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Rei M, Costa A, Sosa S, da Costa S, Torres D, Sage C, Rodrigues S. Multicriteria Measures to Assess the Sustainability of Diets: A Systematic Review. Nutr Rev 2024:nuae081. [PMID: 38942740 DOI: 10.1093/nutrit/nuae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
CONTEXT Assessing the overall sustainability of a diet is a challenging undertaking requiring a holistic approach capable of addressing the multicriteria nature of this concept. OBJECTIVE The aim was to identify and summarize the multicriteria measures used to assess the sustainability characteristics of diets reported at the individual level by healthy adults. DATA SOURCES Articles were identified via PubMed, Scopus, and Web of Science. The search strategy consisted of key words and MeSH terms, and was concluded in September 2022, covering references in English, Spanish, and Portuguese. DATA EXTRACTION This systematic review followed the PRISMA guidelines. The search identified 5663 references, from which 1794 were duplicates. Two reviewers independently screened the titles and abstracts of each of the 3869 records and the full-text of the 144 references selected. Of these, 7 studies met the inclusion criteria. DATA ANALYSIS A total of 6 multicriteria measures were identified: 3 different Sustainable Diet Indices, the Quality Environmental Costs of Diet, the Quality Financial Costs of Diet, and the Environmental Impact of Diet. All of these incorporated a health/nutrition dimension, while the environmental and economic dimensions were the second and the third most integrated, respectively. A sociocultural sustainability dimension was included in only 1 of the measures. CONCLUSION Despite some methodological concerns in the development and validation process of the identified measures, their inclusion is considered indispensable in assessing the transition towards sustainable diets in future studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022358824.
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Affiliation(s)
- Mariana Rei
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Alexandra Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sofia Sosa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sofia da Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Duarte Torres
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
| | - Colin Sage
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
| | - Sara Rodrigues
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, 4150-180 Porto, Portugal
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
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Reguant-Closa A, Pedolin D, Herrmann M, Nemecek T. Review of Diet Quality Indices that can be Applied to the Environmental Assessment of Foods and Diets. Curr Nutr Rep 2024; 13:351-362. [PMID: 38625631 PMCID: PMC11133024 DOI: 10.1007/s13668-024-00540-0] [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] [Accepted: 04/04/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE OF REVIEW The aim was to identify indices of diet quality and health that could be applied to the environmental assessment of foods in order to provide metrics that collectively assess nutritional, health and environmental dimensions. RECENT FINDINGS The review identified five major groups of indices: nutrient-food quantity-based; guideline-based; diversity-based; nutrient quality-based; health-based. Nutrient-food quantity-based and guideline type indices were the most frequently used to evaluate diet quality. Scaled assessment using a nutritional functional unit is the most common integration of diet quality with the environmental analysis of foods. There are fewer indices that measure the heath impacts of foods, but epidemiological dietary risk factors seem a promising approach to integrate diet and health impacts into the environmental assessment of foods. Five groups of nutritional and health indices were identified that can be applied when performing an environmental assessment of foods. This review proposes different methodological insights when doing such assessments to ensure transparency and comparability of the results.
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Affiliation(s)
- Alba Reguant-Closa
- Life Cycle Assessment Research Group, 191, CH-8046, Reckenholzstrasse, Zurich, Switzerland.
| | - Dario Pedolin
- Life Cycle Assessment Research Group, 191, CH-8046, Reckenholzstrasse, Zurich, Switzerland
| | - Moritz Herrmann
- Life Cycle Assessment Research Group, 191, CH-8046, Reckenholzstrasse, Zurich, Switzerland
| | - Thomas Nemecek
- Life Cycle Assessment Research Group, 191, CH-8046, Reckenholzstrasse, Zurich, Switzerland
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Jung S, Young HA, Braffett BH, Simmens SJ, Ogden CL. Development of a sustainable diet index in US adults. Nutr J 2024; 23:46. [PMID: 38658958 PMCID: PMC11040758 DOI: 10.1186/s12937-024-00943-3] [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: 01/04/2024] [Accepted: 03/19/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND A transformation towards healthy diets through a sustainable food system is essential to enhance both human and planet health. Development of a valid, multidimensional, quantitative index of a sustainable diet would allow monitoring progress in the US population. We evaluated the content and construct validity of a sustainable diet index for US adults (SDI-US) based on data collected at the individual level. METHODS The SDI-US, adapted from the SDI validated in the French population, was developed using data on US adults aged 20 years and older from the National Health and Nutrition Examination Survey, 2007-2018 (n = 25,543). The index consisted of 4 sub-indices, made up of 12 indicators, corresponding to 4 dimensions of sustainable diets (nutritional quality, environmental impacts, affordability (economic), and ready-made product use behaviors (sociocultural)). A higher SDI-US score indicates greater alignment with sustainable diets (range: 4-20). Validation analyses were performed, including the assessment of the relevance of each indicator, correlations between individual indicators, sub-indices, and total SDI-US, differences in scores between sociodemographic subgroups, and associations with selected food groups in dietary guidelines, the alternative Mediterranean diet (aMed) score, and the EAT-Lancet diet score. RESULTS Total SDI-US mean was 13.1 (standard error 0.04). The correlation between SDI-US and sub-indices ranged from 0.39 for the environmental sub-index to 0.61 for the economic sub-index (Pearson Correlation coefficient). The correlation between a modified SDI-US after removing each sub-index and the SDI-US ranged from 0.83 to 0.93. aMed scores and EAT-Lancet diet scores were significantly higher among adults in the highest SDI-US quintile compared to the lowest quintile (aMed: 4.6 vs. 3.2; EAT-Lancet diet score: 9.9 vs. 8.7 p < .0001 for both). CONCLUSIONS Overall, content and construct validity of the SDI-US were acceptable. The SDI-US reflected the key features of sustainable diets by integrating four sub-indices, comparable to the SDI-France. The SDI-US can be used to assess alignment with sustainable diets in the US. Continued monitoring of US adults' diets using the SDI-US could help improve dietary sustainability.
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Affiliation(s)
- Sukyoung Jung
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
- The Korean Institute of Nutrition, Hallym University, 1 Hallymdaehak-gil, Chuncheon, 24252, South Korea.
| | - Heather A Young
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Barbara H Braffett
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Samuel J Simmens
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Cynthia L Ogden
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Ran Y, Cederberg C, Jonell M, Bergman K, De Boer IJM, Einarsson R, Karlsson J, Potter HK, Martin M, Metson GS, Nemecek T, Nicholas KA, Strand Å, Tidåker P, Van der Werf H, Vanham D, Van Zanten HHE, Verones F, Röös E. Environmental assessment of diets: overview and guidance on indicator choice. Lancet Planet Health 2024; 8:e172-e187. [PMID: 38453383 DOI: 10.1016/s2542-5196(24)00006-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 03/09/2024]
Abstract
Comprehensive but interpretable assessment of the environmental performance of diets involves choosing a set of appropriate indicators. Current knowledge and data gaps on the origin of dietary foodstuffs restrict use of indicators relying on site-specific information. This Personal View summarises commonly used indicators for assessing the environmental performance of diets, briefly outlines their benefits and drawbacks, and provides recommendations on indicator choices for actors across multiple fields involved in activities that include the environmental assessment of diets. We then provide recommendations on indicator choices for actors across multiple fields involved in activities that use environmental assessments, such as health and nutrition experts, policy makers, decision makers, and private-sector and public-sector sustainability officers. We recommend that environmental assessment of diets should include indicators for at least the five following areas: climate change, biosphere integrity, blue water consumption, novel entities, and impacts on natural resources (especially wild fish stocks), to capture important environmental trade-offs. If more indicators can be handled in the assessment, indicators to capture impacts related to land use quantity and quality and green water consumption should be used. For ambitious assessments, indicators related to biogeochemical flows, stratospheric ozone depletion, and energy use can be added.
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Affiliation(s)
- Ylva Ran
- Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - Christel Cederberg
- Division of Physical Resource Theory, Department of Space, Earth and Environment, Chalmers University of Technology, Göteborg, Sweden
| | - Malin Jonell
- Global Economic Dynamics and the Biosphere, Royal Swedish Academy of Science, Stockholm, Sweden; Stockholm Resilience Centre, Stockholm University, Stockholm, Sweden
| | - Kristina Bergman
- KTH Royal Institute of Technology, Department of Sustainable Development, Environmental Science and Engineering, Stockholm, Sweden
| | - Imke J M De Boer
- Animal Production Systems Group, Wageningen University & Research, Wageningen, Netherlands
| | - Rasmus Einarsson
- Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Johan Karlsson
- Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Hanna Karlsson Potter
- Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Michael Martin
- IVL Swedish Environmental Research Institute, Stockholm, Sweden
| | - Geneviève S Metson
- Department of Geography and Environment, Social Sciences Centre, University of Western Ontario, London, ON, Canada; Ecological and Environmental Modeling Division, Department of Physics, Chemistry and Biology, Linköping University, Linköping, Sweden
| | - Thomas Nemecek
- Agroscope, Life Cycle Assessment Research Group, Zurich, Switzerland
| | | | - Åsa Strand
- IVL Swedish Environmental Research Institute, Stockholm, Sweden
| | - Pernilla Tidåker
- Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Hayo Van der Werf
- French National Research Institute for Agriculture, Food and Environment, l'Institut Agro Rennes-Angers, Rennes, France
| | | | - Hannah H E Van Zanten
- Farming Systems Ecology Group, Wageningen Universityand Research, Wageningen, Netherlands; Department of Global Development, College of Agriculture and Life Sciences, and Cornell Atkinson Center for Sustainability, Cornell University, Ithaca, NY, USA
| | - Francesca Verones
- Industrial Ecology Programme, Department of Energy and Process Engineering, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elin Röös
- Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Erdoğan Gövez N, Akpınar Şentüre Ş, Ayten Ş, Köksal E. Evaluation of the Turkey Nutrition and Health Surveys according to the mediterranean adequacy index and sustainability through water footprints. Public Health Nutr 2023; 26:2927-2935. [PMID: 37721220 PMCID: PMC10755400 DOI: 10.1017/s1368980023001957] [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: 11/23/2022] [Revised: 08/02/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE Sustainable diet is one of the main factors that support food security, and the Mediterranean diet (MD) one of the sustainable diet models associated with low ecological impact and optimum health results has come to the fore. It was aimed to compare the results of the 2010 and 2017 Turkey Nutrition and Health Studies (TNHS) according to the Mediterranean Adequacy Index (MAI) and in order to evaluate the environmental impact of the current nutritional status in Turkey through water footprints (WF). DESIGN The MAI score was calculated using the published results of the 2010 and 2017 TNHS, and the WF have been calculated as indicators of environmental impact. SETTING Turkey. PARTICIPANTS There are no participants. RESULTS In the TNHS, there was an increase in the amount of energy provided by foods non-MD in 2017 compared to 2010, with a decrease in the total MAI score. The group with the lowest adherence to the MD in both years was the adult group (MAI20102·74 and MAI20172·31), while the group with the highest adherence was the adolescent group (MAI20103·21 and MAI20172·53). The MAI scores of females were higher than those of males in both years. The males aged 19-64 years had the largest (841 m3/year) WF and the females aged 65+ years had the smallest (483 m3/year). The food group that contributed the most to WF was meat and meat products (21·0-35·0 %). CONCLUSIONS Adherence to the MD has decreased due to the increase in the consumption of the Western-type diet in Turkey.
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Affiliation(s)
- Nazlıcan Erdoğan Gövez
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Emek, Ankara, 06560, Turkey
| | - Şerife Akpınar Şentüre
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Emek, Ankara, 06560, Turkey
| | - Şerife Ayten
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Emek, Ankara, 06560, Turkey
| | - Eda Köksal
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Emek, Ankara, 06560, Turkey
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Patra E, Kokkinopoulou A, Pagkalos I. Focus of Sustainable Healthy Diets Interventions in Primary School-Aged Children: A Systematic Review. Nutrients 2023; 15:nu15112460. [PMID: 37299423 DOI: 10.3390/nu15112460] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/13/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Research and public policy interest regarding Sustainable Healthy Diets (SHDs) have increased during the last decades, as nutrition recommendations and diet practices should align with growing environmental concerns. SHDs encompass sociocultural, economic and environmental components of nutrition and health and raising awareness across all these dimensions, as well as providing relevant education, especially to young children, is important for adopting SHD practices. Primary school students (5-12 years old) are often the target population for interventions, as they are considered agents of change for educating the community. The objective of this systematic review is to map the SHD indicators addressed by such interventions in order to identify gaps and opportunities for future interventions in this population. Scopus, PubMed and Web of Science were searched for available publications, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020) methodology. After screening for eligibility, thirteen intervention studies were included and reviewed. Results showed that indicator definitions and measuring methods were not harmonized across research efforts. Implemented SHD interventions address predominantly food waste and diet quality, while social and economic indicators are underrepresented. The standardization of SHD, focusing on measurable harmonized indicators, should be a priority for policy actors in order to enable impactful research efforts. Future interventions should incorporate clear SHD indicators to raise awareness and consider the application of composite tools or indexes to evaluate outcomes and maximize impact in the community.
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Affiliation(s)
- Elena Patra
- Nutrition Information Systems Laboratory (NISLAB), Department of Nutritional Sciences and Dietetics, International Hellenic University, 57001 Thessaloniki, Greece
| | - Anna Kokkinopoulou
- Nutrition Information Systems Laboratory (NISLAB), Department of Nutritional Sciences and Dietetics, International Hellenic University, 57001 Thessaloniki, Greece
| | - Ioannis Pagkalos
- Nutrition Information Systems Laboratory (NISLAB), Department of Nutritional Sciences and Dietetics, International Hellenic University, 57001 Thessaloniki, Greece
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Webb P, Livingston Staffier K, Lee H, Howell B, Battaglia K, Bell BM, Matteson J, McKeown NM, Cash SB, Zhang FF, Decker Sparks JL, Blackstone NT. Measurement of diets that are healthy, environmentally sustainable, affordable, and equitable: A scoping review of metrics, findings, and research gaps. Front Nutr 2023; 10:1125955. [PMID: 37077905 PMCID: PMC10106581 DOI: 10.3389/fnut.2023.1125955] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
IntroductionResearch on the impacts of dietary patterns on human and planetary health is a rapidly growing field. A wide range of metrics, datasets, and analytical techniques has been used to explore the role of dietary choices/constraints in driving greenhouse gas (GHG) emissions, environmental degradation, health and disease outcomes, and the affordability of food baskets. Many argue that each domain is important, but few have tackled all simultaneously in analyzing diet-outcome relationships.MethodsThis paper reviews studies published between January 2015 and December 2021 (inclusive) that examined dietary patterns in relation to at least two of the following four thematic pillars: (i) planetary health, including, climate change, environmental quality, and natural resource impacts, (ii) human health and disease, (iii) economic outcomes, including diet cost/affordability, and (iv) social outcomes, e.g., wages, working conditions, and culturally relevant diets. We systematically screened 2,425 publications by title and abstract and included data from 42 eligible publications in this review.ResultsMost dietary patterns used were statistically estimated or simulated rather than observed. A rising number of studies consider the cost/affordability of dietary scenarios in relation to optimized environmental and health outcomes. However, only six publications incorporate social sustainability outcomes, which represents an under-explored dimension of food system concerns.DiscussionThis review suggests a need for (i) transparency and clarity in datasets used and analytical methods; (ii) explicit integration of indicators and metrics linking social and economic issues to the commonly assessed diet-climate-planetary ecology relationships; (iii) inclusion of data and researchers from low- and middle-income countries; (iv) inclusion of processed food products to reflect the reality of consumer choices globally; and (v) attention to the implications of findings for policymakers. Better understanding is urgently needed on dietary impacts on all relevant human and planetary domains simultaneously.
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Affiliation(s)
- Patrick Webb
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- *Correspondence: Patrick Webb,
| | - Kara Livingston Staffier
- Nutritional Epidemiology Program, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Hyomin Lee
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Brian Howell
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Kyra Battaglia
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Brooke M. Bell
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Julia Matteson
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nicola M. McKeown
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- Department of Health Science, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Sean B. Cash
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Fang Fang Zhang
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Jessica L. Decker Sparks
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nicole Tichenor Blackstone
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
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Muñoz-Martínez J, Carrillo-Álvarez E, Janiszewska K. European dietitians as key agents of the green transition: An exploratory study of their knowledge, attitudes, practices, and training. Front Nutr 2023; 10:1129052. [PMID: 37063337 PMCID: PMC10102641 DOI: 10.3389/fnut.2023.1129052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/06/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction How food systems are currently provisioning food to the population is a matter of debate worldwide. Food systems, driven by widespread and increasing adherence to a westernized dietary pattern, are failing to meet people's basic needs and are draining natural resources. There is a push to make food systems more healthy, fair, and sustainable. To this end, action from all players is needed to meet the international agenda. In this regard, dietitians play a crucial role, as they can provide advice and promote actions that foster the adoption of more sustainable dietary patterns (SDP) as well as the promotion of sustainable food systems. As an emerging requirement in their training, it is crucial to know what dietitians know about SDP as well as their attitudes and current practices in this field in order to strengthen their competences and be key agents for the green transition. For this reason, the aim of the present study is to explore the knowledge, attitudes, practices, and training (KAPT) of European dietitians on SDP by administering an online survey. Methods Cross-sectional survey administered between April-August 2021 to dietitians based in the European countries with National Dietetic Associations or Education Associate Members affiliated to the European Federation of Associations of Dietitians (EFAD). Results were analyzed based on European region of professional practice (Northern/Southern/Western/South-East Europe), area of expertise and years of experience. Results Responses from 2211 dietitians from 25 countries were received, although the analysis was based on those that responded at least 90% of the survey (n=208). European dietitians are lacking training on SDP but are willing to learn more about it. Most dietitians perceive themselves as able to define an SDP, although aspects concerning social and economic sustainability were underestimated. Dietitians concur that barriers exist to the promotion of SDP, such as the lack of updated national food-based dietary guidelines and the absence of support from peers and managers. The country of professional activity seemed to be key to influencing dietitians' KAPT. Discussion These results emphasize the need to strengthen European dietitians' training in SDP and increase public/private commitment to consider dietitians as key professionals for the transition towards SDP.
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Affiliation(s)
- Júlia Muñoz-Martínez
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Barcelona, Spain
- Pedagogy, Society, and Innovation with ICT support (PSITIC) Research Group, Blanquerna School of Psychology, Education and Sport Sciences, Ramon Llull University, Barcelona, Spain
| | - Elena Carrillo-Álvarez
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Barcelona, Spain
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Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition-Narrative Review. Nutrients 2023; 15:nu15020416. [PMID: 36678287 PMCID: PMC9865989 DOI: 10.3390/nu15020416] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition.
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10
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Polzin SS, Lusk JL, Wahdat AZ. Measuring sustainable consumer food purchasing and behavior. Appetite 2023; 180:106369. [PMID: 36375601 DOI: 10.1016/j.appet.2022.106369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/26/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
Abstract
Consumer food purchasing and willingness to adopt a sustainable healthy diet (SHD) is a key factor affecting the sustainability of the entire food system. Studies have developed scales to measure consumer preferences for particular consumption patterns, while others have sought to empirically define the multiple dimensions of a sustainable food system (environmental, social, economic, etc.). This paper builds on these literatures by tracking consumers' SHD behaviors using a large-scale, longitudinal survey of adults in the United States and mapping them onto multiple systems-level indicators. We wanted to know whether consumers interact with the sustainability of their food along the same principles developed by experts. Our study defines 18 food purchasing behaviors that support the sustainability goals of leading scientific institutions, uses factor analysis to identify the unobserved drivers behind these behaviors, and creates SHD scores to investigate their correlations with other consumer characteristics and behaviors. Factor analysis results show consumer food purchasing is motivated by three underlying sustainability dimensions-Economic Security, Socio-Environment, and Nutrition-which are fewer constructs than often defined by academic researchers. SHD scores reveal higher adoption of behaviors that fall under Economic Security relative to the other two dimensions. All three sustainability constructs are impacted by socio-economic and demographic characteristics.
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Affiliation(s)
- Samuel S Polzin
- Center for Food Demand Analysis and Sustainability, Purdue University, 403 W. State Street, West Lafayette, IN, 47907, USA.
| | - Jayson L Lusk
- Center for Food Demand Analysis and Sustainability, Purdue University, 403 W. State Street, West Lafayette, IN, 47907, USA; Agricultural Economics Department, Purdue University, 403 W. State Street, West Lafayette, IN, 47907, USA.
| | - Ahmad Zia Wahdat
- Center for Food Demand Analysis and Sustainability, Purdue University, 403 W. State Street, West Lafayette, IN, 47907, USA; Agricultural Economics Department, Purdue University, 403 W. State Street, West Lafayette, IN, 47907, USA.
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11
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Incorporating environmental and sustainability considerations into health technology assessment and clinical and public health guidelines: a scoping review. Int J Technol Assess Health Care 2022; 38:e84. [PMID: 36510398 DOI: 10.1017/s0266462322003282] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Healthcare systems account for a substantial proportion of global carbon emissions and contribute to wider environmental degradation. This scoping review aimed to summarize the evidence currently available on incorporation of environmental and sustainability considerations into health technology assessments (HTAs) and guidelines to support the National In stitute for Health and Care Excellence and analogous bodies in other jurisdictions developing theirown methods and processes. Overall, 7,653 articles were identified, of which 24 were included in this review and split into three key areas - HTA (10 studies), healthcare guidelines (4 studies), and food and dietary guidelines (10 studies). Methodological reviews discussed the pros and cons of different approaches to integrate environmental considerations into HTAs, including adjustments to conventional cost-utility analysis (CUA), cost-benefit analysis, and multicriteria decision analysis. The case studies illustrated the challenges of putting this into practice, such as lack of disaggregated data to evaluate the impact of single technologies and difficulty in conducting thorough life cycle assessments that consider the full environmental effects. Evidence was scant on the incorporation of environmental impacts in clinical practice and public health guidelines. Food and dietary guidelines used adapted CUA based on life cycle assessments, simulation modeling, and qualitative judgments made by expert panels. There is uncertainty on how HTA and guideline committees will handle trade-offs between health and environment, especially when balancing environmental harms that fall largely on society with health benefits for individuals. Further research is warranted to enable integration of environmental considerations into HTA and clinical and public health guidelines.
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12
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Gutiérrez-Villar B, Melero-Bolaños R, Montero-Simo MJ, Araque-Padilla RA. Profiling consumers with an environmentally sustainable and healthy diet: The case of Spanish households. Front Nutr 2022; 9:1035142. [PMID: 36438776 PMCID: PMC9684671 DOI: 10.3389/fnut.2022.1035142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/26/2022] [Indexed: 01/18/2023] Open
Abstract
Our diet has substantial implications not only for our health but also for the environment. However, the two dimensions are not comparable, even though consumers often associate them with their purchasing choices. Promoting more sustainable diets requires a better knowledge of household profiles considering the healthy and organically sustainable character of the food purchased. Previous studies have approached the analysis of consumer profiles separately, differentiating both dimensions without clear conclusion regarding the variables that make up these profiles. In this study, we looked for household profiles by cross-referencing the organic nature of the products consumed (environmental sustainability) with their degree of processing (healthfulness) in Spain. The results show that the most sustainable products are consumed in tiny municipalities (less than 2,000 inhabitants). In contrast, less sustainable products are consumed in high-income, single-family households or households with small children. The person responsible for the purchase is working or between 39 and 45 years old. In conclusion, our study shows that socio-demographic variables are statistically significant in identifying household profiles with sustainable diets.
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13
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Lisa Clodoveo M, Tarsitano E, Crupi P, Pasculli L, Piscitelli P, Miani A, Corbo F. Towards a new food labelling system for sustainable food production and healthy responsible consumption: The Med Index Checklist. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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14
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IUNS sustainable diets task force. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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15
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Alexandropoulou I, Goulis DG, Merou T, Vassilakou T, Bogdanos DP, Grammatikopoulou MG. Basics of Sustainable Diets and Tools for Assessing Dietary Sustainability: A Primer for Researchers and Policy Actors. Healthcare (Basel) 2022; 10:healthcare10091668. [PMID: 36141280 PMCID: PMC9498311 DOI: 10.3390/healthcare10091668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Climate change can have economic consequences, affecting the nutritional intake of populations and increasing food insecurity, as it negatively affects diet quality parameters. One way to mitigate these consequences is to change the way we produce and consume our food. A healthy and sustainable diet aims to promote and achieve the physical, mental, and social well-being of the populations at all life stages, while protecting and safeguarding the resources of the planet and preserving biodiversity. Over the past few years, several indexes have been developed to evaluate dietary sustainability, most of them based on the EAT-Lancet reference diet. The present review explains the problems that arise in human nutrition as a result of climate change and presents currently available diet sustainability indexes and their applications and limitations, in an effort to aid researchers and policy actors in identifying aspects that need improvement in the development of relevant indexes. Overall, great heterogeneity exists among the indicators included in the available indexes and their methodology. Furthermore, many indexes do not adequately account for the diets’ environmental impact, whereas others fall short in the economic impact domain, or the ethical aspects of sustainability. The present review reveals that the design of one environmentally friendly diet that is appropriate for all cultures, populations, patients, and geographic locations is a difficult task. For this, the development of sustainable and healthy diet recommendations that are region-specific and culturally specific, and simultaneously encompass all aspects of sustainability, is required.
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Affiliation(s)
- Ioanna Alexandropoulou
- Department of Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, GR-57400 Thessaloniki, Greece
- Correspondence: (I.A.); (M.G.G.)
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 76 Agiou Pavlou Street, GR-56429 Thessaloniki, Greece
| | - Theodora Merou
- Department of Forest and Natural Environment Sciences, International Hellenic University, GR-66100 Drama, Greece
| | - Tonia Vassilakou
- Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Avenue, GR-11521 Athens, Greece
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
| | - Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
- Correspondence: (I.A.); (M.G.G.)
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16
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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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17
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Harrison MR, Palma G, Buendia T, Bueno-Tarodo M, Quell D, Hachem F. A Scoping Review of Indicators for Sustainable Healthy Diets. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2021.822263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Introduction: Diets are currently unsustainable in many countries as evidenced by the growing burden of malnutrition, degradation of natural resources, contributions to climate change, and unaffordability of healthy diets. Agreement on what constitutes a healthy and sustainable diet has been debated. In 2019, FAO and WHO published the Sustainable Healthy Diets Guiding Principles, defining what qualifies as a sustainable healthy diet. While valuable, these principles require measurable indicators to support their operationalization. Our scoping review aims to describe how sustainable healthy diets have been assessed in the literature since 2010.Methods: A search for English-language articles published in peer-reviewed journals was conducted from January 2010 through February 2020 across three databases. Out of the 504 articles initially identified, 103 articles were included. Metadata were extracted from each article on: publication year, country of study, study aims, methods, main data sources, indicators used to assess sustainable healthy diets, reported indicator strengths or limitations, and main study findings. A qualitative content analysis identified major conceptual themes across indicators and their frequency of use.Findings: From the 103 empirical articles included in our review, 57.3% were published after 2017. Most studies were carried out in high-income countries (74%). Approximately 42% of the articles assessed the sustainability of diets using solely health and environmental indicators; <25% assessed the sustainability of diets across health, environmental, and sociocultural aspects of sustainability. We found a substantial number of unique indicators used for assessing health (n = 82), environmental (n = 117), and sociocultural (n = 43) aspects of diets. These indicators covered concepts related to health outcomes, aspects of diet quality, natural resources, climate change, cultural acceptability, and cost of diets. The preponderance of indicators currently used in research likely poses challenges for stakeholders to identify the most appropriate measures.Conclusion: Robust indicators for sustainable healthy diets are critical for understanding trends, setting targets, and monitoring progress across national and sub-national levels. Our review highlights the geographical imbalance, the narrow focus on health and environmental aspects, and the lack of common measures used in research. Measures registries could provide the decision-support needed by stakeholders to aid in the indicator selection process.
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18
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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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19
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van Selm B, Frehner A, de Boer IJM, van Hal O, Hijbeek R, van Ittersum MK, Talsma EF, Lesschen JP, Hendriks CMJ, Herrero M, van Zanten HHE. Circularity in animal production requires a change in the EAT-Lancet diet in Europe. NATURE FOOD 2022; 3:66-73. [PMID: 37118484 DOI: 10.1038/s43016-021-00425-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 11/04/2021] [Indexed: 04/30/2023]
Abstract
It is not known whether dietary guidelines proposing a limited intake of animal protein are compatible with the adoption of circular food systems. Using a resource-allocation model, we compared the effects of circularity on the supply of animal-source nutrients in Europe with the nutritional requirements of the EAT-Lancet reference diet. We found the two to be compatible in terms of total animal-source proteins but not specific animal-source foods; in particular, the EAT-Lancet guidelines recommend larger quantities of poultry meat over beef and pork, while a circular food system produces mainly milk, dairy-beef and pork. Compared with the EAT-Lancet reference diet, greenhouse gas emissions were reduced by up to 31% and arable land use reduced by up to 42%. Careful consideration of the feasible substitutability between animal-source foods is needed to define potential roles of animal products in circular human diets.
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Affiliation(s)
- Benjamin van Selm
- Animal Production Systems Group, Wageningen University & Research, Wageningen, Netherlands.
- Plant Production Systems Group, Wageningen University & Research, Wageningen, Netherlands.
| | - Anita Frehner
- Animal Production Systems Group, Wageningen University & Research, Wageningen, Netherlands
- Department of Socioeconomics, Research Institute of Organic Agriculture FiBL, Frick, Switzerland
| | - Imke J M de Boer
- Animal Production Systems Group, Wageningen University & Research, Wageningen, Netherlands
| | - Ollie van Hal
- Animal Production Systems Group, Wageningen University & Research, Wageningen, Netherlands
| | - Renske Hijbeek
- Plant Production Systems Group, Wageningen University & Research, Wageningen, Netherlands
| | - Martin K van Ittersum
- Plant Production Systems Group, Wageningen University & Research, Wageningen, Netherlands
| | - Elise F Talsma
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Jan Peter Lesschen
- Wageningen Environmental Research, Wageningen University & Research, Wageningen, Netherlands
| | - Chantal M J Hendriks
- Wageningen Environmental Research, Wageningen University & Research, Wageningen, Netherlands
| | - Mario Herrero
- Department of Global Development, College of Agriculture and Life Sciences and Cornell Atkinson Center for Sustainability, Cornell University, Ithaca, NY, USA
| | - Hannah H E van Zanten
- Farming Systems Ecology Group, Wageningen University & Research, Wageningen, Netherlands
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20
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Dave LA, Hodgkinson SM, Roy NC, Smith NW, McNabb WC. The role of holistic nutritional properties of diets in the assessment of food system and dietary sustainability. Crit Rev Food Sci Nutr 2021:1-21. [PMID: 34933622 DOI: 10.1080/10408398.2021.2012753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Advancing sustainable diets for nutrition security and sustainable development necessitates clear nutrition metrics for measuring nutritional quality of diets. Food composition, nutrient requirements, and dietary intake are among the most common nutrition metrics used in the current assessment of sustainable diets. Broadly, most studies in the area classify animal-source foods (ASF) as having a substantially higher environmental footprint in comparison to plant-source foods (PSF). As a result, much of the current dietary advice promulgates diets containing higher proportions of PSF. However, this generalization is misleading since most of these studies do not distinguish between the gross and bioavailable nutrient fractions in mixed human diets. The bioavailability of essential nutrients including β-carotene, vitamin B-12, iron, zinc, calcium, and indispensable amino acids varies greatly across different diets. The failure to consider bioavailability in sustainability measurements undermines the complementary role that ASF play in achieving nutrition security in vulnerable populations. This article critically reviews the scientific evidence on the holistic nutritional quality of diets and identifies methodological problems that exist in the way the nutritional quality of diets is measured. Finally, we discuss the importance of developing nutrient bioavailability as a requisite nutrition metric to contextualize the environmental impacts of different diets.
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Affiliation(s)
- Lakshmi A Dave
- Riddet Institute, Massey University, Palmerston North, New Zealand.,Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand
| | | | - Nicole C Roy
- Riddet Institute, Massey University, Palmerston North, New Zealand.,Department of Human Nutrition, University of Otago, Dunedin, New Zealand.,High-Value Nutrition National Science Challenge, Auckland, New Zealand
| | - Nick W Smith
- Riddet Institute, Massey University, Palmerston North, New Zealand.,Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Warren C McNabb
- Riddet Institute, Massey University, Palmerston North, New Zealand.,Sustainable Nutrition Initiative, Riddet Institute, Massey University, Palmerston North, New Zealand.,High-Value Nutrition National Science Challenge, Auckland, New Zealand
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21
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Moltedo A, Jiménez S, Álvarez-Sánchez C, Manyani T, Ramos MP, Custodio E. Raw versus cooked food matching: Nutrient intake using the 2015/16 Kenya Integrated Household Budget Survey. J Food Compost Anal 2021; 102:103879. [PMID: 34483479 PMCID: PMC8356072 DOI: 10.1016/j.jfca.2021.103879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 11/20/2022]
Abstract
Dietary energy assessment does not require matching foods in cooked form. Macronutrient dietary assessment does not require matching foods in cooked form. Vitamin and mineral dietary assessment requires matching foods in cooked form.
In many countries, statistics from household consumption and expenditure surveys are increasingly being used to inform policies and programs. In household surveys, foods are typically reported as they are acquired (the majority are raw). However, the micronutrient content of some foods diminishes during processing and cooking. Using food consumption data from the 2015/16 Kenya Integrated Household Budget Survey, this study analyzes whether mean consumption estimates of dietary energy, macronutrients, and eight micronutrients are equivalent (applying a two-side paired equivalence test) when matching foods: (1) considering the nutrient content in raw foods (as reported in the survey), and (2) considering the nutrient content in foods as typically consumed, thus applying yield and retention factors as needed. Both food matching approaches rendered statistically equivalent mean consumption estimates, at national and county levels, for dietary energy, protein, fats, available carbohydrates, total fiber, calcium and zinc. Non-equivalent means were found for iron, vitamins A, B1, B2, B12, and C. The higher differences between the means were, in percentage change, for vitamin C (47 %), B1 (34 %) and B12 (26 %).
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Affiliation(s)
- Ana Moltedo
- Statistics Division, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153, Rome, Italy
| | - Sofía Jiménez
- Joint Research Centre, Sustainable Resources, Economics of Agriculture, European Commission, Joint Research Centre, C/Inca Garcilaso s/n, Sevilla, E-41092, Spain
| | - Cristina Álvarez-Sánchez
- Statistics Division, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153, Rome, Italy
| | - Talent Manyani
- Statistics Division, Food and Agriculture Organization of the United Nations, Viale delle Terme di Caracalla, 00153, Rome, Italy
| | - María Priscila Ramos
- Universidad de Buenos Aires. Facultad de Ciencias Económicas. Departamento de Economía, Buenos Aires, Argentina.,CONICET-Universidad de Buenos Aires, Instituto Interdisciplinario de Economía Política de Buenos Aires (IIEP-Baires), Avenida Córdoba 2122 - 2do Piso, C1120AAQ, Ciudad Autónoma de Buenos Aires, Argentina.,Centre d'Etudes Prospectives et d'Information Internationale (CEPII), 20 avenue de Ségur, 75334, Paris cedex 07, France
| | - Estefanía Custodio
- Joint Research Centre, Sustainable Resources, Economics of Agriculture, European Commission, Joint Research Centre, C/Inca Garcilaso s/n, Sevilla, E-41092, Spain
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22
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Abstract
Balancing the social, economic and environmental priorities for public health is at the core of the United Nations (UN) approaches to sustainable development, including the Sustainable Development Goals (SDGs). The four dimensions of sustainable diets are often presented as health, society, economics, and the environment. Although sustainable diet research has focused on health and the environment, the social and economic dimensions of sustainable diets and food systems should not be forgotten. Some research priorities and sociocultural indicators for sustainable healthy diets and food systems are outlined in this report. The present goal is to improve integration of the social dimension into research on food and nutrition security.
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23
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Hebinck A, Zurek M, Achterbosch T, Forkman B, Kuijsten A, Kuiper M, Nørrung B, Veer PV’, Leip A. A Sustainability Compass for policy navigation to sustainable food systems. GLOBAL FOOD SECURITY 2021; 29:100546. [PMID: 34178596 PMCID: PMC8204684 DOI: 10.1016/j.gfs.2021.100546] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 05/01/2021] [Accepted: 05/02/2021] [Indexed: 01/26/2023]
Abstract
Growing acknowledgement that food systems require transformation, demands comprehensive sustainability assessments that can support decision-making and sustainability governance. To do so, assessment frameworks must be able to make trade-offs and synergies visible and allow for inclusive negotiation on food system outcomes relevant to diverse food system actors. This paper reviews literature and frameworks and builds on stakeholder input to present a Sustainability Compass made up of a comprehensive set of metrics for food system assessments. The Compass defines sustainability scores for four societal goals, underpinned by areas of concern. We demonstrate proof of concept of the operationalization of the approach and its metrics. The Sustainability Compass is able to generate comprehensive food system insights that enables reflexive evaluation and multi-actor negotiation for policy making.
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Affiliation(s)
- Aniek Hebinck
- Environmental Change Institute, University of Oxford, United Kingdom
- Dutch Research Institute for Transitions (DRIFT), Erasmus University Rotterdam, Netherlands
| | - Monika Zurek
- Environmental Change Institute, University of Oxford, United Kingdom
| | - Thom Achterbosch
- Wageningen Economic Research, Wageningen University and Research, Netherlands
| | - Björn Forkman
- Dept. of Veterinary and Animal Sciences, University of Copenhagen, Denmark
| | - Anneleen Kuijsten
- Division of Human Nutrition and Health, Wageningen University and Research, Netherlands
| | - Marijke Kuiper
- Wageningen Economic Research, Wageningen University and Research, Netherlands
| | - Birgit Nørrung
- Dept. of Veterinary and Animal Sciences, University of Copenhagen, Denmark
| | - Pieter van ’t Veer
- Division of Human Nutrition and Health, Wageningen University and Research, Netherlands
| | - Adrian Leip
- European Commission, Joint Research Centre (JRC), Ispra, VA, Italy
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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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Proceedings of a Workshop on Characterizing and Defining the Social and Economic Domains of Sustainable Diets. SUSTAINABILITY 2020. [DOI: 10.3390/su12104163] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Global challenges associated with a growing demand for food in the face of finite natural resources and climate change have prompted concerns about the sustainability of our current food systems. As formulated by the Food and Agriculture Organization, the four principal domains of sustainable diets are health, economics, society, and the environment. While emphasizing the environmental cost and health impacts of current diets, the research literature has virtually ignored the vital economic and social aspects of sustainability. Without these components, critical inputs for decision-making about global challenges related to climate change and a growing demand for food are missing. National Dairy Council convened experts in sociology, economics, human nutrition, food systems science, food security, environmental health, and sustainable agriculture for a one-day workshop to define the social and economic domains of sustainability in service of better characterizing food-based dietary guidance that is both healthy and sustainable. The consensus recommendations were to (1) select social and economic indicators to complement the existing environmental and health ones, (2) better define appropriate concepts, terms, and measures to foster discussion across scientific disciplines, (3) reframe the focus on sustainable diets towards the goal of “achieving healthy dietary patterns from sustainable food systems”, and (4) complement the four domains, and incorporate the notions of geography, time, and cross-cutting considerations into sustainability frameworks. This publication summarizes the presentations, discussions, and findings from the 2019 workshop, and aims to catalyze further action to advance sustainability research and practice in the context of food-based dietary guidance and the Sustainable Development Goals.
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Supporting Women's Participation in Developing A Seaweed Supply Chain in Kiribati for Health and Nutrition. Foods 2020; 9:foods9040382. [PMID: 32224935 PMCID: PMC7230817 DOI: 10.3390/foods9040382] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/13/2020] [Accepted: 03/23/2020] [Indexed: 12/17/2022] Open
Abstract
Seaweeds are a source of food throughout the Pacific region. Kiribati, however, does not have a strong history of using seaweed in their diets, despite having reliable access to indigenous edible seaweeds. A series of peer-led seaweed training workshops held in Kiribati between 2018 and 2019 provided women with knowledge, skills, and motivational support needed to engage in the seaweed supply chain, from harvesting, processing, and marketing to consumption. This study aimed to identify opportunities and enablers to support women’s participation across the seaweed supply chain. Structured interviews with 49 women explored their interest and expected costs and benefits from involvement in the supply chain. There was high interest in most seaweed-related activities and the key motivators were health and nutrition for themselves and their family. Participants were also interested in developing and sharing new skills and saw the potential for income generation. However, there were also clear barriers including a desire for further training in seaweed harvesting, processing, and recipe creation; additional social support; and in public promotion. Given the natural resources and desire of women to engage in developing this new edible seaweed supply chain in Kiribati, there is now a need for capacity development to build social and economic wellbeing and food security across the broader community. Additional peer-to-peer training opportunities may look to other Pacific Islands where seaweed is already an established and traditional food.
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Samoggia A, Bertazzoli A, Ruggeri A. European Rural Development Policy Approaching Health Issues: An Exploration of Programming Schemes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2973. [PMID: 31426621 PMCID: PMC6720636 DOI: 10.3390/ijerph16162973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/31/2019] [Accepted: 08/16/2019] [Indexed: 01/01/2023]
Abstract
Malnutrition, obesity, type 2 diabetes, micronutrient deficiencies, and the increase in non-communicable diseases are among the future European key challenges in health and welfare. Agriculture and rural development policies can positively contribute to a healthier and nutritious supply of food. The objective of the research is to analyze to what extent European 2007-2013 and 2014-2020 rural development programmes address the nexus between agriculture, food, health, and nutrition to respond to the evolving dietary needs. The research carries out a quali-quantitative content analysis on all 210 European rural development programmes. Results show that the interconnection between agriculture, food, health, and nutrition is present, with differences in the European agricultural and rural policy programming periods. The main interlinking issues of the nexus are food safety, food quality, diseases, nutritional aspect, animal health and welfare, plant health, and environmental health. Healthier and nutritious food-related issues are emerging, addressing dietary needs, and sustaining consumer food trends. Healthy and nutritious food is pursued by combating foodborne communicable diseases and non-communicable diseases. The future Common Agricultural Policy, including its rural dimensions, should support the consumption of healthy foods produced in ways that are environmentally and economically sustainable.
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Affiliation(s)
- Antonella Samoggia
- Department of Agricultural and Food Sciences, University of Bologna, 40127 Bologna, Italy.
| | - Aldo Bertazzoli
- Department of Agricultural and Food Sciences, University of Bologna, 40127 Bologna, Italy
| | - Arianna Ruggeri
- Department of Agricultural and Food Sciences, University of Bologna, 40127 Bologna, Italy
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