Searching for a Measure Integrating Sustainable and Healthy Eating Behaviors

Adaptation of the Food Literacy (FOODLIT) Tool for Turkish Adults: A Validity and Reliability Study

BACKGROUND

Food literacy is associated with sustainable food systems and encourages individuals to adopt healthy eating habits. However, there is no validated method that can be used to measure food literacy related to sustainable food systems of Turkish adults. This research aimed to assess the validity and reliability of the Turkish adaptation of the "Food Literacy (FOODLIT) Tool" for Turkish adults.

METHODS

The study involved 328 people aged 19 to 58 years. The FOODLIT-Tool is a five-point Likert-type scale consisting of 24 items and five factors ("culinary competencies", "production and quality", "selection and planning", "environmentally safe" and "origin").

RESULTS

The Cronbach's alpha coefficient was applied to assess internal consistency reliability, showing an excellent scale coefficient of 0.927. The model was evaluated with a confirmatory factor analysis (CFA). The findings of the CFA suggested that the fit indices were acceptable (χ2/df = 1.257, comparative fit index: 0.991, goodness-of-fit index: 0.977, normed fit index: 0.990 and root mean error of approximation: 0.028). Furthermore, there was a positive relationship between the FOODLIT-Tool score and the "Sustainable and Healthy Eating Behaviors Scale" (SHEB) score (r = 0.518, p < 0.001).

CONCLUSION

Our study shows that the Turkish version of the FOODLIT-Tool integrated with sustainable food systems is a valid and reliable measurement tool for assessing the food literacy of Turkish adults.

Adherence to the Mediterranean diet is associated with sustainable nutrition and environmental footprints on higher educated individuals

Introduction: This study aimed to investigate the relationship between Med-Diet adherence with sustainable nutrition and environmental footprints in academicians. Methods: The study involved 153 academicians aged 23-64 working in a university in Turkey. Data were collected through a questionnaire including socio-demographic characteristics, anthropometric measurements, Mediterranean Diet Adherence Scale (MEDAS) and Sustainable and Healthy Eating Behaviours Scale (SHEBS). Carbon and water footprints were calculated. Results: All sub-scales of SHEBS were higher in individuals who adhered to Med-Diet than those who did not (p<0.05). The carbon and water footprints of individuals with high adherence to the Med-Diet were lower than those of no adherence (p<0.05). Each 1-point increase in MEDAS score was associated with a 1-point increase in SHEBS score, a 0.15 CO2 eq/kg and a 0.001 m3/year decrease in the amount of carbon and water footprint of food. Conclusion: Higher adherence to the Med-Diet was associated with higher sustainable nutrition behaviours, and lower environmental footprints.

Validity and reliability of the Sustainable HEalthy Diet (SHED) index by comparison with EAT-Lancet diet, Mediterranean diet in Turkish adults

Background

Food consumption and diet are strongly associated with sustainability. The Sustainable HEalthy Diet index was developed to measure the nutritional, environmental, and sociocultural components of sustainable diets and healthy eating patterns. However, a methodological approach has yet to be proposed for Turkish adults. This study aimed to determine the validity and reliability of the SHED index in Turkish adults.

Methods

Data were collected from 558 healthy adults using a web-based questionnaire. Internal consistency reliability was evaluated using Cronbach's alpha coefficient, and repeatability was evaluated using the test-retest method. Construct validity was investigated using the EAT-Lancet diet and the Mediterranean Diet Adherence Screener (MEDAS), and the adapted SHED index structures' accordance was evaluated with confirmatory factor analysis.

Results

Good reliability and repeatability were found (r = 0.758 and 0.795, respectively). A higher SHED index score was related to a greater intake of grains, fruits, and vegetables and a lower intake of meat, eggs, and dairy compared to EAT-Lancet diet food groups. A higher SHED index score was associated with a lower saturated fat and added sugar intake. While the SHED index was associated with greater adherence to the Mediterranean diet (r = 0.334, p < 0.001), it was negatively associated with non-alcoholic and diet non-alcoholic beverage consumption (r = -0.257 and -0.264, respectively; p < 0.001).

Conclusion

The SHED index showed good validity and reliability in Turkish adults. Our results suggest that the SHED index can be used in epidemiological and intervention studies because it allows the measurement of diets in terms of health and sustainability to propose adaptations accordingly.

Sustainable household capability of young adults: Role of parental norms

This paper aims to investigate the influence of two types of parental norms, descriptive and injunctive, on young adults' sustainable attitudes and sustainable household capability through the application of the Knowledge-Attitude-Behaviour (KAB) theory. Empirical research was conducted by an online questionnaire on a sample of 356 young adults in Croatia aged 18 to 28. The results confirmed that young adults had high levels of sustainable knowledge and attitudes. They exhibited a high tendency towards saving water and energy, and a low tendency towards sustainable and green household purchases and recycling and reusing as integral practices of sustainable household capability. The results proved the adequacy of the KAB theory in the context of sustainable knowledge, attitudes, and behaviour, affirming the theory's assumptions in terms of sustainable household capability among young adults. The results also confirmed that young adults' sustainable knowledge had a strong significant positive impact on sustainable attitudes, that sustainable attitudes had a significant positive impact on sustainable behaviour in the context of sustainable household capability, and that sustainable knowledge had an indirect significant positive impact on sustainable behaviour in the context of sustainable household capability. Considering parental norms, the results confirmed a significant positive impact of descriptive parental norms related to sustainable parental behaviour on the practices constituting sustainable household capability of young adults. At the same time, injunctive parental norms were shown to have a limited impact on both attitudes and behaviours in the context of capability. Given that previous research brought contradictory and inconclusive findings that lead to misinterpretation in the research field, the results bring a comprehensive and transparent understanding and an overview of sustainable behaviour among young adults in the context of their sustainable household capability.

When food is uncertain, how much does sustainability matter? A qualitative exploration of food values and behaviours among users of a social grocery store

A transition towards sustainable diets ensuring food security while preserving ecosystems is necessary, but remains challenging. Low-income consumers, particularly those experiencing food insecurity, require specific consideration since they face financial constraints when making food choices, leading to poorer diets. However, little is known about the place given to sustainability in their choices. This study thus aims to identify the role played by sustainability in the food values of food-insecure consumers in France. Twenty-nine semi-structured interviews with users of a social grocery store were conducted to investigate food values and actual behaviours, with a focus on the four dimensions of sustainable diets - health, economic, sociocultural and environmental. Verbatims were analysed through thematic analysis. Five core values were identified, namely health and nutrition, naturalness, trust and control, solidarity and frugality, and preferences. Participants valued all dimensions of food sustainability but notably valued less the environmental dimension. Despite various strategies, participants felt unable to adhere to their values in practice, mainly because of their socioeconomic vulnerability. They insisted on their lack of control over their food behaviour. These findings provide insights into the disempowerment experienced by consumers with low financial resources regarding more sustainable food choices. Our study calls for interventions addressing affordability issues and considering consumers' food values, while providing opportunities to make consumers feel involved in the transition of the food system.

Relationship between adherence to the Mediterranean diet, sustainable and healthy eating behaviors, and climate change awareness: A cross-sectional study from Turkey

OBJECTIVES

This study aimed to evaluate the relationship between adherence to the Mediterranean diet, sustainable and healthy eating behaviors, and climate change awareness in adults.

METHODS

This descriptive and cross-sectional study was conducted with 1797 adults ages 19-65 y. Demographic characteristics, anthropometric measurements, adherence to the Mediterranean diet, sustainable and healthy eating behaviors, and climate change awareness were ascertained through a questionnaire.

RESULTS

The mean age of the individuals was 27.5 ± 11.76 y, and 50.5% of the participants were adherent to the Mediterranean diet. A statistically significant difference was found between individuals who did and did not adhere to the Mediterranean diet in terms of age, income status, total score and subscores on the Sustainable and Healthy Eating Behaviors Scale, and subscores for information on climate change causes (P < 0.05). A statistically significant positive correlation was found between the Mediterranean Diet Adherence Scale (MEDAS) total score, the Sustainable and Healthy Eating Behaviors Scale total score and subscores, and the Climate Change Awareness Scale total score and subscores (P < 0.05). It was determined that sex, education level, and income status affected the Climate Change Awareness Scale total score (P < 0.05). It was determined that age, income status, the Sustainable and Healthy Eating Behaviors Scale total score, and the Climate Change Awareness Scale total score affected the MEDAS total score (P < 0.05). Also, it was determined that age, sex, education level, MEDAS total score, and Climate Change Awareness Scale total score affected the Sustainable and Healthy Eating Behaviors Scale total score (P < 0.05).

CONCLUSIONS

This study showed a significant effect of climate change awareness on sustainable and healthy eating behaviors and adherence to the Mediterranean diet.

Advancing sustainability in the food and nutrition system: a review of artificial intelligence applications

Promoting sustainability in food and nutrition systems is essential to address the various challenges and trade-offs within the current food system. This imperative is guided by key principles and actionable steps, including enhancing productivity and efficiency, reducing waste, adopting sustainable agricultural practices, improving economic growth and livelihoods, and enhancing resilience at various levels. However, in order to change the current food consumption patterns of the world and move toward sustainable diets, as well as increase productivity in the food production chain, it is necessary to employ the findings and achievements of other sciences. These include the use of artificial intelligence-based technologies. Presented here is a narrative review of possible applications of artificial intelligence in the food production chain that could increase productivity and sustainability. In this study, the most significant roles that artificial intelligence can play in enhancing the productivity and sustainability of the food and nutrition system have been examined in terms of production, processing, distribution, and food consumption. The research revealed that artificial intelligence, a branch of computer science that uses intelligent machines to perform tasks that require human intelligence, can significantly contribute to sustainable food security. Patterns of production, transportation, supply chain, marketing, and food-related applications can all benefit from artificial intelligence. As this review of successful experiences indicates, artificial intelligence, machine learning, and big data are a boon to the goal of sustainable food security as they enable us to achieve our goals more efficiently.

Evaluation of sustainable and healthy eating behaviors and adherence to the planetary health diet index in Turkish adults: a cross-sectional study

Aim

The Planetary Health Diet Index (PHDI) is a relatively new index, and studies about its relationship with eating behaviors, nutritional status, and obesity in adults are very limited. For this reason, in this study, sustainable healthy eating behaviors of individuals and compliance of their diets with PHDI were evaluated.

Methods

This cross-sectional study was conducted with 1,112 adults (70.1% women and 29.9% men with mean age = 28.7 years, SE = 9.47). Study data were obtained with the face-to-face interview method via a questionnaire including sociodemographic characteristics, anthropometric measurements, the Sustainable and Healthy Eating (SHE) Behaviors Scale, and 24-h dietary recall. PHDI was evaluated for adherence to EAT-Lancet Commission recommendations.

Results

The average PHDI total score was 41.5 points. Higher SHE Behaviors Scale and PHDI scores were observed in participants with a duration of education above 8 years (p < 0.05). Those with lower SHE Behaviors Scale and PHDI scores were more likely to be obese (p < 0.001). The total PHDI score was positively associated with fiber, vitamin E, potassium, and folate, and negatively associated with pyridoxine and calcium (p < 0.05). The total SHE Behaviors Scale score was positively associated with carbohydrates, fiber, and potassium and negatively associated with pyridoxine, calcium, and energy (p < 0.05). A one-unit increase in SHE Behaviors Scale total score resulted in a 5,530 unit (95%CI: 4.652; 6.407) increase in PHDI total score and a one-unit increase in duration of education (years) resulted in a 0.660 unit (95%CI: 0.403; 0.918) increase in PHDI total score. Furthermore, a one-unit increase in Body Mass Index (BMI) (kg/m2) resulted in a - 0.218 unit (95%CI: -0.424; -0.013) decrease in PHDI total score.

Conclusion

The participants' PHDI index scores were low; therefore, the adherence to the EAT-Lancet recommendation was low which might be associated with obesity. Clinical studies evaluating the effects of adherence to sustainable diets on adequate and balanced nutrition and health outcomes are recommended.

Implementing micronutrient fortification programs as a potential practical contribution to achieving sustainable diets

Due to sustainability concerns related to current diets and environmental challenges, it is crucial to have sound policies to protect human and planetary health. It is proposed that sustainable diets will improve public health and food security and decrease the food system's effect on the environment. Micronutrient deficiencies are a well-known major public health concern. One-third to half of the world's population suffers from nutrient deficiencies, which have a negative impact on society in terms of unrealised potential and lost economic productivity. Large-scale fortification with different micronutrients has been found to be a useful strategy to improve public health. As a cost-effective strategy to improve micronutrient deficiency, this review explores the role of micronutrient fortification programmes in ensuring the nutritional quality (and affordability) of diets that are adjusted to help ensure environmental sustainability in the face of climate change, for example by replacing some animal-sourced foods with nutrient-dense, plant-sourced foods fortified with the micronutrients commonly supplied by animal-sourced foods. Additionally, micronutrient fortification considers food preferences based on the dimensions of a culturally sustainable diet. Thus, we conclude that investing in micronutrient fortification could play a significant role in preventing and controlling micronutrient deficiencies, improving diets and being environmentally, culturally and economically sustainable.

Effect of perception of sustainability in local food experiences on healthy eating tendency: mediator and moderator effects

Tourists who favor local food typically care about healthy food choices. Their view of locally produced food as healthy is related to perceptions of sustainability. This relationship can be explained by tourists' personality traits and tendency to eat local food. This study aimed to establish the effect of tourists' perceptions of sustainability in the context of local food experiences on healthy eating tendencies. In addition, we aimed to determine the role of tourists' personality traits and local eating tendencies and elucidate the moderating role of searching online for information on food choices. An online questionnaire (via e-mail and WhatsApp) was used to obtain data from 379 research participants, recruited using a non-probabilistic sampling technique. A research model and hypotheses were formed based on Hayes PROCESS Macro models 90 and 6, and moderator and mediator effects were analyzed using these models. Healthy eating was well-explained by the model, and the perception of social and environmental sustainability in local food experiences (LFE-SES) positively affected food-related personality traits (FRPT), local food eating tendencies (LFET), and healthy eating (HE). While food-related personality traits did not mediate the relationship between the perception of sustainability and healthy eating, local food eating tended to mediate this relationship. In addition, when food-related personality traits and local food eating tendencies were evaluated together, they had a mediating role between the perception of sustainability and healthy eating. Searching online for information had an insignificant moderating effect. These findings help promote an understanding of healthy eating tendencies. Within the context of local food, they suggest critical theoretical and practical implications for the relationship between the perception of sustainability, food-related personality traits, local food eating tendencies, and healthy eating.

Is food insecurity related to sustainable and healthy eating behaviors?

In this cross-sectional study, it was aimed to investigate the relationship between sustainable and healthy eating behaviors such as nutritional insecurity and a healthy and balanced diet, interest in regional and organic food products, consumption of seasonal food and avoidance of food waste, preference for locally produced foods, reduction of meat consumption, preference for eggs from free-range chickens, and sustainable fishery products, and consumption of low-fat food products in adults. The study included 410 adults who were reached through social media applications. Data were collected through an online questionnaire including the Descriptive Information Form, the Household Food Insecurity Access Scale (HFIAS), and the Sustainable Healthy Eating Behaviors Scale (SHEBS). The proportion of participants determined as mildly food insecure, moderately food insecure, and severely food insecure was 10.2%, 6.6%, and 7.6%, respectively. Linear regression analysis revealed that in Models 1, 2, and 3, there was a statistically significant negative association between food insecurity and the components of sustainable and healthy eating behaviors such as healthy and balanced diet (β - 0.226, p < 0.001), quality labels (β - 0.230, p < 0.001), seasonal foods, which are of avoidance of food waste (β - 0.261, p < 0.001), animal welfare (β - 0.174, p < 0.001), and fat intake (β - 0.181, p < 0.001). In conclusion, food insecurity negatively affects healthy and balanced diet behaviors, interest in regional and organic food products, seasonal food products consumption and avoidance of food waste, consumption of low-fat food products, and the choice of products such as free-range chicken eggs, and sustainable fisheries.

Relationship between adherence to the Mediterranean diet, sustainable and healthy eating behaviors, and awareness of reducing the ecological footprint

This study evaluated the relationship between adherence to the Mediterranean diet (MD), sustainable and healthy eating behaviors, and awareness of reducing the ecological footprint. It was conducted with 1333 adults (38.2% male, 61.8% female, mean age 24.2 ± 7.5 years). The questionnaire included socio-demographic characteristics, anthropometric measurements, the Awareness Scale for Reducing Ecological Footprint (ASREF), the Sustainable and Healthy Eating (SHE) Behaviors Scale, and Mediterranean Diet Adherence Scale (MEDAS). 40.2% of the participants adhered to the MD (≥7 scores). Obese individuals' total scores on MEDAS, SHE Behaviors Scale, and ASREF were the lowest (p < 0.05). In regression analysis, education duration, SHE Behaviors Scale total score, and BMI affected the ASREF score (p < 0.05). The education duration, SHE Behaviors Scale scores, and ASREF scores were higher in those in MD-adherence group (p < 0.05). In conclusion, adherence to the MD was associated with higher sustainable and healthy eating behaviors and higher awareness of ecological footprint reduction.

Integrated consumers' sustainable and healthy dietary behavior patterns: Associations between demographics, psychological factors, and meal preparation habits among Japanese adults

The consumers' Sustainable and Healthy Dietary Behaviors (SHDBs) links sustainable behaviors related to eating (e.g., choosing, cooking, eating, and disposing of foods) with the level of "dietary behavior." It was hypothesized that SHDBs will vary depending on consumers' meal preparation habits, such as food selection, cooking frequency, and skill. This study examined (1) some of the behavioral patterns of SHDBs and (2) independent predictors of each pattern. In total, 508 Japanese adults who completed cross-sectional self-administered questionnaire surveys in December 2021 were included in the study. Principal component analysis (PCA) was used to identify the behavioral patterns of the 30-item SHDBs developed previously by the authors. Additionally, independent predictors of each component score were analyzed using multiple linear regression models, which included demographics, psychological factors concerning SHDBs (pros and cons for the decisional balance of SHDBs and number of environmental issues of interest), and meal preparation habits. Participants' median age was 41 (18-59) years (women: n = 259, 51.0%). Five SHDB patterns with several independent predictors were identified: amalgamation of all SHDBs, healthy food choices but unsustainable cooking, sustainable disposal, avoiding plastic products, and sustainable behaviors regarding expiry date. The multiple linear regression analysis demonstrated the independent predictors of the amalgamation of all SHDBs, such as being a man (β = -0.105), greater pros (β = 0.134), higher cooking frequency (β = 0.443) and skill (β = 0.244). Greater pros and/or smaller cons were associated with four of the five SHDB patterns, including an amalgamation of all SHDBs, healthy food choice and unsustainable cooking, avoiding disposal, and avoiding plastic products. Sustainable and healthy diet education must be implemented to ensure the adoption of all SHDBs.

Measuring sustainable consumer food purchasing and behavior

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.

"Unhealthy = Tasty": How Does It Affect Consumers' (Un)Healthy Food Expectations?

Consumers having a strong unhealthy = tasty (UT) belief are less likely to choose healthy food even though they recognize its health benefits, because they assume healthy food to be unpalatable. The aim of this study was to profile consumers according to their UT belief and specify the strength of the belief among a demographically representative consumer group. The other aim was to investigate the effect of UT belief on expectations of two food products representing either an unhealthy or a healthy image. A total of 1537 consumers participated in the online survey. The scale-based (1-7) mean for UT belief was 3.27 and related positively to male gender and food pleasure orientation and negatively to general health interest. The results indicate that a strong UT belief correlates with positive expectations of unhealthy food and with negative expectations of healthy food. UT belief seemed to increase expected food-associated guilt, but other strong food-related attitudes (health interest with unhealthy food and pleasure orientation with healthy food) reduced this effect. In practice, understanding the relationship between UT belief and personal factors and attitudes, and the importance of this belief to food expectations can assist in finding the tools to encourage consumers towards healthier food choices.

Validity and Reliability of the Turkish Version of the Sustainable and Healthy Eating Behaviors Scale

This study was conducted to determine the validity and reliability of the Turkish version of the Sustainable and Healthy Eating (SHE) Behaviors Scale. The original scale included 8 factors and 34 items related to the SHE behaviors of adults. The research was carried out in three stages with a total of 586 participants aged 19 to 50 years. The Cronbach alpha coefficient was used to evaluate internal consistency reliability and the test-retest method was applied. Exploratory factor analysis (EFA) was performed to determine the factor structure. The model obtained with EFA was evaluated with confirmatory factor analysis (CFA). The Cronbach alpha coefficient of the scale was found to be excellent at 0.912, and the intra-class correlation coefficient was found to be good at 0.832 using the test-retest method. Considering the suitability of the data for factor analysis, the KMO coefficient was 0.859, and the significance level of the Bartlett test of sphericity was less than 0.05 (χ2=3.803,25; p<0.05). As a result of EFA, the items of the scale were found to be distributed in 7 factor dimensions. The factor loadings of the items were between 0.516 and 0.890, and the factors explained 67% of the variance. Considering the fit indices obtained as a result of the analysis of this model with CFA, it was seen that the model had an acceptable fit (χ2/sd=2.593, CFI=0.915, Tucker-Lewis index=0.902, SRMR=0.0754, and RMSEA=0.067). In conclusion, the Turkish version of the SHE Behaviors Scale has credible reliability and construct validity to assess the sustainable and healthy eating behaviors of the Turkish adult population.

The relationship between traditional and common Japanese childhood education and adulthood towards avoiding food waste behaviors

Japanese parents and educators teach children to refrain from leaving food in their plates. Their teachings have direct (advising children to refrain from leaving food uneaten) and indirect (meal-related rituals before and after mealtimes) influence in enhancing gratitude for food in daily life. This cross-sectional study aimed to examine 1) the interaction of direct and indirect approaches to avoiding food waste behaviors and 2) the mediation of gratitude for food by preventing such behaviors. Overall, 400 Japanese adults (female: n = 200) responded to a self-administrated anonymous questionnaire survey measuring: the present food waste avoiding behaviors; current gratitude for food; direct and indirect childhood approaches for avoiding food waste behaviors. Participants' mean (standard deviation) age and body mass index were 40.0 (11.6) and 21.9 (3.9), respectively. A significant main effect of the indirect approach and the interaction of direct and indirect approaches were obtained by adjusting the participants' background. Moreover, through mediation analyses with percentile-corrected bootstrap confidence intervals, it was observed that gratitude for food mediated the association between direct and indirect childhood approaches and avoiding food waste behaviors. Despite no information on the current meal-related rituals of the respondents, this study suggests the potential of these approaches in enhancing gratitude for food as a new approach to reduce food waste worldwide.

Drivers and Barriers Toward Healthy and Environmentally Sustainable Eating in Switzerland: Linking Impacts to Intentions and Practices

Food consumption is among the activities with the most significant environmental impacts, and furthermore contributes to rising health costs. We explored the factors that foster or hinder healthy and sustainable eating in Switzerland. Based on an online household survey with 620 respondents, we first determined the disability adjusted life years and greenhouse gas impacts associated with individuals' dietary habits to measure healthy and environmentally sustainable eating. We then relate the nutritional health and environmental impacts to individual's intentions, and explore what interpersonal and societal factors foster or hinder healthy and sustainable eating. Results suggest that intentions for healthy eating are stronger than intentions to eat environmentally sustainable and that intentions for healthy eating transmit better into behavior than intentions for environmentally sustainable eating. Males and females had similar intentions but males showed substantially higher dietary related health impacts with 12 min of healthy life lost per day and 14% higher carbon footprint than females. Furthermore, vegan and vegetarian diets yielded very high nutritional health benefits of &gt;23 min of healthy life gained per person and day, mostly realized through the reduced intake in processed and red meat and increased consumption of nuts, wholegrain, and to a lesser extent in fruits and vegetables. Meatless diets show concurrent high reductions in the carbon footprint of −42% for vegetarians and −67% for vegan. A key obstacle to healthier and more environmentally sustainable eating is that people do not recognize the high nutritional and environmental co benefits of vegetarian and vegan diets. This suggests that policies promoting healthy eating can target factors affecting intentions, while measures targeting environmentally sustainable eating should aim at overcoming the intention behavior gap, by informing on e.g. the importance of reducing meat consumption toward environmental sustainability.

Development and validation of the Expanded Mindful Eating Scale

PURPOSE

To develop and validate the Expanded Mindful Eating Scale (EMES), an expanded mindful eating model created for the promotion of health and sustainability.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional study using self-administered questionnaire surveys on Ochanomizu Health Study (OHS) was conducted. The survey was provided to 1,388 female university students in Tokyo, Japan. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and a partial correlation analysis were used to confirm construct and criterion validity. Internal consistency of the EMES was confirmed to calculate Cronbach's alpha.

FINDINGS

The response rate was 38.7 % (n = 537). Mean BMI was 20.21 ± 2.12, and 18.8% of them were classified as "lean" (BMI < 18.5). The authors listed 25 items and obtained a final factor structure of five factors and 20 items, as a result of EFA. Through CFA, the authors obtained the following fit indices for a final model: GFI = 0.914, AGFI = 0.890, CFI = 0.870 and RMSEA = 0.061. The total EMES score was significantly correlated with BMI, mindfulness, body dissatisfaction, drive for thinness and life satisfaction (r = -0.138, -0.315, -0.339, -0.281 and 0.149, p < 0.01, respectively). Cronbach's alpha for all items in this scale was 0.687.

PRACTICAL IMPLICATIONS

The authors suggest the possibility that practitioners and researchers of mindful eating that includes this new concept can use authors' novel scale as an effective measurement tool.

ORIGINALITY/VALUE

The EMES, which can multidimensionally measure the concept of the expanded model of mindful eating was first developed in this study.

Effect of Nutrition Education on Diet Quality, Sustainable Nutrition and Eating Behaviors among University Students

Nutrition information is provided by proper nutrition education and nutrition education programs have a direct impact on nutrition knowledge and behavior. This study aims to determine the effect of nutrition education on diet quality, sustainable nutrition and eating behavior.

Cross-sectional survey.

PARTICIPANTS

The study was carried out on a total of 204 individuals, 21 males and 183 females, who were studying in the 3rd and 4th grades of Başkent University Faculty of Health Sciences.

Mean Adequacy Ratio (MAR) score calculated with the Nutrient Adequacy Ratio (NAR) was used to evaluate the diet quality. 'Sustainable and Healthy Eating Behaviors Scale' was applied to measure sustainable and healthy eating behaviors.

A questionnaire including personal information and anthropometric measurements of the individuals and a 24-hour dietary recall was taken. Food consumption records were evaluated using the Nutrition Information System. In order to evaluate the quality of the diet, the Mean Adequacy Ratio (MAR) score calculated with the Nutrient Adequacy Ratio (NAR) was used. 'Sustainable and Healthy Eating Behaviors Scale' was applied to measure sustainable and healthy eating behaviors. SPSS 20.0 package program was applied to evaluate the data.

In the study, 47.5% of the individuals were educated in Nutrition and Dietetics program and 52.5% were in other programs. The diet quality of 44.8% of the individuals studying in the Nutrition and Dietetics program and 56.4% of the individuals studying in the other programs were determined as 'good' according to the MAR levels classification. No significant difference was found in terms of MAR levels of individuals according to the departments they read (p > 0.05). The average score of the 'Healthy and Balanced Nutrition' factor in the scale of sustainable and healthy eating behaviors was higher in individuals who were studying in the Nutrition and Dietetics program. The average scores of 'Seasonal Food' and 'Low Fat' factor were found to be significantly higher in girls studying in the Nutrition and Dietetics program (p < 0.05).

It was determined that nutrition education is effective on sustainable and healthy eating behaviors. Considering the importance of nutrition education on the health of individuals and sustainable environment, it is of great importance in terms of public health to increase the awareness of the society on this issue.

Reshaping the Traditional Pattern of Food Consumption in Romania through the Integration of Sustainable Diet Principles. A Qualitative Study

The Romanian traditional pattern of food consumption as a whole is no longer a reference point in shaping a healthy and sustainable food behavior due to the growing discrepancies between the return to traditions and the constraints of sustainable development, so the aim of this study is to provide solutions for reshaping the food pattern by incorporating the principles of sustainable diet. The research conducted is based on qualitative data and the semi-structured interview was used as method of data collection from a sample of 21 Romanians traditional food consumers. The study led to a typology of respondents that combines two consumption orientations, “healthy” and “convenience”, with two attitudes towards traditional diet, “hedonism” and “conformism”. Although respondents do not completely reject the idea of flexitarianism, they showed the tendency for overconsumption of meat-based traditional foods and a weak concern for environmental sustainability. For these reasons, a set of recommendations for a new model of sustainable diet for Romanian population, focused on the relationship between traditionality, sustainability, and health, was put forward. The research findings show the need for supporting nutritional education programs and extensive information campaigns targeted at Romanian consumers to encourage the adoption of flexitarian style and the switch to a more sustainable diet in the near future.

Research on Food Behavior in Romania from the Perspective of Supporting Healthy Eating Habits

Today’s human society provides to food consumers many options that involve difficult decisions. Disoriented and stressed by contradictory messages of mass media and by the warnings of being as slim as possible, a modern consumer gets confused and shows a tendency towards losing his traditional habits. Still, most experts suggest that the adoption of a healthy food behavior, based on minimally processed natural products, may contribute to the development of a sustainable food system. The study aims to design the food profile of Romanian consumers by presenting the underlying factors of a balanced diet. The conducted marketing study was of quantitative nature, in which, a face-to-face survey was used. The questionnaire was applied to individuals aged over 18 years old, and the tool used for collecting data was the structured questionnaire applied to a sample of 1185 Romanian respondents. In this study, the following methods of analysis were used: factor analysis, cluster analysis, and structural equation modeling. The research results present the main aspects underlying the food products classification, the clustering of Romanian consumers by their interest in healthy diet, and the relationships between specific variables influencing the healthy food habits. These results have shown the need for supporting educational campaigns targeted at Romanian consumers aimed to develop healthy food habits that could create conditions needed to reshape food supply, and implicitly, to contribute to the development of environmental sustainability.