, which is characterized by chronic low-grade inflammation, some inflammatory cytokines are increased. This review aimed to explain possible mechanisms of inflammation in PCOS and the effects of Mediterranean diet components on reducing this inflammation. RECENT FINDINGS Although the exact mechanisms of inflammation in PCOS are not yet fully known, it is stated that it is mediated by obesity, insulin resistance, and high androgen concentration. This inflammatory state negatively impacts the risk of future health problems and the quality of life of PCOS. Therefore, strategies to reduce inflammation are thought to be important. Dietary adjustments have important effects in reducing this inflammation and preventing disease. At this point, the Mediterranean diet, which has been proven to have a protective effect against many diseases, draws attention. Among the components of the Mediterranean diet, especially omega-3, antioxidants and dietary fiber may contribute to the reduction of inflammation through different mechanisms. PCOS is characterized by chronic low-grade inflammation, which increases women's risk of health problems, both now and in the future. Reducing inflammation is therefore extremely important, and it can be achieved with adherence to the Mediterranean diet. Inflammation pathways and the effect of the components of the Mediterranean diet in PCOS. AGE, advanced glycation end products; NF-κB, nuclear factor kappa-B. Obesity, insulin resistance, and hyperandrogenism may cause inflammation in PCOS through different mechanisms. Antioxidants, omega-3, and dietary fiber, which are the main components of the Mediterranean diet, may be effective in reducing this inflammation in PCOS. (Created with BioRender.com).
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Affiliation(s)
- Merve Esra Çıtar Dazıroğlu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Emek, Ankara, Turkey.
| | - Nilüfer Acar Tek
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Emek, Ankara, Turkey
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11
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Carey CN, Paquette M, Sahye-Pudaruth S, Dadvar A, Dinh D, Khodabandehlou K, Liang F, Mishra E, Sidhu M, Brown R, Tandon S, Wanyan J, Bazinet RP, Hanley AJ, Malik V, Sievenpiper JL, Jenkins DJ. The Environmental Sustainability of Plant-Based Dietary Patterns: A Scoping Review. J Nutr 2023; 153:857-869. [PMID: 36809853 DOI: 10.1016/j.tjnut.2023.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 01/28/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A large part of the existential threat associated with climate change is the result of current human feeding patterns. Over the last decade, research evaluating the diet-related environmental impacts of plant-based diets has emerged, and a synthesis of the available data is now due. OBJECTIVES The objectives of the study were as follows: 1) to compile and summarize the literature on diet-related environmental impacts of plant-based dietary patterns; 2) to assess the nature of the data on impacts of plant-based dietary patterns on both environmental parameters and health (e.g., if land use is reduced for a particular diet, is cancer risk also reduced?); and 3) to determine where sufficient data exist for meta-analyses, in addition to identifying gaps within the literature. METHODS Global peer-reviewed studies on the environmental impacts of plant-based diets were searched in Ovid MEDLINE, EMBASE, and Web of Science. After removing duplicates, the screening identified 1553 records. After 2 stages of independent review by 2 reviewers, 65 records met the inclusion criteria and were eligible to be used in synthesis. RESULTS Evidence suggests that plant-based diets may offer lower greenhouse gas emissions (GHGEs), land use, and biodiversity loss than offered by standard diets; however, the impact on water and energy use may depend on the types of plant-based foods consumed. Further, the studies were consistent in demonstrating that plant-based dietary patterns that reduce diet-related mortality also promote environmental sustainability. CONCLUSIONS Overall, there was agreement across the studies regarding the impact of plant-based dietary patterns on GHGE, land used, and biodiversity loss despite varied plant-based diets assessed.
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Affiliation(s)
- Cassandra N Carey
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Melanie Paquette
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Sandhya Sahye-Pudaruth
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Abolfazl Dadvar
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Dorothy Dinh
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Fred Liang
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Ekta Mishra
- McMaster University, Toronto, Ontario, Canada
| | - Mandeep Sidhu
- School of Global Health, York University, Toronto, Ontario, Canada
| | - Ramon Brown
- Department of Biology, Western University, Toronto, Ontario, Canada
| | - Shilpa Tandon
- Farncombe Family Digestive Health Research Institute, McMaster University, Toronto, Ontario, Canada
| | - Jessica Wanyan
- Department of Human Biology, University of Toronto, Toronto, Ontario, Canada
| | - Richard P Bazinet
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Vasanti Malik
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - David Ja Jenkins
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
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12
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Minotti B, Antonelli M, Dembska K, Marino D, Riccardi G, Vitale M, Calabrese I, Recanati F, Giosuè A. True Cost Accounting of a healthy and sustainable diet in Italy. Front Nutr 2022; 9:974768. [PMID: 35967799 PMCID: PMC9372443 DOI: 10.3389/fnut.2022.974768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
It is widely upheld that global food systems are unsustainable. Sustainable diets are gaining prominence as key components to entangle global food system challenges, as well as to transition towards the pathway of the 2030 Agenda and the Sustainable Development Goals (SDGs). Hence, sustainable and healthy diets are at the core of much research with the aim to bring together nutritional adequacy, cultural acceptability, environmental sustainability, economic affordability, and shape future consumption patterns. This article contributes to advancing knowledge on sustainable diets by proposing a True Cost Accounting method to assess the cost and impact of the adoption of a more sustainable and healthier diet, using Italy as an illustration. The research analyses the complexity of a diet from an environmental, health, and socioeconomic point of view and defines a new assessment framework that can be replicated and adapted to other contexts. Results show that in Italy, the adoption of a sustainable and healthy diet has a 47% lower carbon footprint and 25% lower water footprint than the current diet, while impacting 13% less on the average income and food monthly expenditure. Also, the desirable diet has a 21% lower impact on the sanitary costs related to cardiovascular disease. This study corroborates that the consumption of the desirable diet would provide a total cost saving of 741 EUR per year per capita, if we consider its impact on the environment, health, and socio-economic costs.
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Affiliation(s)
- Bianca Minotti
- Department of Bioscience and Territory, University of Molise, Campobasso, Italy.,Department of Humanities, Faculty of Economics and Management, Czech University of Life Science, Prague, Czechia
| | - Marta Antonelli
- Barilla Center for Food & Nutrition Foundation, Parma, Italy.,Division on Climate Change, Impacts on Agriculture, Forests and Ecosystem Services (IAFES), Fondazione Centro Euro-Mediterraneo sui Cambiamenti Climatici, Viterbo, Italy
| | | | - Davide Marino
- Department of Bioscience and Territory, University of Molise, Campobasso, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | | | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
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13
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Bôto JM, Rocha A, Miguéis V, Meireles M, Neto B. Sustainability Dimensions of the Mediterranean Diet: A Systematic Review of the Indicators Used and Its Results. Adv Nutr 2022; 13:2015-2038. [PMID: 35679078 PMCID: PMC9526822 DOI: 10.1093/advances/nmac066] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/28/2022] [Accepted: 06/02/2022] [Indexed: 01/28/2023] Open
Abstract
The concern about sustainability is growing and the Mediterranean diet has been extensively identified as a promising model, with benefits for human and environmental health. This systematic review aims to identify and describe the indicators that have been used to evaluate the sustainability of the Mediterranean diet and the results from their application. A methodology using PRISMA guidelines was followed, and searches were performed in Web of Science, PubMed, Scopus, and GreenFile. A total of 32 studies assessing the sustainability of the Mediterranean diet were identified. Twenty-five of these studies quantified the environmental impact, 7 studies evaluated the nutritional quality, and 12 studies assessed the daily cost of this dietary pattern. A total of 33 distinct indicators were identified, of which 10 were used to assess the environmental dimension (mainly, carbon, water, and ecological footprint), 8 were used to assess the nutritional dimension (mainly Health score and Nutrient Rich Food Index), 1 was used to assess the economic dimension (dietary cost), and 8 used combined indicators. The remaining 6 indicators for the assessment of sociocultural dimension were only identified in 1 study but were not measured. The Mediterranean diet had a lower environmental impact than Western diets and showed a carbon footprint between 0.9 and 6.88 kg CO2/d per capita, a water footprint between 600 and 5280 m3/d per capita, and an ecological footprint between 2.8 and 53.42 m2/d per capita. With regard to the nutritional dimension, the Mediterranean diet had a high nutritional quality and obtained 122 points on the Health score and ranged between 12.95 and 90.6 points on the Nutrient Rich Food Index. The cost of the Mediterranean diet is similar to other diets and varied between 3.33 and 14.42€/d per capita. These findings show that no uniformity in assessing the MDiet's sustainability exists.
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Affiliation(s)
- Joana Margarida Bôto
- GreenUPorto—Sustainable Agrifood Production Research Centre/Inov4Agro, Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal,Faculty of Sciences, University of Porto, Porto, Portugal,LEPABE (Laboratory for Process Engineering, Environment, Biotechnology and Energy), Faculty of Engineering, University of Porto, Porto, Portugal,InescTec (Institute of Systems and Computer Engineering, Technology and Science), Faculty of Engineering, University of Porto, Porto, Portugal
| | - Ada Rocha
- GreenUPorto—Sustainable Agrifood Production Research Centre/Inov4Agro, Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Vera Miguéis
- InescTec (Institute of Systems and Computer Engineering, Technology and Science), Faculty of Engineering, University of Porto, Porto, Portugal
| | - Manuela Meireles
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus Santa Apolónia, Bragança, Portugal
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14
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Naja F, Ismail LC, Abbas N, Saleh S, Ali HI. Adherence to the Mediterranean diet and its association with environmental footprints among women of childbearing age in the United Arab Emirates. Eur J Nutr 2022; 61:2585-2599. [PMID: 35229167 DOI: 10.1007/s00394-022-02835-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/09/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE To examine the association of adherence to the Mediterranean Diet (MD) with Environmental Footprints (EFPs) among women of childbearing age in the United Arab Emirates (UAE). METHODS Data belonging to a nationally representative sample of 482 women (19-50 years) were derived from a previous survey in the UAE. In face-to-face interviews, participants completed questionnaires addressing sociodemographic, physical activity, and dietary intake characteristics; the latter assessed using a multiple pass 24-h recall. The composite Mediterranean (c-MED) index was used to examine the adherence to the MD. Metrics for the EFPs (water use, energy use, and GHG emissions) were calculated using Life Cycle Analyses. Descriptive statistics and linear regressions were used in data analysis. RESULTS In the study sample, the distribution of the c-MED scores was skewed to the right, indicating a low adherence to the MD. The lowest contributions to the total c-MED score were observed for legumes (2.9%) and olive oil (1.8%). The EFPs associated with food consumption per 1000 kcal were: water use: 1256.89 ± 544.95 L/day; energy use: 18.01 ± 7.85 MJ/day, and GHG: 2.46 ± 1.46 kg CO2 eq/day. After adjustment for age, energy intake, and potential confounders, being adherent to the MD was associated with 540.57 [95% CI (- 726.6; - 354.54)] units decrease in water use and 0.94 units decrease in GHG emissions [95% CI (- 1.45; - 0.43)]. CONCLUSIONS The findings of this study revealed an inverse association between adherence to the MD and EFPs. As such, the MD may represent a promising dietary strategy to improve health outcomes and reduce the environmental impact. Public health programs addressing the low adherence to the MD among women of childbearing age in the UAE are warranted.
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Affiliation(s)
- Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Nada Abbas
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Sheima Saleh
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Habiba I Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
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15
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Portugal-Nunes C, Nunes FM, Fraga I, Saraiva C, Gonçalves C. Assessment of the Methodology That Is Used to Determine the Nutritional Sustainability of the Mediterranean Diet-A Scoping Review. Front Nutr 2022; 8:772133. [PMID: 35004806 PMCID: PMC8733552 DOI: 10.3389/fnut.2021.772133] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022] Open
Abstract
Mediterranean diet (MedDiet) is often used as an example of a sustainable diet that promotes a sustainable food system. MedDiet presents low environmental impacts, is characterized by high sociocultural food values, allows for positive local economic returns, and presents major health and nutrition benefits. Previous studies have not systematically examined the methodological assessment of MedDiet nutritional sustainability. In our study, we review the methodological assessment of nutritional sustainability, filling a crucial gap in the literature that can inform the state of the art regarding the cross-disciplinary assessment of MedDiet nutritional sustainability. Through a systematic search on PubMed and Scopus, we identified 28 studies, published between 2013 and 2021, that dealt with the MedDiet nutritional sustainability. Studies that assessed the sustainability of MedDiet based on dietary consumption data, studies that explored the MedDiet sustainability resorting to dietary scenarios, and studies with a mixed approach (dietary consumption and dietary scenarios) and proposals of methodological approaches to assess the MedDiet nutritional sustainability were summarized. We identified 24 studies exploring the dimensions of nutritional sustainability of the MedDiet, and 4 proposing the methodological approaches to assess the MedDiet nutritional sustainability or the sustainability of MedDiet typical agro-foods. From the 24 studies exploring the sustainability of MedDiet, none fully addressed the complexity of the four dimensions of nutritional sustainability (environmental, economic, socio-cultural, and health-nutrition). One of the methodological proposals to assess the MedDiet nutritional sustainability contemplated on the four dimensions of nutritional sustainability, as well as one of the methodological proposals to assess the sustainability of typical agro-foods of MedDiet. Environmental sustainability was the most well-studied dimension, while no study focuses on the socio-cultural dimension of sustainability. Our study reviewed for the first time the assessment of nutritional sustainability of MedDiet. To the best of our knowledge, no research has been made assessing MedDiet in all the dimensions of the complex concept, that is nutritional sustainability. Integrating health and nutrition, environmental, economic, and socio-cultural considerations across scales and contexts can offer a more complete understanding of the opportunities and barriers to achieving nutritional sustainability not only in MedDiet but also in other dietary patterns and food products.
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Affiliation(s)
| | - Fernando M Nunes
- Food and Wine Chemistry Laboratory, CQ-VR-Chemistry Research Centre-Vila Real, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Chemistry Department, School of Life Sciences and Environment, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Irene Fraga
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Cristina Saraiva
- CECAV-Veterinary and Animal Science Research Centre, Vila Real, Portugal.,Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Carla Gonçalves
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,CIAFEL-Research Center for Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal.,Biology and Environment Department, School of Life Sciences and Environment, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
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16
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Cacau LT, Benseñor IM, Goulart AC, Cardoso LO, Lotufo PA, Moreno LA, Marchioni DM. Adherence to the Planetary Health Diet Index and Obesity Indicators in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Nutrients 2021; 13:3691. [PMID: 34835947 PMCID: PMC8625681 DOI: 10.3390/nu13113691] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/17/2021] [Accepted: 10/19/2021] [Indexed: 12/23/2022] Open
Abstract
The EAT-Lancet Commission has proposed a model diet to improve the health of human beings and that of the planet. Recently, we proposed the Planetary Health Diet Index (PHDI) to assess adherence of the population to this model diet. In this study, we aimed to evaluate adherence to the PHDI and obesity outcomes using baseline data from 14,515 participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The dietary data were assessed using a 114-item FFQ. Body mass index (BMI) and waist circumference (WC) were both used continuously and categorized. Linear and multinomial regression models adjusted for potential confounding factors were performed to assess the relationship between adherence to PHDI and outcomes. An inverse association was observed between adherence to PHDI and obesity indicators. Individuals with high adherence to the PHDI had lower BMI (β-0.50 95% CI-0.73:-0.27) and WC (β-1.70 95% CI-2.28:-1.12) values. They were also 24% less likely to be overweight (OR 0.76 95% CI 0.67:0.85) or obese (OR 0.76 95% CI 0.65:0.88), and they were 14% and 27% less likely to have increased WC (OR 0.86 95% CI 0.75:0.98) or substantially increased WC (OR 0.73 95% CI 0.64:0.83) than those with lower adherence. Our results showed that higher adherence to the PHDI may decrease obesity indicators.
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Affiliation(s)
- Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (L.T.C.); (D.M.M.)
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Isabela Martins Benseñor
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil; (I.M.B.); (A.C.G.); (P.A.L.)
- Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | - Alessandra Carvalho Goulart
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil; (I.M.B.); (A.C.G.); (P.A.L.)
| | | | - Paulo Andrade Lotufo
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil; (I.M.B.); (A.C.G.); (P.A.L.)
- Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28040 Madrid, Spain
- Instituto Agroalimentario de Aragon (IA2), 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón, 50009 Zaragoza, Spain
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (L.T.C.); (D.M.M.)
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17
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Biasini B, Rosi A, Menozzi D, Scazzina F. Adherence to the Mediterranean Diet in Association with Self-Perception of Diet Sustainability, Anthropometric and Sociodemographic Factors: A Cross-Sectional Study in Italian Adults. Nutrients 2021; 13:nu13093282. [PMID: 34579159 PMCID: PMC8468784 DOI: 10.3390/nu13093282] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 01/04/2023] Open
Abstract
The adoption of sustainable dietary models, such as the Mediterranean Diet (MD), can be a valuable strategy to preserve ecosystems and human health. This study aims to investigate in an Italian adult representative sample the adherence to the MD and to what extent it is associated with the self-perceived adoption of a sustainable diet, the consideration of the MD as a sustainable dietary model, and anthropometric and sociodemographic factors. By applying an online survey (n = 838, 18-65 years, 52% female), an intermediate level of MD adherence (median: 4.0, IR: 3.0-4.0) in a 0-9 range was observed. Only 50% of the total sample confirmed the MD as a sustainable dietary model, and 84% declared no or low perception of adopting a sustainable diet. Being female, having a higher income and education level, considering the MD as a sustainable dietary model, as well as the perception of having a sustainable diet were the most relevant factors influencing the probability of having a high score (≥6) of adherence to the MD. This study suggests a gradual shift away from the MD in Italy and supports the need to address efforts for developing intervention strategies tailored to adults for improving diet quality. Furthermore, a public campaign should stress the link between a diet and its environmental impact to foster nutritionally adequate and eco-friendly dietary behaviors.
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Affiliation(s)
- Beatrice Biasini
- Department of Food and Drug, University of Parma, Via Volturno 39, 43125 Parma, Italy; (B.B.); (A.R.)
| | - Alice Rosi
- Department of Food and Drug, University of Parma, Via Volturno 39, 43125 Parma, Italy; (B.B.); (A.R.)
| | - Davide Menozzi
- Department of Food and Drug, University of Parma, Via Kennedy 6, 43125 Parma, Italy;
| | - Francesca Scazzina
- Department of Food and Drug, University of Parma, Via Volturno 39, 43125 Parma, Italy; (B.B.); (A.R.)
- Correspondence: ; Tel.: +39-0521-906203
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18
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Abstract
The rapid changes that societies have gone through in the last few decades have led to the increase in the prevalence of malnutrition in all its forms and to the degradation of natural resources and the environment. The change in the dietary habits and production systems are responsible for much of this change. Some territorial diets have been shown as potentially capable of reversing these trends by positively contributing to the health of people and the environment such as the Mediterranean Diet and the New Nordic Diet. In this paper, we review the contribution of these 2 diets to health and nutrition and to environmental, sociocultural, and economic sustainability proposing pertinent indicators. Learning from a culturally established diet and a constructed one, tradeoff could be reached to ensure better health and sustainability outcomes. Strong factors for achieving this goal lie in building on the sociocultural appropriation of diets, having the proper tools and indicators, investing in cross-sector collaboration and policy coherence, and having the necessary political support to push the agenda of sustainability forward.
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Affiliation(s)
- Fatima Hachem
- 17107Food and Agriculture Organization of the United Nations, Rome, Italy
| | - Davy Vanham
- 99013European Commission, Joint Research Centre (JRC), Ispra, Italy
| | - Luis A Moreno
- 16765Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
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19
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Sotos-Prieto M, Del Rio D, Drescher G, Estruch R, Hanson C, Harlan T, Hu FB, Loi M, McClung JP, Mojica A, Puglielli D, Toong K, Yangarber F, Kales SN. Mediterranean diet - promotion and dissemination of healthy eating: proceedings of an exploratory seminar at the Radcliffe institute for advanced study. Int J Food Sci Nutr 2021; 73:158-171. [PMID: 34225548 DOI: 10.1080/09637486.2021.1941804] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The traditional Mediterranean diet is considered the world's most evidence-based eating pattern for promoting health and longevity. However, institutional food environments and their busy consumers often sacrifice health benefits for the convenience of faster and cheaper foods that generally are of lower quality and are more processed, and thus, contribute to the current epidemics of obesity and diabetes. Expert consensus has even identified the Mediterranean diet as the easiest to follow among healthy eating patterns. Nonetheless, fewer American families cook at home and many food services have been slow to implement healthier food options compatible with the Mediterranean diet. In September 2019, we convened a group of thought leaders at an exploratory seminar entitled: "Mediterranean Diet: Promotion and Dissemination of Healthy Eating", hosted by the Radcliffe Institute for Advanced Studies at Harvard University. The multidisciplinary faculty discussed best practices for translating traditional Mediterranean lifestyle principles to modern society.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain.,CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.,IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Daniele Del Rio
- School of Advanced Studies on Food and Nutrition, University of Parma, Parma, Italy
| | - Greg Drescher
- The Culinary Institute of America, Hyde Park, NY, USA
| | - Ramon Estruch
- Internal Medicine Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain.,Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Chavanne Hanson
- Global, Food Choice Architecture and Nutrition Manager, Google, Mountain View, CA, USA
| | - Timothy Harlan
- School of Medicine, Tulane University, New Orleans, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maria Loi
- Loi Estiatorio and Loi Brand, New York, NY, USA
| | - James P McClung
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | | | | | - Ken Toong
- University of Massachusetts, Amherst, MA, USA
| | | | - Stefanos N Kales
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
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20
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Lares-Michel M, Housni FE, Aguilera Cervantes VG, Carrillo P, Michel Nava RM, Llanes Cañedo C. Eat Well to Fight Obesity… and Save Water: The Water Footprint of Different Diets and Caloric Intake and Its Relationship With Adiposity. Front Nutr 2021; 8:694775. [PMID: 34277688 PMCID: PMC8281344 DOI: 10.3389/fnut.2021.694775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/04/2021] [Indexed: 12/12/2022] Open
Abstract
Water scarcity and excess adiposity are two of the main problems worldwide and in Mexico, which is the most obese country in the world and suffers from water scarcity. Food production represents 90% of a person's water footprint (WF), and healthy diets can lead to less WF than do unhealthy diets related to obesity. We calculated the WF of the diet and caloric intake of adults in Mexico and analyzed its relationship with adiposity. Also, the risk of water expenditure due to adiposity and adherence to dietary recommendations regarding WF of international healthy diets were examined. A Food Consumption Frequency Questionnaire (FCFQ) was applied to 395 adults. Body mass index (BMI), associated with adiposity indicators, was used as a reference for grouping a sample into adiposity levels. The WF was calculated according to the WF Assessment Method, considering correction factors and accounting for water involved in cooking and food washing. Our results showed that the Mexican diet spends 6,056 liters per person per day (L p-1d-1) and is 55% higher than international healthy diets WF. Consumption of beef, milk, fruits, chicken, and fatty cereals represented 56% of total WF. Strong relations appeared between hypercaloric diets and high WF. Diets of people with excess adiposity generated statistically higher WF with extra expenses of 729 L p-1d-1 compared with the normal adiposity population. Following nutritional recommendations offers a protective factor in water care, whereas not adhering to these represents a risk up to 93 times greater of water expenditure regarding international healthy diets. Therefore, both for the general population and to regulate obesity, adequate diets can help mitigate the problem of water scarcity.
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Affiliation(s)
- Mariana Lares-Michel
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Ciudad Guzmán, Mexico
| | - Fatima Ezzahra Housni
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Ciudad Guzmán, Mexico
| | - Virginia Gabriela Aguilera Cervantes
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Ciudad Guzmán, Mexico
| | - Presentación Carrillo
- Instituto Universitario de Investigación del Agua, Universidad de Granada, Granada, Spain
| | - Rosa María Michel Nava
- Departamento de Sistemas y Computación, Tecnológico Nacional de México, Campus Ciudad Guzmán, Ciudad Guzmán, Mexico
| | - Claudia Llanes Cañedo
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Ciudad Guzmán, Mexico
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21
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Hwalla N, Jomaa L, Hachem F, Kharroubi S, Hamadeh R, Nasreddine L, Naja F. Promoting Sustainable and Healthy Diets to Mitigate Food Insecurity Amidst Economic and Health Crises in Lebanon. Front Nutr 2021; 8:697225. [PMID: 34249999 PMCID: PMC8270169 DOI: 10.3389/fnut.2021.697225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/28/2021] [Indexed: 12/27/2022] Open
Abstract
Introduction: Lebanon, a middle-income Eastern Mediterranean country, continues to face detrimental economic, health and socio-political challenges that are further exacerbated by the COVID-19 pandemic. In parallel, the country has been experiencing a remarkable nutrition transition that has contributed to the burden of malnutrition and non-communicable diseases, all imposing serious repercussions on people's livelihoods, food security, and health. Such circumstances have prodded public demand for guidance on affordable, healthy, and sustainable dietary choices to alleviate the burden to this emerging unfortunate situation. Objective: The purpose of this study is to provide evidence-based sustainable and healthy dietary recommendations which balance the tradeoffs among the health, environmental footprint and cost dimensions of sustainability, while closely resembling the usual food consumption pattern. Methodology: Data from the latest available national food consumption survey was used as the usual food consumption pattern of Lebanese adults. Optimized dietary patterns were calculated using the optimization model Optimeal which produced patterns most similar to the usual diet and simultaneously satisfying the three main sets of constraints: health, environmental footprints, and cost. The identified healthy and sustainable dietary options were vetted by multiple key stakeholders from the government, academia, international, and national non-governmental organizations. Results: Compared to the usual intake, the optimized diet included higher intakes of whole grain bread, dark green vegetables, dairy products, and legumes, and lower intakes of refined bread, meat, poultry, added sugars, saturated fat, as compared to usual national mean consumption. The optimized dietary model resulted in a decrease in the associated environmental footprints: water use (-6%); and GHG (-22%) with no change in energy use. The cost of the optimized diet was not different from that of the usual intake. Conclusion: An evidence-based sustainable and healthy diet was developed for Lebanon providing the population and policy makers with some answers to a complex situation. Findings highlight the need for the development of sustainable food based dietary guidelines for Lebanon to promote diets that are healthy, sustainable, culturally acceptable, and affordable and that can alleviate food insecurity among the general population.
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Affiliation(s)
- Nahla Hwalla
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Lamis Jomaa
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Fatima Hachem
- Nutrition and Food Systems Division, Food and Agricultural Organization of the United Nations, Rome, Italy
| | - Samer Kharroubi
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Rena Hamadeh
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
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22
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Agri-Food Contexts in Mediterranean Regions: Contributions to Better Resources Management. SUSTAINABILITY 2021. [DOI: 10.3390/su13126683] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The agri-food frameworks have specific characteristics (production units with small dimensions and in great number with implications in the respective markets) that call for adjusted approaches, even more so when they are considered in Mediterranean contexts (where global warming will have relevant impacts). In fact, the Mediterranean regions and countries have particular specificities (due to their climate conditions) that distinguish them from their neighbours. This is particularly true in Europe, for example, where the southern countries present socioeconomic dynamics (associated with the respective public debt) that are different from those identified in the northern regions. From this perspective, it seems pertinent to analyse the several dimensions of the agri-food systems in the Mediterranean area. To achieve these objectives, a search was carried out on 26 December 2020 on the scientific databases Web of Science Core Collection (WoS) and Scopus for the topics “agr*-food” and “Mediterranean”. These keywords were selected after a previous literature survey and to capture the agri-food contexts in Mediterranean regions. The keyword “agr*-food” was considered in this way to allow for a wider search (including “agri-food”, “agro-food”, etc.). Considering only articles (excluding proceeding papers, book chapters, and books, because in some cases it is difficult to access the entire content of the document), 100 and 117 documents were obtained from the WoS and Scopus, respectively. After removing the duplicated studies and taking into account the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, 137 documents were surveyed through a literature review. As main insights, several dimensions embedded in the concept of agri-food were highlighted, from those related to heritage subjects to natural assets. On the other hand, the following subtopics were identified: agri-food dynamics and sustainability, agriculture and agri-food systems, agri-chains and food consumption, and food production and composition impact on agri-chains. Stressing the gaps in the scientific literature, related to the topics here addressed, there are possibilities to better explore the several dimensions and solutions offered by the new developments associated with smart agriculture and agriculture 4.0, specifically for the Mediterranean contexts and their challenges. Finally, to complement the PRISMA methodologies, an MB2MBA2 (Methodology Based on Benchmarking of Metadata, from scientific databases, and Bibliometric Assessment and Analysis) approach is suggested to carry out systematic literature reviews, based on bibliometric analysis.
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23
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Martini D, Tucci M, Bradfield J, Di Giorgio A, Marino M, Del Bo’ C, Porrini M, Riso P. Principles of Sustainable Healthy Diets in Worldwide Dietary Guidelines: Efforts So Far and Future Perspectives. Nutrients 2021; 13:1827. [PMID: 34071933 PMCID: PMC8228140 DOI: 10.3390/nu13061827] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/20/2021] [Accepted: 05/25/2021] [Indexed: 11/18/2022] Open
Abstract
Food choices and eating behaviours have a large impact on both human and planetary health. Recently, the Food and Agricultural Organisation (FAO) of the United Nations and the World Health Organisation have developed a list of 16 guiding principles to achieve sustainable healthy diets (SHDs). They proposed that development of food-based dietary guidelines (FBDGs) should be a core element in the implementation of these SHDs in each country. The objective of this review is to explore the degree of alignment of current FBDGs to these guiding principles. A total of 43 FBDGs, written or translated into English, were collected from the online repository developed by the FAO and were analysed for their adherence to each of the guiding principles. Results were stratified for period of publication and geographical macro-area. Overall, there were high levels of inclusion of the factors related to health outcomes, especially in the most recent FBDGs. Conversely, environmental impact and socio-cultural aspects of diet were considered less frequently, especially in the older FBDGs. These results highlight the importance of revising FBDGs, especially to include emerging topics which represent the areas with the highest scope for improvement in the future versions of FBDGs. Replication of the present study in the coming years will be worthwhile to monitor improvements in the adherence of global FBDGs to the guiding principles of SHDs. The attainment of such a goal could promote a more rapid transition towards SHDs, as well as highlighting pivotal research trajectories to increase adoption and evaluate the impact on the food system.
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Affiliation(s)
- Daniela Martini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (M.T.); (A.D.G.); (M.M.); (C.D.B.); (P.R.)
| | - Massimiliano Tucci
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (M.T.); (A.D.G.); (M.M.); (C.D.B.); (P.R.)
| | - James Bradfield
- NNEdPro Global Centre for Nutrition and Health, Cowley Road, Cambridge CB4 0WS, UK;
| | - Antonio Di Giorgio
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (M.T.); (A.D.G.); (M.M.); (C.D.B.); (P.R.)
| | - Mirko Marino
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (M.T.); (A.D.G.); (M.M.); (C.D.B.); (P.R.)
| | - Cristian Del Bo’
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (M.T.); (A.D.G.); (M.M.); (C.D.B.); (P.R.)
| | - Marisa Porrini
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (M.T.); (A.D.G.); (M.M.); (C.D.B.); (P.R.)
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, 20133 Milan, Italy; (M.T.); (A.D.G.); (M.M.); (C.D.B.); (P.R.)
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24
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Aldaya MM, Ibañez FC, Domínguez-Lacueva P, Murillo-Arbizu MT, Rubio-Varas M, Soret B, Beriain MJ. Indicators and Recommendations for Assessing Sustainable Healthy Diets. Foods 2021; 10:999. [PMID: 34063236 PMCID: PMC8147455 DOI: 10.3390/foods10050999] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 12/12/2022] Open
Abstract
Research coupling human nutrition and sustainability concerns is a rapidly developing field, which is essential to guide governments' policies. This critical and comprehensive review analyzes indicators and approaches to "sustainable healthy diets" published in the literature since this discipline's emergence a few years ago, identifying robust gauges and highlighting the flaws of the most commonly used models. The reviewed studies largely focus on one or two domains such as greenhouse gas emissions or water use, while overlooking potential impact shifts to other sectors or resources. The present study covers a comprehensive set of indicators from the health, environmental and socio-economic viewpoints. This assessment concludes that in order to identify the best food option in sustainability assessments and nutrition analysis of diets, some aspects such as the classification and disaggregation of food groups, the impacts of the rates of local food consumption and seasonality, preservation methods, agrobiodiversity and organic food and different production systems, together with consequences for low-income countries, require further analysis and consideration.
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Affiliation(s)
- Maite M. Aldaya
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
| | - Francisco C. Ibañez
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
| | | | - María Teresa Murillo-Arbizu
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
| | - Mar Rubio-Varas
- Institute for Advanced Research in Business and Economics (INARBE), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain;
| | - Beatriz Soret
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
| | - María José Beriain
- Institute on Innovation & Sustainable Development in the Food Chain (IS-FOOD), Public University of Navarra (UPNA), Jerónimo de Ayanz Building, Arrosadia Campus, 31006 Pamplona, Spain; (F.C.I.); (M.T.M.-A.); (B.S.); (M.J.B.)
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25
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Trajkovska Petkoska A, Trajkovska-Broach A. Mediterranean diet: a nutrient-packed diet and a healthy lifestyle for a sustainable world. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2021; 101:2627-2633. [PMID: 33140412 DOI: 10.1002/jsfa.10907] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/29/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
The Mediterranean diet (MD), as a sustainable diet and a healthy way of living, is in a good agreement with the UN's Sustainable Development Goals (2015). © 2020 Society of Chemical Industry.
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Affiliation(s)
- Anka Trajkovska Petkoska
- St Clement of Ohrid University of Bitola, Faculty of Technology and Technical Sciences, Veles, Republic of North Macedonia
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Tepper S, Geva D, Shahar DR, Shepon A, Mendelsohn O, Golan M, Adler D, Golan R. The SHED Index: a tool for assessing a Sustainable HEalthy Diet. Eur J Nutr 2021; 60:3897-3909. [PMID: 33904997 DOI: 10.1007/s00394-021-02554-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 04/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Promoting sustainable diets through sustainable food choices is essential for achieving the sustainable development goals set by the United Nations. Establishing a practical tool that can measure and score sustainable and healthy eating is highly important. METHODS We established a 30-item questionnaire to evaluate sustainable-dietary consumption. Based on the literature and a multidisciplinary advisory panel, the questionnaire was computed by principal component analysis, yielding the Sustainable-HEalthy-Diet (SHED) Index. A rigorous multi-stage process included validation in training-verification sets, across recycling efforts, as an indicator of environmental commitment; and validation across the proportion of animal-protein consumption, as an indicator of adherence to a sustainable and healthy dietary-pattern. The EAT-Lancet reference-diet and the Mediterranean-Diet-score were used to investigate the construct validity of the SHED Index score. Reliability was assessed with a test-retest sample. RESULTS Three-hundred-forty-eight men and women, aged 20-45 years, completed both the SHED Index questionnaire and a validated Food-Frequency-Questionnaire. Increased dietary animal-protein intake was associated with a lower SHED Index total score (p < 0.001). Higher recycling efforts were associated with a higher total SHED Index score (p < 0.001). A linear correlation was found between the SHED Index score and food-groups of the Eat-Lancet-reference diet. A significant correlation was found between the Mediterranean-Diet-score and the SHED Index score (r = 0.575, p < 0.001). The SHED Index score revealed high reliability in test-retest, high validity in training and verification sets, and internal consistency. CONCLUSION We developed the SHED Index score, a simple, practical tool, for measuring healthy and sustainable individual-diets. The score reflects the nutritional, environmental and sociocultural aspects of sustainable diets; and provides a tangible tool to be used in intervention studies and in daily practice.
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Affiliation(s)
- Sigal Tepper
- Department of Nutritional Sciences, Tel-Hai College, Upper Galilee, 1220800, Tel Hai, Israel.
| | - Diklah Geva
- IntegriStat, Studio for Biostatistics, Tel Aviv, Israel
| | - Danit R Shahar
- Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alon Shepon
- Department of Environmental Studies, The Porter School of the Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel.,The Steinhardt Museum of Natural History, Tel Aviv University, Tel Aviv, Israel
| | | | - Moria Golan
- Department of Nutritional Sciences, Tel-Hai College, Upper Galilee, 1220800, Tel Hai, Israel
| | - Dorit Adler
- The Israeli Forum for Sustainable Nutrition, Hailanot 1, Bitan Aharon, Israel
| | - Rachel Golan
- Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
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A quantitative estimation of the water footprint of the Mexican diet, corrected for washing and cooking water. Food Secur 2021. [DOI: 10.1007/s12571-021-01160-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Timlin D, Giannantoni B, McCormack JM, Polito A, Ciarapica D, Azzini E, Giles M, Simpson EEA. Comparison of barriers and facilitators of MIND diet uptake among adults from Northern Ireland and Italy. BMC Public Health 2021; 21:265. [PMID: 33530965 PMCID: PMC7852355 DOI: 10.1186/s12889-021-10307-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 01/21/2021] [Indexed: 02/07/2023] Open
Abstract
Background The aim of the study was to identify and compare components of the COM-B (capability, opportunity, motivation and behaviour) model, that influences behaviour to modify dietary patterns in 40–55-year olds living in Northern Ireland (NI) and Italy, in order to reduce the risk of cognitive decline in later life. Methods This was a qualitative study examining factors influencing Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay (MIND) diet behaviour. This study further elaborated the COM-B components into the 14 domains of the Theoretical Domains Framework to further understand behaviour. Twenty-five Northern Irish and Italian participants were recruited onto the study, to take part in either a focus group or an interview. Participants were both male and female aged between 40 and 55 years. Results Thematic analysis revealed that the main barriers to the uptake of the MIND diet were; time, work environment (opportunity), taste preference and convenience (motivation). Culture (motivation), seasonal foods and lack of family support (opportunity) to be a barrier to the Italian sample only. The main facilitators reported were; improved health, memory, planning and organisation (motivation) and access to good quality food (opportunity). Cooking skills, knowledge (capability) and heathy work lunch (opportunity) reported as a facilitator to the Italian sample only. Conclusions Cross-cultural differences in relation to psychosocial barriers and facilitators were found in both samples. More barriers than facilitators towards uptake of the MIND diet were found. There is a need for interventions that increase capability, opportunity, and motivation to aid behaviour change. The findings from this study will be used to design a behaviour change intervention using the subsequent steps from the Behaviour Change Wheel.
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Affiliation(s)
| | - Barbara Giannantoni
- CREA - Council for Agricultural Research and Economics Research Centre for Food and Nutrition, Via Ardeatina, 546, 00178, Rome, Italy
| | | | - Angela Polito
- CREA - Council for Agricultural Research and Economics Research Centre for Food and Nutrition, Via Ardeatina, 546, 00178, Rome, Italy
| | - Donatella Ciarapica
- CREA - Council for Agricultural Research and Economics Research Centre for Food and Nutrition, Via Ardeatina, 546, 00178, Rome, Italy
| | - Elena Azzini
- CREA - Council for Agricultural Research and Economics Research Centre for Food and Nutrition, Via Ardeatina, 546, 00178, Rome, Italy
| | - Melanie Giles
- Psychology Research Institute, Ulster University, Coleraine, UK
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Verhagen H, Alonso-Andicoberry C, Assunção R, Cavaliere F, Eneroth H, Hoekstra J, Koulouris S, Kouroumalis A, Lorenzetti S, Mantovani A, Menozzi D, Nauta M, Poulsen M, Rubert J, Siani A, Sirot V, Spaggiari G, Thomsen ST, Trevisan M, Cozzini P. Risk-benefit in food safety and nutrition - Outcome of the 2019 Parma Summer School. Food Res Int 2021; 141:110073. [PMID: 33641961 DOI: 10.1016/j.foodres.2020.110073] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022]
Abstract
Risk-benefit assessment is the comparison of the risk of a situation to its related benefits, i.e. a comparison of scenarios estimating the overall health impact. The risk-benefit analysis paradigm mirrors the classical risk analysis one: risk-benefit assessment goes hand-in-hand with risk-benefit management and risk-benefit communication. The various health effects associated with food consumption, together with the increasing demand for advice on healthy and safe diets, have led to the development of different research disciplines in food safety and nutrition. In this sense, there is a clear need for a holistic approach, including and comparing all of the relevant health risks and benefits. The risk-benefit assessment of foods is a valuable approach to estimate the overall impact of food on health. It aims to assess together the negative and positive health effects associated with food intake by integrating chemical and microbiological risk assessment with risk and benefit assessment in food safety and nutrition. The 2019 Parma Summer School on risk-benefit in food safety and nutrition had the objective was to provide an opportunity to learn from experts in the field of risk-benefit approach in food safety and nutrition, including theory, case studies, and communication of risk-benefit assessments plus identify challenges for the future. It was evident that whereas tools and approaches have been developed, more and more case studies have been performed which can form an inherent validation of the risk-benefit approach. Executed risk-benefit assessment case studies apply the steps and characteristics developed: a problem formulation (with at least 2 scenarios), a tiered approach until a decision can be made, one common currency to describe both beneficial and adverse effects (DALYs in most instances). It was concluded that risk-benefit assessment in food safety and nutrition is gaining more and more momentum, while also many challenges remain for the future. Risk-benefit is on the verge of really enrolling into the risk assessment and risk analysis paradigm. The interaction between risk-benefit assessors and risk-benefit managers is pivotal in this, as is the interaction with risk-benefit communicators.
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Affiliation(s)
- Hans Verhagen
- University of Ulster, Northern Ireland, United Kingdom; European Food Safety Authority, Parma, Italy; Technical University of Denmark, Lyngby, Denmark.
| | | | - Ricardo Assunção
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | | | | | - Jeljer Hoekstra
- National Institute for Public Health and the Environment (RIVM), the Netherlands
| | | | | | - Stefano Lorenzetti
- Istituto Superiore di Sanità - ISS, Dpt. of Food Safety, Nutrition and Veterinary Public Health, Rome, Italy
| | - Alberto Mantovani
- Istituto Superiore di Sanità - ISS, Dpt. of Food Safety, Nutrition and Veterinary Public Health, Rome, Italy
| | | | | | | | - Josep Rubert
- CIBIO, Department of Cellular, Computational and Integrative Biology, University of Trento, Via Sommarive 9, Povo 38123, Italy; Interdisciplinary Research Structure of Biotechnology and Biomedicine, Department of Biochemistry and Molecular Biology, Universitat de Valencia, 46100 Burjassot, València, Spain
| | | | | | | | | | - Marco Trevisan
- DiSTAS, Università Cattolica del Sacro Cuore, Piacenza Campus, Italy
| | - Pietro Cozzini
- University of Parma, Department of Food and Drug, Italy.
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Cheikh Ismail L, Osaili TM, Mohamad MN, Al Marzouqi A, Jarrar AH, Abu Jamous DO, Magriplis E, Ali HI, Al Sabbah H, Hasan H, AlMarzooqi LMR, Stojanovska L, Hashim M, Shaker Obaid RR, Saleh ST, Al Dhaheri AS. Eating Habits and Lifestyle during COVID-19 Lockdown in the United Arab Emirates: A Cross-Sectional Study. Nutrients 2020; 12:E3314. [PMID: 33137947 PMCID: PMC7693610 DOI: 10.3390/nu12113314] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease is still spreading in the United Arab Emirates (UAE) with subsequent lockdowns and social distancing measures being enforced by the government. The purpose of this study was to assess the effect of the lockdown on eating habits and lifestyle behaviors among residents of the UAE. A cross-sectional study among adults in the UAE was conducted using an online questionnaire between April and May 2020. A total of 1012 subjects participated in the study. During the pandemic, 31% reported weight gain and 72.2% had less than eight cups of water per day. Furthermore, the dietary habits of the participants were distanced from the Mediterranean diet principles and closer to "unhealthy" dietary patterns. Moreover, 38.5% did not engage in physical activity and 36.2% spent over five hours per day on screens for entertainment. A significantly higher percentage of participants reported physical exhaustion, emotional exhaustion, irritability, and tension "all the time" during the pandemic compared to before the pandemic (p < 0.001). Sleep disturbances were prevalent among 60.8% of the participants during the pandemic. Although lockdowns are an important safety measure to protect public health, results indicate that they might cause a variety of lifestyle changes, physical inactivity, and psychological problems among adults in the UAE.
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Affiliation(s)
- Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, UAE; (T.M.O.); (H.H.); (M.H.); (R.R.S.O.); (S.T.S.)
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX1 2JD, UK
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE;
| | - Tareq M. Osaili
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, UAE; (T.M.O.); (H.H.); (M.H.); (R.R.S.O.); (S.T.S.)
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE;
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Maysm N. Mohamad
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, UAE; (M.N.M.); (A.H.J.); (H.I.A.); (L.S.); (A.S.A.D.)
| | - Amina Al Marzouqi
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah 27272, UAE;
| | - Amjad H. Jarrar
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, UAE; (M.N.M.); (A.H.J.); (H.I.A.); (L.S.); (A.S.A.D.)
| | - Dima O. Abu Jamous
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE;
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece;
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, UAE; (M.N.M.); (A.H.J.); (H.I.A.); (L.S.); (A.S.A.D.)
| | - Haleama Al Sabbah
- College of Natural and Health Sciences, Zayed University, Dubai 19282, UAE;
| | - Hayder Hasan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, UAE; (T.M.O.); (H.H.); (M.H.); (R.R.S.O.); (S.T.S.)
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE;
| | | | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, UAE; (M.N.M.); (A.H.J.); (H.I.A.); (L.S.); (A.S.A.D.)
- Institute for Health and Sport, Victoria University, Melbourne 14428, Australia
| | - Mona Hashim
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, UAE; (T.M.O.); (H.H.); (M.H.); (R.R.S.O.); (S.T.S.)
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE;
| | - Reyad R. Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, UAE; (T.M.O.); (H.H.); (M.H.); (R.R.S.O.); (S.T.S.)
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, UAE;
| | - Sheima T. Saleh
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, UAE; (T.M.O.); (H.H.); (M.H.); (R.R.S.O.); (S.T.S.)
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, UAE; (M.N.M.); (A.H.J.); (H.I.A.); (L.S.); (A.S.A.D.)
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Rosi A, Biasini B, Donati M, Ricci C, Scazzina F. Adherence to the Mediterranean Diet and Environmental Impact of the Diet on Primary School Children Living in Parma (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176105. [PMID: 32825740 PMCID: PMC7503352 DOI: 10.3390/ijerph17176105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/12/2020] [Accepted: 08/18/2020] [Indexed: 12/14/2022]
Abstract
The key role of diet in both human health and environmental sustainability is well known. However, there is a lack of studies investigating the environmental impact of children's dietary behavior. The aim of this observational study was to investigate the dietary environmental impact in a sample of primary school children living in Parma (Italy, n = 172, 8-10 years), in relation to their adherence to the Mediterranean diet (MD). Children completed a 3-day food record in both winter and spring. Dietary records were processed to obtain: (i) adherence to the MD and (ii) mean daily carbon and ecological footprints. Adherence to the MD was similar in winter and spring, with almost half of the participants showing a medium MD score. Carbon and ecological footprints were higher during winter, and the main dietary contributors were red and processed meat for both indexes. A small positive correlation was observed between adherence to the MD and total carbon and ecological footprints. This study provided the first analysis of the relationship between adherence to the MD and environmental impact of primary school children. Further research is needed to better investigate the environmental impact of primary school children's diet and the possible relationship between the MD and environmental sustainability.
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Affiliation(s)
- Alice Rosi
- Department of Food and Drugs, University of Parma, 43124 Parma, Italy; (A.R.); (B.B.)
| | - Beatrice Biasini
- Department of Food and Drugs, University of Parma, 43124 Parma, Italy; (A.R.); (B.B.)
| | - Michele Donati
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43124 Parma, Italy;
| | - Cristian Ricci
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, 04103 Leipzig, Germany;
| | - Francesca Scazzina
- Department of Food and Drugs, University of Parma, 43124 Parma, Italy; (A.R.); (B.B.)
- Correspondence: ; Tel.: +39-0521-906203
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Using the COM-B model to identify barriers and facilitators towards adoption of a diet associated with cognitive function (MIND diet). Public Health Nutr 2020; 24:1657-1670. [PMID: 32799963 PMCID: PMC8094434 DOI: 10.1017/s1368980020001445] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of the study was to identify components of the COM-B (capability, opportunity, motivation and behaviour) model that influences behaviour to modify dietary patterns in 40-55-year-olds living in the UK, in order to influence the risk of cognitive decline in later life. DESIGN This is a qualitative study using the COM-B model and theoretical domains framework (TDF) to explore beliefs to adopting the Mediterranean-DASH Intervention for Neurodegenerative delay (MIND) diet. SETTING Northern Ireland. PARTICIPANTS Twenty-five participants were recruited onto the study to take part in either a focus group or an interview. Participants were men and women aged between 40 and 55 years. Participants were recruited via email, Facebook and face to face. RESULTS Content analysis revealed that the main perceived barriers to the adoption of the MIND diet were time, work environment, taste preference and convenience. The main perceived facilitators reported were improved health, memory, planning and organisation, and access to good quality food. CONCLUSIONS This study provides insight into the personal, social and environmental factors that participants report as barriers and facilitators to the adoption of the MIND diet among middle-aged adults living in the UK. More barriers to healthy dietary change were found than facilitators. Future interventions that increase capability, opportunity and motivation may be beneficial. The results from this study will be used to design a behaviour change intervention using the subsequent steps from the Behaviour Change Wheel.
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Seconda L, Egnell M, Julia C, Touvier M, Hercberg S, Pointereau P, Lairon D, Allès B, Kesse-Guyot E. Association between sustainable dietary patterns and body weight, overweight, and obesity risk in the NutriNet-Santé prospective cohort. Am J Clin Nutr 2020; 112:138-149. [PMID: 31725157 DOI: 10.1093/ajcn/nqz259] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/20/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Improving the sustainability of current food systems may prevent future public health, environmental, and social concerns. OBJECTIVE Our objective was to investigate the associations between sustainable dietary patterns, assessed using the Sustainable Diet Index (SDI), and the risk of obesity, overweight, and weight gain in French adults, with a prospective design. METHODS In 2014, the SDI was computed among 15,626 participants of the NutriNet-Santé study (of whom 76% were women) using data collected within the BioNutriNet project. The SDI ranges from 4 (lowest sustainability) to 20 points and includes 4 subindexes representing the 4 pillars of a sustainable diet. Longitudinal data of weight and height were collected yearly from 2014 to 2018. We used mixed models to estimate the associations between sex-specific quintiles (Qs) of the SDI and weight change and Cox proportional hazard models with different levels of adjustments to assess the association between sex-specific Qs of the SDI and risk of obesity and overweight (mean follow-up time: 2.8 y). RESULTS At baseline, a higher percentage of participants with overweight was observed in the first SDI Q, reflecting the lowest sustainable dietary patterns (Q1), than in Q5 (29.83% compared with 12.71%). Compared with Q5, a slight increase (at the population level) of almost 160 g/y was observed in Q1, whereas weight remained relatively stable among participants in other Qs. In total, 281 incident cases of obesity and 777 cases of overweight were identified during the follow-up. Participants in Q1 had a higher risk of obesity and overweight than participants in Q5 (HR comparing Q1 with Q5: 4.03; 95% CI: 2.42, 6.10; P-trend < 0.001; and HR comparing Q1 with Q5: 1.49; 95% CI: 1.13, 1.95; P-trend < 0.001, respectively). CONCLUSIONS The findings support a potential protective role for more sustainable diets to prevent the risk of weight gain, overweight, and obesity.This trial was registered at clinicaltrials.gov as NCT03335644.
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Affiliation(s)
- Louise Seconda
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France.,Environment and Energy Management Agency, Angers, France
| | - Manon Egnell
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Chantal Julia
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Mathilde Touvier
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Serge Hercberg
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France.,Public Health Department, Avicenne Hospital, Bobigny, France
| | | | - Denis Lairon
- Aix Marseille University, National Institute for Health and Medical Research, National Institute for Agricultural Research, C2VN, Marseille, France.,Timone Faculty of Medicine, Marseille, France
| | - Benjamin Allès
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
| | - Emmanuelle Kesse-Guyot
- Paris 13 University, Research Team in Nutritional Epidemiology, Epidemiology and Statistics Center Sorbonne Paris Cité, National Institute for Health and Medical Research (U1153), National Institute for Agricultural Research (U1125), National Conservatory of Arts and Crafts, COMUE Sorbonne Paris Cité, Bobigny, France
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Coats L, Aboul-Enein BH, Dodge E, Benajiba N, Kruk J, Khaled MB, Diaf M, El Herrag SE. Perspectives of Environmental Health Promotion and the Mediterranean Diet: A Thematic Narrative Synthesis. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2020. [DOI: 10.1080/19320248.2020.1777242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Laura Coats
- Department of Physiology and Biophysics, Arthur C. Guyton Research Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Basil H. Aboul-Enein
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Elizabeth Dodge
- College of Graduate & Professional Studies, University of New England, Portland, ME, USA
| | - Nada Benajiba
- Department of Health Sciences, Track of Clinical Nutrition, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Joanna Kruk
- Faculty of Physical Culture and Health Promotion, University of Szczecin, Szczecin, Poland
| | - Meghit Boumédiène Khaled
- Faculty of Life and Natural Science, Department of Biology, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria
| | - Mustapha Diaf
- Faculty of Life and Natural Science, Department of Biology, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria
| | - Salah Eddine El Herrag
- Faculty of Life and Natural Science, Department of Biology, Djillali Liabes University of Sidi-Bel-Abbes, Sidi-Bel-Abbes, Algeria
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[Different classification of an adult population by two validated indexes of adherence to the Mediterranean diet]. NUTR HOSP 2020; 36:1116-1122. [PMID: 31526010 DOI: 10.20960/nh.02625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: the Mediterranean diet (MD) has been related to a good state of health. There are different index to evaluate the adherence to Mediterranean dietary pattern. Objective: the purpose of the study was to evaluate the classification of the adult population of the Comunitat Valenciana according to their suitability to the MD using two validated indexes, and analyze the degree of agreement between them. Methods: methodological study of the concordance of classification of a population through two instruments for measuring adherence to MD, of a representative sample of 2,728 adult of the Comunitat Valenciana. Data obtained from Encuesta de Nutrición de la Comunitat Valenciana 2010-2011. The adhesion was determined by "Puntuación Modificada de Dieta Mediterránea" and "Cribado de Adherencia de Dieta Mediterránea". The population was classified as low, medium or high according to each index. A statistical analysis was performed for qualitative and quantitative variables. The concordance of the indexes was evaluated by the Kappa test. Results: in both indixes, the highest percentage (41% and 71%, respectively) of the population was in medium adherence to MD. Between both indexes, the value of the kappa index was 0.169, for men 0.163 and for women 0.174. By age groups: 0.158 for those aged 16-24 years, 0.139 for 25-44 years, 0.185 for 45-64 years, and 0.161 for those over 64 years. Conclusions: the two indexes tested showed a degree of poor agreement and classified the same population differently.
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Seconda L, Baudry J, Allès B, Touvier M, Hercberg S, Pointereau P, Lairon D, Kesse-Guyot E. Prospective associations between sustainable dietary pattern assessed with the Sustainable Diet Index (SDI) and risk of cancer and cardiovascular diseases in the French NutriNet-Santé cohort. Eur J Epidemiol 2020; 35:471-481. [DOI: 10.1007/s10654-020-00619-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 02/25/2020] [Indexed: 12/17/2022]
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Grosso G, Fresán U, Bes-Rastrollo M, Marventano S, Galvano F. Environmental Impact of Dietary Choices: Role of the Mediterranean and Other Dietary Patterns in an Italian Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1468. [PMID: 32106472 PMCID: PMC7084186 DOI: 10.3390/ijerph17051468] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 12/19/2022]
Abstract
Background: Current scientific literature suggests healthy dietary patterns may have less environmental impact than current consumption patterns, but most of the studies rely on theoretical modeling. The aim of this study was to assess the impact on resources (land, water, and energy) use and greenhouse gas (GHG) emissions of healthy dietary patterns in a sample of Italian adults. METHODS Participants (n = 1806) were recruited through random sampling in the city of Catania, southern Italy. Dietary consumption was assessed through a validated food frequency questionnaire (FFQ); dietary patterns were calculated through dietary scores. The specific environmental footprints of food item production/processing were obtained from various available life-cycle assessments; a sustainability score was created based on the impact of the four environmental components calculated. RESULTS The contribution of major food groups to the environmental footprint showed that animal products (dairy, egg, meat, and fish) represented more than half of the impact on GHG emissions and energy requirements; meat products were the stronger contributors to GHG emissions and water use, while dairy products to energy use, and cereals to land use. All patterns investigated, with the exception of the Dietary Approach to Stop Hypertension (DASH), were linearly associated with the sustainability score. Among the components, higher adherence to the Mediterranean diet and Alternate Diet Quality Index (AHEI) was associated with lower GHG emissions, dietary quality index-international (DQI-I) with land use, while Nordic diet with land and water use. CONCLUSIONS In conclusion, the adoption of healthy dietary patterns involves less use of natural resources and GHG emissions, representing eco-friendlier options in Italian adults.
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Affiliation(s)
- Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
| | - Ujué Fresán
- CIBER-ESP, 28029 Madrid, Spain;
- Instituto de Salud Pública y Laboral de Navarra, 31003 Pamplona, Spain
| | - Maira Bes-Rastrollo
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra’s Health Research Institute, 31008 Pamplona, Spain
- CIBERobn, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Stefano Marventano
- Department of Childhood and Adolescent, AUSL Romagna, Rimini Women’s Health, 47921 Rimini, Italy;
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy;
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Mediterranean Diet and its Environmental Footprints amid Nutrition Transition: The Case of Lebanon. SUSTAINABILITY 2019. [DOI: 10.3390/su11236690] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many Mediterranean countries, including Lebanon, are experiencing a shift in food consumption away from the traditional Mediterranean diet (MD), concomitant with the escalating burden of non-communicable diseases and dwindling environmental resources. Objective: to examine the adherence to the MD and its association with environmental footprints (EFPs), including water use, energy use, and greenhouse gas (GHG) emissions, among Lebanese adults. Data of Lebanese adults were drawn from the national food consumption survey (n = 2610). Assessment of dietary intake was conducted using a food-frequency questionnaire. Adherence to the MD was examined using four published MD scores. Metrics for the EFPs were calculated using a review of existing life cycle assessments (LCAs). For all MD scores, less than 13% of participants were in the highest tertile. After adjustments for covariates, two of the MD scores were associated with lower water use. For GHG, significant inverse associations were observed with all MD scores. Energy use was not associated with MD scores. Overall, low adherence to the MD among Lebanese adults was observed, together with an inverse association between adherence to the MD and water use and GHG emissions. These findings support and enforce ongoing efforts that aim to increase adherence to the MD in order to address health issues, as well as tackle environmental sustainability.
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Wilson N, Cleghorn CL, Cobiac LJ, Mizdrak A, Nghiem N. Achieving Healthy and Sustainable Diets: A Review of the Results of Recent Mathematical Optimization Studies. Adv Nutr 2019; 10:S389-S403. [PMID: 31728498 PMCID: PMC6855945 DOI: 10.1093/advances/nmz037] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/26/2018] [Accepted: 03/19/2019] [Indexed: 12/26/2022] Open
Abstract
Climate protection and other environmental concerns render it critical that diets and agriculture systems become more sustainable. Mathematical optimization techniques can assist in identifying dietary patterns that both improve nutrition and reduce environmental impacts. Here we review 12 recent studies in which such optimization was used to achieve nutrition and environmental sustainability aims. These studies used data from China, India, and Tunisia, and from 7 high-income countries (France, Finland, Italy, the Netherlands, Sweden, the United Kingdom, and the United States). Most studies aimed to reduce greenhouse gas emissions (10 of 12) and half aimed also to reduce ≥1 other environmental impact, e.g., water use, fossil energy use, land use, marine eutrophication, atmospheric acidification, and nitrogen release. The main findings were that in all 12 studies, the diets optimized for sustainability and nutrition were more plant based with reductions in meat, particularly ruminant meats such as beef and lamb (albeit with 6 of 12 of studies involving increased fish in diets). The amount of dairy products also tended to decrease in most (7 of 12) of the studies with more optimized diets. Other foods that tended to be reduced included: sweet foods (biscuits, cakes, and desserts), savory snacks, white bread, and beverages (alcoholic and soda drinks). These findings were broadly compatible with the findings of 7 out of 8 recent review articles on the sustainability of diets. The literature suggests that healthy and sustainable diets may typically be cost neutral or cost saving, but this is still not clear overall. There remains scope for improvement in such areas as expanding research where there are no competing interests; improving sustainability metrics for food production and consumption; consideration of infectious disease risks from livestock agriculture and meat; and researching optimized diets in settings where major policy changes have occurred (e.g., Mexico's tax on unhealthy food).
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Affiliation(s)
- Nick Wilson
- BODE Programme, University of Otago, Wellington, New Zealand,Address correspondence to NW (e-mail: )
| | | | - Linda J Cobiac
- BODE Programme, University of Otago, Wellington, New Zealand
| | - Anja Mizdrak
- BODE Programme, University of Otago, Wellington, New Zealand
| | - Nhung Nghiem
- BODE Programme, University of Otago, Wellington, New Zealand
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Translation of a Mediterranean-Style Diet into the Australian Dietary Guidelines: A Nutritional, Ecological and Environmental Perspective. Nutrients 2019; 11:nu11102507. [PMID: 31635208 PMCID: PMC6835345 DOI: 10.3390/nu11102507] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/07/2019] [Accepted: 10/15/2019] [Indexed: 12/13/2022] Open
Abstract
A Mediterranean diet (MedDiet) has been widely investigated and promoted as one of the 'healthiest' dietary patterns with respect to reductions in chronic disease risk and longevity. Moreover, it also emphasizes a plant-based dietary pattern consistent with an environmentally sustainable healthy reference diet conveyed by the EAT-Lancet Commission report. Nevertheless, the MedDiet does not exclude, but rather moderates consumption of animal-based foods, and therefore has emerged as a dietary pattern that could address both health and environmental concerns. However, whether non-Mediterranean countries such as Australia can adhere to such dietary principles is less clear. In this narrative review, we present evidence from eight randomized control trials conducted in Australia which demonstrates impressive and sustained adherence to a MedDiet intervention. However, we also report heterogeneity in the dietary protocols and prescriptive interpretation of a MedDiet across all studies presented in this review, making interpretations of the efficacy and adherence challenging. Based on the observable health benefits, translating key dietary elements of a Mediterranean-style diet within the Australian population remains attractive. However, adapting or modernizing traditional dietary patterns to satisfy the population's nutritional requirements and/or acceptability warrants further exploration.
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Real H, Queiroz J, Graça P. Mediterranean food pattern vs. Mediterranean diet: a necessary approach? Int J Food Sci Nutr 2019; 71:1-12. [PMID: 31122086 DOI: 10.1080/09637486.2019.1617838] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
"Food pattern" and "diet" sometimes are referred with the same meaning. "Food pattern" can be defined by a priori and a posteriori approaches and refers to the characterisation of foods and frequency of consumption within a population combining with various characteristics. "Diet" may be represented as an individual way of life and considers the food consumption and others like culture, history, society, economy, sustainability, culinary activities, conviviality, physical activity and rest. Mediterranean diet fits on these two concepts. The question is if we are measuring Mediterranean diet as a whole, or whether we are only measuring one of its parts, neglecting the rest of components. Can this compromise the way we monitor its adherence and evolution, with the possibility of losing the perception of certain aspects? How can we preserve and promote the concept if we do not monitor all the pieces of the puzzle?
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Affiliation(s)
- Helena Real
- Associação Portuguesa de Nutrição, Rua João das Regras, Porto, Portugal.,Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Jorge Queiroz
- Câmara Municipal de Tavira, Praça da República, Tavira, Portugal
| | - Pedro Graça
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
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Vandevijvere S, Young N, Mackay S, Swinburn B, Gahegan M. Modelling the cost differential between healthy and current diets: the New Zealand case study. Int J Behav Nutr Phys Act 2018; 15:16. [PMID: 29426334 PMCID: PMC5807767 DOI: 10.1186/s12966-018-0648-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 01/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Evidence on whether healthy diets are more expensive than current diets is mixed due to lack of robust methodology. The aim of this study was to develop a novel methodology to model the cost differential between healthy and current diets and apply it in New Zealand. Methods Prices of common foods were collected from 15 supermarkets, 15 fruit/vegetable stores and from the Food Price Index. The distribution of the cost of two-weekly healthy and current household diets was modelled using a list of commonly consumed foods, a set of min and max quantity/serves constraints for each, and food group and nutrient intakes based on dietary guidelines (healthy diets) or nutrition survey data (current diets). The cost differential between healthy and current diets was modelled for several diet, prices and policy scenarios. Acceptability of resulting meal plans was validated. Results The average cost of healthy household diets was $27 more expensive than the average cost of current diets, but 25.8% of healthy diets were cheaper than the average cost of current diets. This cost differential could be reduced if fruits and vegetables became exempt from Goods and Services Tax. Healthy diets were cheaper with an allowance for discretionary foods and more expensive when including takeaway meals. For Māori and Pacific households, healthy diets were on average $40 and $60 cheaper than current diets due to large energy intakes. Discretionary foods and takeaway meals contributed 30-40% to the average cost of current diets. Conclusion Healthy New Zealand diets were on average more expensive than current diets, but one-quarter of healthy diets were cheaper than the average cost of current diets. The impact of diet composition, types of prices and policies on the cost differential was substantial. The methodology can be used in other countries to monitor the cost differential between healthy and current household diets. Electronic supplementary material The online version of this article (10.1186/s12966-018-0648-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stefanie Vandevijvere
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Nick Young
- Centre for e-Research, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Boyd Swinburn
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Mark Gahegan
- Centre for e-Research, Faculty of Science, The University of Auckland, Auckland, New Zealand
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The Mediterranean diet, an environmentally friendly option: evidence from the Seguimiento Universidad de Navarra (SUN) cohort. Public Health Nutr 2018; 21:1573-1582. [PMID: 29380717 DOI: 10.1017/s1368980017003986] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE How food is produced and consumed has consequences for ecosystems, such as resource use and greenhouse gas (GHG) emission among others. The Mediterranean diet (MedDiet) was proposed as a sustainable dietary model, due to its nutritional, environmental, economic and sociocultural dimensions. However, further evidence is needed. Thus, our objective was to evaluate the impact on resource (land, water and energy) use and GHG emission of better adherence to the MedDiet in a Mediterranean Spanish cohort. DESIGN We analysed the dietary pattern of participants through a validated FFQ. The outcomes were land use, water and energy consumption and GHG emission according to MedDiet adherence. The specific environmental footprints of food item production and processing were obtained from different available life-cycle assessments. SETTING Spanish university graduates. SUBJECTS Participants (n 20 363) in the Seguimiento Universidad de Navarra (SUN) cohort. RESULTS Better adherence to the MedDiet was associated with lower land use (-0·71 (95 % CI -0·76, -0·66) m2/d), water consumption (-58·88 (95 % CI -90·12, -27·64) litres/d), energy consumption (-0·86 (95 % CI -1·01, -0·70) MJ/d) and GHG emission (-0·73 (95 % CI -0·78, -0·69) kg CO2e/d). A statistically significant linear trend (P<0·05) was observed in all these analyses. CONCLUSIONS In this Mediterranean cohort, better adherence to the MedDiet was an eco-friendly option according to resource consumption and GHG emission.
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Benedetti I, Laureti T, Secondi L. Choosing a healthy and sustainable diet: A three-level approach for understanding the drivers of the Italians' dietary regime over time. Appetite 2018; 123:357-366. [PMID: 29330002 DOI: 10.1016/j.appet.2018.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/04/2017] [Accepted: 01/03/2018] [Indexed: 01/13/2023]
Abstract
Dietary patterns play key roles in health promotion and in preserving the environment. A growing number of studies show the importance of individual factors on food consumption choices, such as socio-economic status, lifestyle variables and contextual and social factors that characterize the geographical area in which individuals reside. The Mediterranean Diet is a sustainable diet that respects the environment, thus reducing per capita emissions from food production in respect to less sustainable diet. The aim of this paper is to determine the Italians' prevailing food patterns using a composite indicator and to identify which factors determine a higher adherence to the Mediterranean Diet in Italy. By using 15 waves of the ISTAT "Aspect of Daily Life" survey, we constructed an original data set and referred to the multilevel approach which enabled us to distinguish between temporal and cross-sectional effects thus providing valuable insights to policy makers and stakeholders in order to promote the Mediterranean Diet and reap environmental and public health. The results show that education plays an important role in determining food consumption behavior while the tendency to practice sports on a regular basis and to have breakfast and lunch at home positively influence people's adherence to this diet.
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Affiliation(s)
- Ilaria Benedetti
- Department of Economics and Legal Studies, University of Naples "Parthenope", Via Generale Parisi, 13 80132 Napoli, Italy.
| | - Tiziana Laureti
- Department of Economics, Engineering, Society and Business Organization, University of Tuscia, Via del Paradiso, 37 01100 Viterbo, Italy.
| | - Luca Secondi
- Department for Innovation in Biological, Agro-food and Forest Systems (DIBAF), University of Tuscia, Via S.C. De Lellis, snc, 01100 Viterbo, Italy.
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45
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Ridoutt BG, Hendrie GA, Noakes M. Dietary Strategies to Reduce Environmental Impact: A Critical Review of the Evidence Base. Adv Nutr 2017; 8:933-946. [PMID: 29141975 PMCID: PMC5682998 DOI: 10.3945/an.117.016691] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The food system is a major source of environmental impact, and dietary change has been recommended as an important and necessary strategy to reduce this impact. However, assessing the environmental performance of diets is complex due to the many types of foods eaten and the diversity of agricultural production systems and local environmental settings. To assess the state of science and identify knowledge gaps, an integrative review of the broad topic of environment and diet was undertaken, with particular focus on the completeness of coverage of environmental concerns and the metrics used. Compared with the 14 discrete environmental areas of concern identified in the United Nations Sustainable Development Goals, the located journal literature mainly addressed greenhouse gas (GHG) emissions and, to a lesser extent, land and water use. Some relevant concerns were rarely addressed or not addressed at all. In the case of GHG emissions, changes in land use and soil carbon stocks were seldom considered. This represents a disconnect between the science informing strategic climate action in the agricultural sector and the science informing public health nutrition. In the case of land and water use, few studies used metrics that are appropriate in a life-cycle context. Some metrics produce inherently biased results, which misinform about environmental impact. The limited evidence generally points to recommended diets having lower environmental impacts than typical diets, although not in every case. This is largely explained by the overconsumption of food energy associated with average diets, which is also a major driver of obesity. A shared-knowledge framework is identified as being needed to guide future research on this topic. Until the evidence base becomes more complete, commentators on sustainable diets should not be quick to assume that a dietary strategy to reduce overall environmental impact can be readily defined or recommended.
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Affiliation(s)
- Bradley G Ridoutt
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, Victoria, Australia;,University of the Free State, Department of Agricultural Economics, Bloemfontein, South Africa; and
| | - Gilly A Hendrie
- CSIRO Biosecurity and Health, Adelaide, South Australia, Australia
| | - Manny Noakes
- CSIRO Biosecurity and Health, Adelaide, South Australia, Australia
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46
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Moustafa K, Cross J, Gasim S. Food and starvation: is Earth able to feed its growing population? Int J Food Sci Nutr 2017; 69:385-388. [PMID: 28929827 DOI: 10.1080/09637486.2017.1378625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Khaled Moustafa
- a Conservatoire National des Arts et Métiers , Paris , France
| | - Joanna Cross
- b Nigde Omer Halisdemir University , Nigde , Turkey
| | - Seif Gasim
- c Faculty of Agriculture , University of Khartoum , Khartoum , Sudan
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47
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Rosi A, Mena P, Pellegrini N, Turroni S, Neviani E, Ferrocino I, Di Cagno R, Ruini L, Ciati R, Angelino D, Maddock J, Gobbetti M, Brighenti F, Del Rio D, Scazzina F. Environmental impact of omnivorous, ovo-lacto-vegetarian, and vegan diet. Sci Rep 2017; 7:6105. [PMID: 28733610 PMCID: PMC5522483 DOI: 10.1038/s41598-017-06466-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 06/02/2017] [Indexed: 01/10/2023] Open
Abstract
Food and beverage consumption has a great impact on the environment, although there is a lack of information concerning the whole diet. The environmental impact of 153 Italian adults (51 omnivores, 51 ovo-lacto-vegetarians, 51 vegans) and the inter-individual variability within dietary groups were assessed in a real-life context. Food intake was monitored with a 7-d dietary record to calculate nutritional values and environmental impacts (carbon, water, and ecological footprints). The Italian Mediterranean Index was used to evaluate the nutritional quality of each diet. The omnivorous choice generated worse carbon, water and ecological footprints than other diets. No differences were found for the environmental impacts of ovo-lacto-vegetarians and vegans, which also had diets more adherent to the Mediterranean pattern. A high inter-individual variability was observed through principal component analysis, showing that some vegetarians and vegans have higher environmental impacts than those of some omnivores. Thus, regardless of the environmental benefits of plant-based diets, there is a need for thinking in terms of individual dietary habits. To our knowledge, this is the first time environmental impacts of three dietary regimens are evaluated using individual recorded dietary intakes rather than hypothetical diet or diets averaged over a population.
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Affiliation(s)
- Alice Rosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Pedro Mena
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Nicoletta Pellegrini
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy.
| | - Silvia Turroni
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Erasmo Neviani
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Ilario Ferrocino
- Department of Agricultural, Forest and Food Science, University of Turin, Turin, Italy
| | - Raffaella Di Cagno
- Faculty of Science and Technology, Libera Università di Bolzano, Bolzano, Italy
| | - Luca Ruini
- Barilla Center for Food & Nutrition, Parma, Italy
| | | | - Donato Angelino
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Jane Maddock
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, CB1 9NL, United Kingdom.,The Need for Nutrition Education/Innovation Programme (University of Cambridge) C/O MRC Elsie Widdowson Laboratory, Cambridge, CB1 9NL, United Kingdom
| | - Marco Gobbetti
- Faculty of Science and Technology, Libera Università di Bolzano, Bolzano, Italy
| | - Furio Brighenti
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Daniele Del Rio
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Francesca Scazzina
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
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Aridi YS, Walker JL, Wright ORL. The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review. Nutrients 2017; 9:E674. [PMID: 28657600 PMCID: PMC5537789 DOI: 10.3390/nu9070674] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 06/14/2017] [Accepted: 06/25/2017] [Indexed: 12/29/2022] Open
Abstract
The ageing population is accompanied by increased rates of cognitive decline and dementia. Not only does cognitive decline have a profound impact on an individual's health and quality of life, but also on that of their caregivers. The Mediterranean diet (MD) has been known to aid in reducing the risk of cardiovascular diseases, cancer and diabetes. It has been recently linked to better cognitive function in the elderly population. The purpose of this review was to compile evidence based data that examined the effect of adherence to the MD on cognitive function and the risk of developing dementia or Alzheimer's disease. This review followed PRISMA guidelines and was conducted using four databases and resulted in 31 articles of interest. Cross-sectional studies and cohort studies in the non-Mediterranean region showed mixed results. However, cohort studies in the Mediterranean region and randomized controlled trials showed more cohesive outcomes of the beneficial effect of the MD on cognitive function. Although more standardized and in-depth studies are needed to strengthen the existing body of evidence, results from this review indicate that the Mediterranean diet could play a major role in cognitive health and risk of Alzheimer's disease and dementia.
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Affiliation(s)
- Yasmine S Aridi
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
| | - Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
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Assessment of the Sustainability of the Mediterranean Diet Combined with Organic Food Consumption: An Individual Behaviour Approach. Nutrients 2017; 9:nu9010061. [PMID: 28085096 PMCID: PMC5295105 DOI: 10.3390/nu9010061] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/28/2016] [Accepted: 01/06/2017] [Indexed: 12/24/2022] Open
Abstract
Mediterranean diets are promising sustainable food models and the organic food system may provide health and environmental benefits. Combining the two models could therefore be a favourable approach for food sustainability. The aim of this study was to draw up a comparative description of four diets differing in the level of organic foods consumption and the adherence to the Mediterranean diet, using multidisciplinary indicators to assess the sustainability of these diets. Four groups of participants were defined and compared, combining the proportion of organic food in their diet (Org versus Conv) and the adherence to the Mediterranean diet (Med versus NoMed). Conv–NoMed: Conventional consumers and non-Mediterranean diet followers; Conv–Med: Conventional consumers and Mediterranean diet followers; Org–NoMed: Organic consumers and non-Mediterranean diet followers; Org–Med: Organic consumers and Mediterranean diet followers. The adherence to nutritional recommendations was higher among the Org–Med and Conv–Med groups compared to the Conv–NoMed group (using the mPNNS-GS (modified-Programme National nutrition santé guidelines score/13.5 points): 9.29 (95% confidence intervals (CI) = 9.23–9.36) and 9.30 (95% CI = 9.24–9.35) versus 8.19 (95% CI = 8.17–8.22)) respectively. The mean plant/animal protein intake ratio was 1.38 (95% CI = 1.01–1.74) for the Org–Med group versus 0.44 (95% CI = 0.28–0.60) for the Conv–NoMed group. The average cost of the diet of Org–Med participants was the highest: 11.43 €/day (95% CI = 11.34–11.52). This study highlighted the importance of promoting the Mediterranean diet combined with organic food consumption for individual health and environmental aspects but challenges with regard to the cost remain.
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50
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Vanham D, Del Pozo S, Pekcan AG, Keinan-Boker L, Trichopoulou A, Gawlik BM. Water consumption related to different diets in Mediterranean cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 573:96-105. [PMID: 27552733 DOI: 10.1016/j.scitotenv.2016.08.111] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/16/2016] [Accepted: 08/16/2016] [Indexed: 06/06/2023]
Abstract
Providing the sustainable development goals (SDGs) water, food and energy security to cities relies strongly on resource use outside city borders. Many modern cities have recently invested in a sustainable urban water system, and score high in international city rankings regarding water management and direct urban water use. However, these rankings generally neglect external resource use for cities. Here we quantify the water resources related to food consumption in thirteen cities located in Mediterranean countries, by means of the water footprint (WF) concept. These WFs amount from 3277l per capita per day (l/cap/d) to 5789l/cap/d. These amounts are about thirty times higher than their direct urban water use. We additionally analyse the WF of three diet scenarios, based upon a Mediterranean dietary pattern. Many authors identify the Mediterranean diet as cultural heritage, being beneficial for human health and a model for a sustainable food system. The first diet scenario, a healthy Mediterranean diet including meat, leads to WF reductions of -19% to -43%. The second diet scenario (pesco-vegetarian), leads to WF reductions of -28% to -52%. The third diet scenario (vegetarian), leads to WF reductions of -30% to -53%. In other words, if urban citizens want to save water, they need to look at their diets.
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Affiliation(s)
- D Vanham
- European Commission, Joint Research Centre, Directorate for Sustainable Resources, Water and Marine Resources Unit, Via E. Fermi 2749, 21027 Ispra, VA, Italy.
| | - S Del Pozo
- Departamento de Nutrición y Bromatología I, Universidad Complutense de Madrid, Madrid, Spain
| | - A G Pekcan
- Department of Nutrition and Dietetics, Hasan Kalyoncu University, School of Health Sciences, Gaziantep, Turkey
| | - L Keinan-Boker
- Israel Center for Disease Control, Israel Ministry of Health, Israel
| | | | - B M Gawlik
- European Commission, Joint Research Centre, Directorate for Sustainable Resources, Water and Marine Resources Unit, Via E. Fermi 2749, 21027 Ispra, VA, Italy
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