"Eat as If You Could Save the Planet and Win!" Sustainability Integration into Nutrition for Exercise and Sport

Impact and process evaluation of a primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia: pragmatic cluster non-randomized controlled trial

BACKGROUND

Environmentally sustainable food initiatives accompanying nutrition education, such as the Food Education and Sustainability Training (FEAST) program, have gained traction in school settings. The aim of this trial was to conduct an impact and process evaluation of FEAST, to evaluate its effect on children's fruit and vegetable (F&V) intakes, and secondary outcomes: F&V variety consumed, nutrition knowledge, food preparation/cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours, and food production knowledge.

METHODS

FEAST was a 10-week curriculum-aligned program, designed to educate children about healthy eating, food waste, and sustainability, while teaching cooking skills. It was implemented by classroom teachers, face-to-face and online, during COVID-19 school closures, in Australia in 2021. A custom designed survey was used to collect baseline and post-intervention data from students. Generalised linear mixed models (GLMM) estimated group differences in pre-post changes for primary and secondary outcomes. Surveys were also administered to students and teachers to evaluate intervention implementation.

RESULTS

Twenty schools participated and self-selected to be either intervention schools (n = 10) or wait-list control (WLC) schools (n = 10). A total of 977, 5th and 6th grade children participated in the trial with a mean age of 11.1 years (SD ± 0.7). The FEAST intervention, compared to WLC, did not result in significant increases in primary outcomes nor secondary outcomes. The process evaluation revealed FEAST was well-received by students and teachers, but COVID-19 school closures hindered implementation fidelity with a less intense program delivered under the constraints of pandemic lockdowns.

CONCLUSIONS

This is the first cluster non-randomized controlled trial designed to independently evaluate FEAST in the primary-school setting. No evidence was found for improved F&V intakes in children, nor secondary outcomes. However, the positive process evaluation results suggest that further trials of the program are warranted. If implemented as originally designed (pre-pandemic), with increased duration and complemented by supporting school policies, such programs have the potential to improve children's daily F&V intakes, cooking skills and food waste behaviours. This would support the Australian curriculum and contribute to: health promotion within schools and sustainable schools initiatives, the national agenda to reduce food waste and sustainable development goals. AUSTRALIAN AND NEW ZEALAND CLINICAL TRIALS REGISTRY: [ACTRN12620001347954]- Registered prospectively on 14/12/2020.

Game changers for meat and masculinity? Male athletes' perspectives on mixed and plant-based diets

The dietary choices of male athletes are increasingly a topic of moral and nutritional debate. Though it has long been a consensus that athletes require animal products to advance their athletic goals, this understanding is now challenged in academic and popular sources based on nutritional evidence and concern about the environmental impacts of animal products. In order to better understand how (semi-)professional male athletes perceive plant-based diets and diets containing animal products, thirteen semi-structured interviews were conducted with male athletes competing nationally and internationally, including mixed and plant-based eaters. Interviews were analysed through reflexive thematic analysis, in line with a critical, qualitative research methodology. Justifications for meat, situated knowledge and masculinity were used as theoretical lenses. Our analysis shows how athletes reproduce nutritional claims about the necessity of protein for athletes, but disagree on the suitability of plant-based sources. This nutritional discourse derives from a broad range of sources, including professional nutritionists, friends, online influencers, and media. Second, when explaining their own food practices, food being 'nice' and 'normal' - common justifications for meat as evidenced in the 4N theory - often supersede necessity. Embedding these views in their everyday lives as athletes shows that food environments and shared eating practices fortify a mixed diet as normal, and plant-based diets as anomalous. It further shows how the view of meat being normal is subject to shifting masculinity norms. Interviewees reject meat eating as normal and masculine for men, while male athletes who show dedication, constraint, and knowledge in a plant-based diet are viewed positively. As role models for diet and masculinity, this has implications for a potential role of athletes in a societal transition towards lower consumption of animal products.

The VegPlate for Sports: A Plant-Based Food Guide for Athletes

Background: Nutrition strategies improve physiological and biochemical adaptation to training, facilitate more intense workouts, promote faster recoveries after a workout in anticipation of the next, and help to prepare for a race and maintain the body’s hydration status. Although vegetarianism (i.e., lacto-ovo and veganism) has become increasingly popular in recent years, the number of vegetarian athletes is not known, and no specific recommendations have been made for vegetarian dietary planning in sports. Well-planned diets are mandatory to obtain the best performance, and the available literature reports that those excluding all types of flesh foods (meat, poultry, game, and seafood) neither find advantages nor suffer from disadvantages, compared to omnivorous diets, for strength, anaerobic, or aerobic exercise performance; additionally, some benefits can be derived for general health. Methods: We conceived the VegPlate for Sports, a vegetarian food guide (VFG) based on the already-validated VegPlate facilitating method, designed according to the Italian dietary reference intakes (DRIs). Results: The VegPlate for Sports is suitable for men and women who are active in sports and adhere to a vegetarian (i.e., lacto-ovo and vegan) diet, and provides weight-based, adequate dietary planning. Conclusions: The VegPlate for Sports represents a practical tool for nutrition professionals and gives the possibility to plan diets based on energy, carbohydrate (CHO), and protein (PRO) necessities, from 50 to 90 Kg body weight (BW).

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.

Effectiveness of current protein recommendations in adolescent athletes on a low-carbon diet

Adolescent athletes require adequate energy and nutrient supply to support growth, development, and the demands associated with exercise and training. However, they are susceptible to nutritional inadequacies affecting their health and physical performance. Food choices with nutrient adequacy and environmental protection is crucial for a sustainable diet. Therefore, we aimed to assess the adequacy of low-carbon diets to meet the protein requirements of adolescent athletes. Therefore, a cross-sectional observational study was conducted with 91 adolescent athletes from sports clubs in Rio de Janeiro who underwent anthropometric and food consumption assessments. To estimate the environmental impact of anthropogenic activities, the sustainability indicators carbon footprint (CF) and water footprint (WF) were used. The CF of the athlete's diet was compared with the benchmark of 1,571 g CO2eq/cap/d estimated by the World Wildlife Fund (WWF). Protein recommendations according to the American Dietetic Association (ADA) for athletes and protein food groups according to the low-carbon EAT-Lancet reference diet were used as references. The results were stratified by sport modality, age, sex, and income range. The Mann-Whitney test was performed, followed by the Kruskal-Wallis test with Dunn's post-hoc test to assess the differences between groups using the statistical program GraphPad PRISM® version 8.0. CF and WF were directly associated with total energy intake, total protein intake, animal-origin protein intake, and the food groups of meat and eggs. Significant differences were observed in the environmental impact of diet based on sports groups and gender. The athletes' profile with higher environmental impact was male, middle-income class, and of any age group. The quartiles of CF of the overall diets were above the 1,571 g CO2eq/cap/d benchmark. Additionally, ADA's recommended range of daily protein consumption was met by most athletes, even in the lowest quartile of CF. Thus, a diet with a lower environmental impact can meet protein recommendations in adolescent athletes. The results found are of interest to the sports and food industries. It could help in designing a balanced diet for athletes as well as ensure less negative environmental impacts of food production and consumption.

The association and mediation role of Food and Nutrition Literacy (FNLIT) with eating behaviors, academic achievement and overweight in 10-12 years old students: a structural equation modeling

Background

Food and nutrition literacy is a key factor in shaping healthy dietary behaviors and may result in decreasing decrease the prevalence of overweight. Empirical research on food and nutrition literacy and its outcomes is limited, especially among children and adolescents. Thus, this study investigates the link between Food and Nutrition Literacy (FNLIT) with eating behaviors, academic performance, and overweight in 10–12 years old students in Tehran, Iran.

Methods

This study was performed through two phases: 1) Proposing a conceptual model of the relationship between FNLIT and its determinants and outcomes, based on the existing evidence and previous models, and 2) Testing the proposed FNLIT model through a cross-sectional study on 803 primary school students (419 boys and 384 girls, from 34 public and 10 private primary schools), aged 10–12 years using structural equation modeling. Demographic, socio-economic, and household food security characteristics were collected by interviewing the students and their mothers/caregivers using a questionnaire. FNLIT was measured by a self-administered, locally designed, and validated questionnaire.

Results

The fit indices suggested a reasonably adequate fit of the data to the hypothesized model (χ²/df = 2.03, p < 0.001, goodness of fit index (GFI) = 0.90, adjusted goodness of fit index (AGFI) = 0.88, comparative fit index (CFI) = 0.91, incremental fit index (IFI) = 0.91, root mean square error of approximation (RMSEA) = 0.04, standardized root mean residual (SRMR) = 0.06). SES was directly and positively related to FNLIT and its subscale in students. FNLIT score had a positive direct (non-mediated) relationship with healthy eating behavior and academic performance. This pattern was strongly reversed in unhealthy eating behavior. There was a full mediation relationship between FNLIT and overweight/obesity via healthy eating behaviors. SES predicted academic performance partially through the mediating effect of Food Label Literacy (FLL). The results indicated that despite the direct relationship between SES and academic performance, an indirect but negative relationship existed with food insecurity.

The finding also revealed the fully mediating role of Food Choice Literacy (FCL) in the relationship between demographic factors and healthy eating behaviors. Our study also found that Interactive Food and Nutrition Literacy (IFNL) protected unhealthy eating behaviors, and FCL predicted healthy eating behaviors in children.

Conclusion

Our study draws attention to FNLIT, especially the skills domain, including IFNL, FCL, and FLL, as the most important determinant of healthy eating behavior, academic performance, and weight status in school-age children reduces social inequalities in children’s development.

To ensure an adequate level of FNLIT, educators should assess and plan to enhance food literacy skills in children and adolescents.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-022-00796-8.

Is high adaptation to the Mediterranean diet effective in increasing ecological footprint awareness? A cross-sectional study from Turkey

BACKGROUND

The effect of diet type on sustainable environment is known. It is important to understand the adaptation of individuals with high ecological footprint awareness to the Mediterranean type diet, especially under the assumption that the Mediterranean diet will reduce the ecological footprint. In the study, it is aimed to examine the relationship between the level of adherence to the Mediterranean diet and Ecological Footprint awareness of adults.

RESULTS

The sample of the study consisted of 395 individuals with a mean age of 26.2 ± 8.7 years: 293 females (74.2%) and 102 males (25.8%). As the Mediterranean Diet Adherence Scale (MDAS) score of individuals increased, the Ecological Footprint Awareness Scale score also increased. Similarly, a positive correlation was found between the participants' MDAS score and the awareness of food (r = 0.157; P = 0.002), energy (r = 0.133; P = 0.008), waste (r = 0.149; P = 0.003) and water consumption (r = 0.101; P = 0.045), which are sub-factors of the Ecological Footprint Awareness Scale.

CONCLUSION

As far as is known, this cross-sectional study is one of the first studies on compliance with the Mediterranean diet and awareness of the ecological footprint. The findings of the study show that as individuals' compliance with the Mediterranean diet increases, their awareness of their ecological footprint will also increase. To reach a conclusion on this issue, future studies should evaluate the relationship between adherence to the Mediterranean diet and awareness of food-environmental impact on different samples. © 2021 Society of Chemical Industry.

Sports Nutrition: Diets, Selection Factors, Recommendations

An athlete’s diet is influenced by external and internal factors that can reduce or exacerbate exercise-induced food intolerance/allergy symptoms. This review highlights many factors that influence food choices. However, it is important to remember that these food choices are dynamic, and their effectiveness varies with the time, location, and environmental factors in which the athlete chooses the food. Therefore, before training and competition, athletes should follow the recommendations of physicians and nutritionists. It is important to study and understand the nutritional strategies and trends that athletes use before and during training or competitions. This will identify future clinical trials that can be conducted to identify specific foods that athletes can consume to minimize negative symptoms associated with their consumption and optimize training outcomes.

Food pedagogy-key elements for urban health and sustainability: A scoping review

Food-related issues are on the rise in urban areas around the world. Issues include unhealthy food habits and eating practices, disconnection from food and culture, social isolation and environmental unsustainability. There has been increasing consideration of pedagogical approaches, or food pedagogies, to address these challenges. This paper aims to identify the key elements and influences over food-related activities within food pedagogies that strive to improve urban health and sustainability. A scoping literature review was conducted using five electronic databases. Of the 271 abstracts identified, thirty-five articles met the inclusion criteria. The review identified four key elements: 'Everyday food experiences', 'Social relations', 'Culture', and 'Sustainable lifestyles' and two main influences: 'Professionals involved with food-related activities' and 'Spaces of learning/experiencing food-related activities'. The key elements and influences embrace pedagogical and practical attributes of food pedagogies that address the complex food-related issues. However, limited published research examines food pedagogies or attempts to develop an agreed, theoretically informed framework. This review provides understanding of important knowledge and practical implications of food pedagogies for multiple stakeholders involved in food-related activities, useful to the development of food education programs and food policies or initiatives for societal health and sustainability in urban areas.

Development of a New Tool for Managing Performance Nutrition: The Athlete Food Choice Questionnaire

This study aimed to develop and refine an Athlete Food Choice Questionnaire (AFCQ) to determine the key factors influencing food choice in an international cohort of athletes. A questionnaire that contained 84 items on a 5-point frequency scale was developed for this study. Athletes at the 2017 Universiade, in Taiwan, were invited to participate. Principal component analysis was utilized to identify key factors and to refine the questionnaire. Completed questionnaires were received from 156 athletes from 31 countries and 17 sports. The principal component analysis extracted 36 items organized into nine factors explaining 68.0% of variation. The nine factors were as follows: nutritional attributes of the food, emotional influences, food and health awareness, influence of others, usual eating practices, weight control, food values and beliefs, sensory appeal, and performance. The overall Kaiser-Meyer-Olkin measure was 0.75, the Bartlett test of sphericity was statistically significant, χ2(666) =2,536.50, p < .001, and all of the communalities remained >0.5. Intercorrelations were detected between performance and both nutritional attributes of the food and weight control. The price of food, convenience, and situational influences did not form part of the factorial structure. This research resulted in an AFCQ that includes factors specific to athletic performance and the sporting environment. The AFCQ will enable researchers and sports dietitians to better tailor nutrition education and dietary interventions to suit the individual or team. The next phase will test the accuracy and reliability of the AFCQ both during and outside of competition. The AFCQ is a useful tool to assist with management of performance nutrition for athletes.

The New Challenge of Sports Nutrition: Accepting Insect Food as Dietary Supplements in Professional Athletes

BACKGROUND

The dietary supplements market is growing, and their use is increasing among professional athletes. Recently, several new protein supplements have been placed in the marketplace, including energy bars enriched with insect flour. Edible insects, which are rich in protein content, have been promoted as the food of the future and athletes could be a reference sample for their continued emphasis on higher protein demand. The present study investigated the potential motivations to accept an energy protein bar with cricket flour, among a group of selected Italian professional athletes. A second aim was also to measure how an information treatment about the benefits of edible insects would have impact on acceptance.

METHODS

61 Italian professional athletes (27 females) completed a structured questionnaire regarding supplements and eating habits, food neophobia, nutrition knowledge, willingness to taste edible insects and the associated factors. A question about sports endorsement was also posed at the end of the survey.

RESULTS

all subjects consumed supplements, generally recommended by medical personnel, even though their general knowledge of nutrition was poor (47.8%). Our main results shown that on a seven-point Likert scale, the protein content (5.74 ± 1.01) and the curiosity about texture (5.24 ± 0.98) were the main drivers to taste the cricket energy bar; whereas the feeling of disgust (5.58 ± 1.08) justified the rejection of tasting insects. In addition, the level of food neophobia increases with age (p < 0.05) and reduces willingness to endorse the cricket bar (p < 0.05). Male athletes (4.47 ± 1.69) were more likely to endorse the product than females (3.3 ± 1.49). An increase in willingness to taste was observed after the information treatment (z = 4.16, p < 0.001). Even though the population under investigation is unique, it is important to mention that this study involves a relatively small and convenience sample, and therefore generalizability of the results should be done with caution.

Sprint Interval Exercise Performance in Vegans

OBJECTIVE

The impact of a vegan diet on sprint interval exercise performance is unknown. Thus, the purpose of the present study was to compare performance during a sprint interval exercise between omnivores and vegans.

METHODS

Nine healthy omnivores (4 men and 5 women) and nine healthy vegans (4 men and 5 women), with similar levels of daily physical activity, performed four bouts (5-min rest between bouts) of a 30-s all-out sprint exercise on a cycle ergometer. Peak power, mean power, fatigue index, and time to reach maximal power output in each bout were recorded.

RESULTS

There was a higher peak power in bouts 1 and 2 compared with bouts 3 and 4 (p < 0.02), and a higher mean power in bout 1 compared with bouts 2, 3 and 4 (p < 0.02). However, for all bouts, there were no significant difference between omnivores and vegans in peak power (7.60 ± 1.55 vs. 8.16 ± 1.27, 7.52 ± 1.6 vs 7.61 ± 0.73, 7.00 ± 1.44 vs. 7.00 ± 1.05 and 6.95 ± 1.42 vs. 6.49 ± 0.90 W.kg^-1, all p > 0.05) and in mean power (5.35 ± 0.93 vs. 5.69 ± 0.84, 5.10 ± 0.88 vs. 5.21 ± 0.49, 4.79 ± 0.81 vs. 4.79 ± 0.45 and 4.81 ± 0.81 vs. 4.69 ± 0.47 W.kg^-1, all p > 0.05). Fatigue index and time to reach maximal power output were not affected by diet or bouts (all p > 0.05).

CONCLUSIONS

These findings indicate that a vegan diet does not compromise sprint interval exercise performance.

Food Next Door: From Food Literacy to Citizenship on a College Campus

Industrial agriculture and food corporations have produced an abundance of food that is highly processed, nutritionally poor, and environmentally burdensome. As part of a healthy campus initiative, generated to address these and other food production and consumption dilemmas, a student-run “local and sustainable” food establishment called Food Next Door (FND) was created. This intrinsic case study evaluated food literacy in health science students, faculty, and staff first as a pilot to build the case for FND and further explicated customers’, volunteers’, and leads’ experiences with FND, identifying potential pathways from food literacy to citizenship. Ten returning customers, eight recurring nutrition student volunteers, and three graduate student leads participated in interviews that were analyzed for themes and subthemes. The findings show a progression in themes. Customers’ experiences highlight FND’s fresh, flavorful food, smiling and supportive staff, and personal transformation. Volunteers’ themes identified greater awareness of new foods and plant-based eating, acquiring new knowledge and skills in commercial kitchens, and deepening their connection to food, each other, and to where food comes from. Leads’ themes show opportunities to gain managerial skills, a deeper understanding of food and skills from being immersed in value-based food systems, and confidence in peer teaching. Experiencing and becoming part of the food value chain through FND built food literacy, shifted values, and transformed students into food citizens.

Case Study: Transition to a Vegan Diet in an Elite Male Gaelic Football Player

Vegan diets are increasingly of interest to athletes, but require a well-planned approach in order to mitigate the risk of potential adverse effects on nutrient intakes, and consequently performance. This case study reports the process of an elite male Gaelic football player (age 25 years; height, 1.88 m; body mass, 87.8 kg; lean body mass, 73.26 kg; body fat, 11.3%) transitioning from an omnivorous diet to a vegan diet at the beginning of a competitive season. The report encompasses key considerations in the planning and provision of nutrition support in this context, in addition to iterations needed based on challenges presented by the athlete. Analysis of nutrient intake (Nutritics Dietary Analysis Software), body composition (dual X-ray absorptiometry; Lunar iDXA, GE Healthcare), and running performance during match-play (global positioning system-based tracking; STATSports Apex) each indicated that with adequate knowledge and education, and appropriate planning, commitment and iterative feedback, the athlete was able to meet nutrition targets on a vegan diet without compromising key performance indicators compared to the omnivorous diet of the previous season. We anticipate that this case study will assist practitioners to recognize the key considerations to address when working with athletes transitioning to a vegan diet.

Knowledge and Perceptions of Plant-Based Diets among Competitive and Recreational Athletes

Little is known about athletes' perceptions of emerging dietary guidance on plant-based diets (PBD). To explore knowledge and perceptions of PBD among competitive and recreational athletes, an online survey was developed, pilot tested, and sent via email to athletes recruited from 2 Canadian post-secondary institutions. Survey questions explored athletes' understanding and views of the proposed Canadian dietary guidelines emphasizing plant-based proteins. Data were analyzed using grounded theory approaches. Forty-eight athletes participated in the survey. Two major themes emerged: (i) athletes had mixed perceptions of plant-based eating (PBE) and (ii) athletes associated PBE with broader food system concerns. Athletes have the potential to be important advocates of healthy and sustainable eating among peer groups and the general public. For effective promotion of PBE, the unique nutrient requirements and performance goals of athletes should be considered. Messaging to encourage a flexible rather than strict view of PBD may be a more feasible and acceptable approach when working with athletes.

Analysis of Association between the Consumer Food Quality Perception and Acceptance of Enhanced Meat Products and Novel Packaging in a Population-Based Sample of Polish Consumers

The consumer acceptance of novel enhanced-quality products and their willingness to buy such products may be a crucial topic in the field of marketing. The aim of this study was to analyze the association between consumers’ perceptions of food quality and their acceptance of enhanced meat products and novel packaging. The study was conducted using the Computer-Assisted Personal Interview (CAPI) method in a random group of 1009 respondents, who were recruited as a representative sample based on data from the Polish National Identification Number database. The participants were asked about the most important quality determinants of food products of animal origin and about quality improvement methods and their acceptance of those methods. The quality determinants of animal-based food products were indicated as follows: origin, production technology, manufacturer, components and nutritional value, visual and sensory characteristics, expiry date, and cost. The quality improvement methods were clustered into groups that were associated with product enhancement and application of novel packaging, and the acceptance of those methods was also verified. Indicating specific quality determinants of animal-derived food products affects the consumer acceptance of product enhancement (p = 0.0264) and novel packaging as quality improvement methods (p = 0.0314). The understanding that enhancement is applied for the purpose of quality improvement did not influence the acceptance of products (p = 0.1582), whereas the knowledge that novel packaging is applied influenced the acceptance (p = 0.0044). The obtained results suggested that in the case of application of novel packaging, a higher level of knowledge may be a reason for consumer’s rejection of the resulting products, but the appearance and taste of products may contribute to the higher acceptance of novel packaging. Educating consumers may improve their acceptance of product enhancement, as concerns about the addition of food preservatives may lead them to reject enhanced products.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

The Environmental Impact of the Athlete's Plate Nutrition Education Tool

Periodized nutrition is necessary to optimize training and enhance performance through the season. The Athlete's Plate (AP) is a nutrition education tool developed to teach athletes how to design their plates depending on training load (e.g., volume × intensity), from easy (E), moderate (M) to hard (H). The AP was validated, confirming its recommendations according to international sports nutrition guidelines. However, the AP had significantly higher protein content than recommended (up to 2.9 ± 0.5 g·kg^-1·d^-1; p < 0.001 for H male). The aim of this study was to quantify the environmental impact (EnvI) of the AP and to evaluate the influence of meal type, training load, sex and registered dietitian (RD). The nutritional contents of 216 APs created by 12 sport RDs were evaluated using Computrition Software (Hospitality Suite, v. 18.1, Chatsworth, CA, USA). The EnvI of the AP was analyzed by life cycle assessment (LCA) expressed by the total amount of food on the AP, kg, and kcal, according to the Swiss Agricultural Life Cycle Assessment (SALCA) methodology. Higher EnvI is directly associated with higher training load when the total amount of food on the plate is considered for E (5.7 ± 2.9 kg CO₂ eq/day); M (6.4 ± 1.5 kg CO₂ eq/day); and H (8.0 ± 2.1 kg CO₂ eq/day). Global warming potential, exergy and eutrophication are driven by animal protein and mainly beef, while ecotoxicity is influenced by vegetable content on the AP. The EnvI is influenced by the amount of food, training load and sex. This study is the first to report the degree of EnvI in sports nutrition. These results not only raise the need for sustainability education in sports nutrition in general, but also the urgency to modify the AP nutrition education tool to ensure sports nutrition recommendations are met, while not compromising the environment.

Bioavailable Methionine Assessed Using the Indicator Amino Acid Oxidation Method Is Greater When Cooked Chickpeas and Steamed Rice Are Combined in Healthy Young Men

BACKGROUND

In general, pulse protein is limiting in the indispensable amino acid methionine, and antinutritional factors in pulses can affect methionine bioavailability. Complementation with grains such as rice can improve pulse protein quality, but knowledge of methionine bioavailability in pulses and grains is necessary to correct for available methionine when planning and assessing dietary protein intake.

OBJECTIVES

The study objectives were to determine the bioavailability of methionine in rice and chickpeas separately and to assess the effect of complementation of chickpeas and rice.

METHODS

Eleven healthy young men (<30 y, BMI <25 kg/m2) were studied in a repeated-measures design using the indicator amino acid oxidation (IAAO) method, with l-[1-13C]phenylalanine as the indicator. Each received 7 or 10 methionine intakes in random order: 4 intakes of l-methionine-0.5, 1, 2, and 3 mg⋅kg-1⋅d-1 (reference diet); 3 intakes of methionine from rice and from chickpeas; and 3 intakes from the mixed meal of chickpeas plus rice (test diets). The bioavailability of methionine and the effect of complementation were assessed by comparing the IAAO response to varying intakes of methionine in rice, in cooked Canadian chickpeas, and in rice plus chickpeas combined compared with the IAAO response to l-methionine intakes in the reference protein (crystalline amino acid mixture patterned after egg protein) using the slope ratio method.

RESULTS

The bioavailability of methionine from rice and from chickpeas was 100% and 63%, respectively. Complementation of cooked chickpeas with rice decreased the oxidation of l-[1-13C]phenylalanine by up to 14% (P < 0.05), suggesting an improved protein quality of the combined chickpeas plus rice protein.

CONCLUSIONS

When chickpeas are the main protein source in the diet of young adult men, the combination of rice and chickpeas in a 3:1 ratio is recommended to improve dietary protein quality. This trial was registered at clinicaltrials.gov as NCT03339154 and NCT03674736.

No Significant Differences in Muscle Growth and Strength Development When Consuming Soy and Whey Protein Supplements Matched for Leucine Following a 12 Week Resistance Training Program in Men and Women: A Randomized Trial

There are conflicting reports regarding the efficacy of plant versus animal-derived protein to support muscle and strength development with resistance training. The purpose of this study was to determine whether soy and whey protein supplements matched for leucine would comparably support strength increases and muscle growth following 12 weeks of resistance training. Sixty-one untrained young men (n = 19) and women (n = 42) (18–35 year) enrolled in this study, and 48 completed the trial (17 men, 31 women). All participants engaged in supervised resistance training 3×/week and consumed 19 grams of whey protein isolate or 26 grams of soy protein isolate, both containing 2 g (grams) of leucine. Multi-level modeling indicated that total body mass (0.68 kg; 95% CI: 0.08, 1.29 kg; p < 0.001), lean body mass (1.54 kg; 95% CI: 0.94, 2.15 kg; p < 0.001), and peak torque of leg extensors (40.27 Nm; 95% CI: 28.98, 51.57 Nm, p < 0.001) and flexors (20.44 Nm; 95% CI: 12.10, 28.79 Nm; p < 0.001) increased in both groups. Vastus lateralis muscle thickness tended to increase, but this did not reach statistical significance (0.12 cm; 95% CI: −0.01, 0.26 cm; p = 0.08). No differences between groups were observed (p > 0.05). These data indicate that increases in lean mass and strength in untrained participants are comparable when strength training and supplementing with soy or whey matched for leucine.

Towards the Implementation of a Conceptual Framework of Food and Nutrition Literacy: Providing Healthy Eating for the Population

Existing definitions of food literacy (FL) and nutrition literacy (NL) in particular refer to individual knowledge, motivation, competences, and awareness, which determine the relationship between individuals and food, the food system, and nutrition information. Several authors proposed specific conceptualization of the terms. Nevertheless, the description of analogies and differences between FL and NL is still lacking, as is an integrated framework which highlights the meaning of the concepts. This work aims to describe and discuss evidence provided by the literature in order to develop and propose a comprehensive conceptualization of FL and NL to the scientific community. We systematically reviewed six databases, considering the search terms of FL and NL. We collected the antecedents, components, and consequences of both FL and NL. We underlined and traced similarities of the concepts as well as prerogative features through the content analysis of definitions. We obtained 14 definitions of NL and 12 definitions of FL; 42 papers presented antecedents and 53 papers contained consequences. We observed that NL could be considered a specific form of FL. In addition, we noted that the consequences of NL are included in the subset of the consequences of FL and the conceptual limits of FL correspond to the outcome of healthful diet. We conclude that FL and NL build a multifaceted concept which implies both individual and public perspectives. We propose a conceptualization which could be useful to develop an executive framework aimed at providing healthy eating for the population.

Dietary Practices Adopted by Track-and-Field Athletes: Gluten-Free, Low FODMAP, Vegetarian, and Fasting

Some track-and-field athletes implement special diets aiming to improve health and/or performance. An evidence-based approach to any diet is recommended to minimize the risks associated with unnecessary dietary restriction, which may potentially do more harm than good. Four prevalent diets are reviewed in this study: (a) gluten-free; (b) low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP); (c) vegetarian; and (d) fasting diets. Recently, gluten-free diets and low FODMAP diets have emerged as novel regimes thought to improve gastrointestinal health and reduce the risk of exercise-associated gastrointestinal symptoms. No direct beneficial outcomes have been associated with avoiding gluten for clinically healthy athletes. Indirectly, a gluten-free diet is associated with other dietary changes, particularly FODMAP reduction, which may improve adverse gastrointestinal symptoms. Vegetarian diets can optimally support athletic demands. However, attention is required to ensure adequate energy and intake of specific nutrients that are less abundant or less well absorbed from plant sources. Finally, fasting is a long-standing concept that is undertaken on a voluntary and obligatory basis. Despite limited supporting research, voluntary fasting is a popular alternative to conventional diets perceptually offering health and body composition benefits. Strict obligatory fasting guidelines likely require the implementation of tailored nutrition strategies to help athletes cope with athletic demands. Overall, a multitude of factors influence adherence to special diets. Even when adherence to a special diet is a necessity, education and advice from an accredited dietitian/nutritionist are recommended for track-and-field athletes to optimize nutrition for health and performance.

Food packaging cues as vehicles of healthy information: Visions of millennials (early adults and adolescents)

Because packaging has become an important marketing tool, firms must know what type of packaging can affect consumers' packaging cues. Also, still today there is little attention paid to the relevance of educating millennials about the importance of a healthier lifestyle and eating. The aim is to analyse the effects of young consumers with varying degrees of healthy lifestyles and food involvement on packaging cues. Also, the paper analyses differences between early adults and adolescents millennials. Using a sample of 890 millennials (300 early adults and 590 adolescents) and SEM methodology, interesting results are reached. Some healthy habits affect food involvement, and this is related to informative packaging cues. Some differences among both groups of millennials are found. The results/ findings would be valuable for the marketers and administration in the food industry to formulate marketing packaging strategies and to promote a healthier lifestyle and food consumption among millennials.

Dialysis or a Plant-Based Diet in Advanced CKD in Pregnancy? A Case Report and Critical Appraisal of the Literature

Pregnancy is increasingly reported in chronic kidney disease (CKD), reflecting higher awareness, improvements in materno-foetal care, and a more flexible attitude towards “allowing” pregnancy in the advanced stages of CKD. Success is not devoid of problems and an important grey area regards the indications for starting dialysis (by urea level, clinical picture, and residual glomerular filtration rate) and for dietary management. The present case may highlight the role of plant-based diets in dietary management in pregnant CKD women, aimed at retarding dialysis needs. The case. A 28-year-old woman, affected by glomerulocystic disease and unilateral renal agenesis, in stage-4 CKD, was referred at the 6th week of amenorrhea: she weighed 40 kg (BMI 16.3), was normotensive, had no sign of oedema, her serum creatinine was 2.73 mg/dL, blood urea nitrogen (BUN) 35 mg/dL, and proteinuria 200 mg/24 h. She had been on a moderately protein-restricted diet (about 0.8 g/kg/real body weight, 0.6 per ideal body weight) since childhood. Low-dose acetylsalicylate was added, and a first attempt to switch to a protein-restricted supplemented plant-based diet was made and soon stopped, as she did not tolerate ketoacid and aminoacid supplementation. At 22 weeks of pregnancy, creatinine was increased (3.17 mg/dL, BUN 42 mg/dL), dietary management was re-discussed and a plant-based non-supplemented diet was started. The diet was associated with a rapid decrease in serum urea and creatinine; this favourable effect was maintained up to the 33rd gestational week when a new rise in urea and creatinine was observed, together with signs of cholestasis. After induction, at 33 weeks + 6 days, she delivered a healthy female baby, adequate for gestational age (39th centile). Urea levels decreased after delivery, but increased again when the mother resumed her usual mixed-protein diet. At the child’s most recent follow-up visit (age 4 months), development was normal, with normal weight and height (50th–75th centile). In summary, the present case confirms that a moderate protein-restricted diet can be prescribed in pregnancies in advanced CKD without negatively influencing foetal growth, supporting the importance of choosing a plant-based protein source, and suggests focusing on the diet’s effects on microcirculation to explain these favourable results.

Searching for a Measure Integrating Sustainable and Healthy Eating Behaviors

Sustainable and healthy food-related behavior is high on the public policy and research agenda due to its potential to cope with negative environmental and health outcomes. There are several measures related to sustainability in food choices but there have not been many attempts to integrate sustainable and healthy eating (SHE) behaviors into one measurement instrument so far. Therefore, the main aim of this study was to identify how young adults interpret the SHE concept and to develop an instrument that measures a self-reported consumer's SHE behavior. The process of scale development involved an exploratory qualitative study and two quantitative studies. As a result of 20 individual in depth interviews with Polish young adults, 50 items were generated reflecting their perspective on principles of SHE (Study 1). Two samples were used in the scale validation process: n = 217 (Study 2) and n = 220 (Study 3). Via principal component analysis, reliability analysis, and confirmatory factor analysis, the final form of the scale was derived. The proposed 34-item scale offers insights into the most relevant aspects of SHE behaviors, grouped in eight factors: "healthy and balanced diet", "certification and quality labels", "meat reduction", "selection of local food", "choice of low fat food products", "avoidance of food waste" and purchase and consumption of food products that are respecting "animal welfare" and finally choice of "seasonal food". Although the developed scale can benefit from further refinement and validity testing in different cultural and social background, it is clear that the scale, as developed, can be a useful tool for researchers who are interested in the study of SHE behaviors.

Plant-Based Diets: Considerations for Environmental Impact, Protein Quality, and Exercise Performance

Plant-based diets provide well-established physical and environmental health benefits. These benefits stem in part from the degree of restriction of animal-derived foods. Historically, meat and other animal-derived proteins have been viewed as an integral component of athletes' diets, leading some to question the adequacy of vegetarian or vegan diets for supporting athletic performance. The purpose of this review is to examine the impact of plant-based diets on human physical health, environmental sustainability, and exercise performance capacity. Based on currently available literature, it is unlikely that plant-based diets provide advantages, but do not suffer from disadvantages, compared to omnivorous diets for strength, anaerobic, or aerobic exercise performance. However, plant-based diets typically reduce the risk of developing numerous chronic diseases over the lifespan and require fewer natural resources for production compared to meat-containing diets. As such, plant-based diets appear to be viable options for adequately supporting athletic performance while concurrently contributing to overall physical and environmental health. Given the sparse literature comparing omnivore, vegetarian, and vegan athletes, particularly at the elite level, further research is warranted to ascertain differences that might appear at the highest levels of training and athletic performance.

Education, practical training and professional development for public health practitioners: a scoping review of the literature and insights for sustainable food system capacity-building

OBJECTIVE

Noting the upstream positioning of sustainable food systems (SFS) to multiple global crises, the present review described examples of emerging and promising practices to support SFS-oriented education, practical training (PT) and continuing professional development (CPD) among trainees and public health practitioners (PHP). A secondary objective was to compile the evidence into practical considerations for educators, supervising practitioners and professional associations.

DESIGN

A scoping review of the literature published between 2007 and 2017 was conducted in May 2017 using four databases: CINAHL, MEDLINE, Scopus and HSSA, along with bibliography hand-searching and expert consultation. Articles were screened for relevance and specificity by independent raters.

RESULTS

Nineteen articles were included for analysis. Two-thirds of the articles related to dietitians and public health nutritionists. Emerging practices included curriculum-based considerations, incorporation of 'sustainability' within professional competencies and self-reflection related to SFS. Descriptions of SFS-related education, PT and CPD practices appeared largely in the literature from developed countries. Articles converged on the need for ecosystems, food systems and sustainability considerations within and across practice to support current and future practitioners.

CONCLUSIONS

There is growing interest in SFS but guidance to support educators and preceptors is lacking. Updates to dietary guidelines to reflect issues of sustainability are a timely prompt to examine the education, training and development needs of trainees and PHP. Practical examples of emerging practices can empower PHP to promote SFS in all areas of practice. More research is needed to address identified gaps in the literature and to improve SFS-specific education, PT and CPD.