Systematic Evaluation of Nutrition Indicators for Use within Food LCA Studies

Validating nutrient selection for product-group-specific nutrient indices for use as functional units in life cycle assessment of foods

The ability to provide adequate nutrition is considered a key factor in evaluating the sustainability of foods and diets. Nutrient indices are used as functional units (FU) in life cycle assessment of foods to include nutritional performance in the environmental assessment of a product. Several general and food-group-specific nutrient indices exist but many lack validation, particularly when used as FU. In addition, the nutrient selection strategies and reference units for nutrient intake can vary considerably among studies. To validate intake-based product-group-specific nutrient indices previously developed for protein (NR-FIprot) and carbohydrate (NR-FIcarb) foods and for fruits and vegetables (NR-FIveg), we applied principal component analysis to investigate correlations between nutrients in foods and dishes representing a typical Finnish diet. The reference amounts for meal components were based on a plate model that reflected Finnish dietary recommendations. The portion sizes for the different food groups were anchored at 100 g, 135 g and 350 g for proteins, carbohydrates and fruits/vegetables, respectively. Statistical modelling largely validated the NR-FI indices, highlighting protein foods as sources of niacin, vitamin B12 and Se, carbohydrate foods as sources of Mg, Fe and phosphorous, and fruits/vegetables as sources of potassium, vitamin K, vitamin C, fibre and thiamine. However, in contrast to the intake-based approach applied in NR-FIprot, the dietary recommendation-based validation process suggested that fruits and vegetables should be favoured as sources of riboflavin and vitamin B6.

Review of Diet Quality Indices that can be Applied to the Environmental Assessment of Foods and Diets

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.

Evidencing the importance of the functional unit in comparative life cycle assessment of organic berry crops

LCA methodology provides the best framework to evaluate environmental impacts in agriculture systems. However, the interpretation of LCA results, in particular when the objective was to compare different production systems, could be affected by the selection of the functional unit (FU). That is why an accurate definition of the FU, in agreement with the function considered for the systems analysed, is essential. In this work, the organic production at small scale of blueberry, raspberry, blackberry and cape gooseberry in North Spain has been analysed following LCA methodology. Although a different distribution of environmental loads was obtained for each crop, in all cases, the main contributions to most of the considered environmental categories were electric and fertiliser consumptions. The different production systems have been compared on the basis of the environmental impacts associated considering different FUs, i.e. based on fruit mass, cultivated area, farm-gate price and nutritional quality of fruits. Carbon footprints (CF) have been also calculated. It was observed that the order of the crops with respect to their environmental performances was the same for the blueberry and raspberry crops (with the lowest and the highest CF, respectively), independently of the selected FU, whereas the order of the blackberry and cape gooseberry crops was interchanged, depending on the FU used. This work supports the need of being aware of the final objective of the orchards when choosing the FU (i.e. producing fruits, cultivating an area, economic benefits or nourishing people), so that valid conclusions can be achieved from the environmental comparison, even for different agricultural products.

Nutritional intake and determinants of nutritional quality changes from pregnancy to postpartum-a longitudinal study

Nutrient requirements vary across the reproductive cycle, but research on changes in nutritional intake and quality from pregnancy to beyond the lactation period is limited. Thus, we aimed to study nutritional intake and quality changes, among Swedish pregnant participants from late pregnancy to 18 months postpartum and to study the determinants of nutritional quality changes. Participants (n = 72) were studied longitudinally from the third trimester of pregnancy and postpartum (2 weeks 4, 12, and 18 months postpartum). At each visit, participant characteristics and 4-day food diaries were collected. Nutritional quality was assessed by energy adjusted Nutrient Rich Food Index 11.3. Linear mixed models were used to analyze the determinants of change in nutritional quality. Intakes of carbohydrate energy percentage (E%), fiber, vitamin A, vitamin C, and potassium were higher in the third trimester compared to postpartum, whereas intakes of E% protein and monounsaturated fat were lower. Adherence to recommended intakes was low at all study visits for saturated fat (4%-11%), fiber (15%-39%), vitamin D (8%-14%), folate (0%-2%), and iron (6%-21%). Overall, nutritional quality did not differ significantly from third trimester to postpartum. Shorter duration (<4 months) of lactation was negatively related to nutritional quality changes, whereas higher age was positively related to changes. In conclusion, nutritional intake from pregnancy to postpartum changed, whereas quality remained relatively stable, with age and lactation duration as determinants. Identification of people at risk of adverse dietary changes from pregnancy to the postpartum period should be further addressed in future larger and more diverse study populations.

Global Food Security and Sustainability Issues: The Road to 2030 from Nutrition and Sustainable Healthy Diets to Food Systems Change

The accomplishment of food/nutrition security for all across sustainable food systems (SFS) is tied to the Sustainable Development Goals (SDGs). SFS is connected to all SDGs via the traditional framework of social inclusion, economic development, environmental safety, inclusivity, and the development of sustainable food systems. We suggest that, for the world to achieve sustainable development, a shift to SFS is necessary to guarantee food/nutrition security for all, while operating within planetary boundaries to protect ecosystems and adapt to and mitigate climate change. Therefore, there is a requirement for original approaches that implement systemic and more participatory methods to engage with a wider range of food system stakeholders. However, the lack of skills and tools regarding novel methodologies for food system transformation is a key obstacle to the deployment of such approaches in practice. In the first part of this review, a summary of some challenges that occur in the governance of food system transformation is given. Through a case study of plant-based proteins and their biological and chemical modification as diets shift towards alternative proteins, we demonstrate that resource-efficient food systems and food waste, through system transformation, are useful in understanding both (i) how food system transformation has ensued and (ii) how the required transformation is prohibited. Finally, we discuss the implications of food system transformation in terms of nutrition and sustainable healthy diets, which are needed to achieve changes in food safety systems in the future. The linkage of food and the environment is evident, focusing on nutrition and sustainable healthy diets. This cannot be accomplished without system change and research towards new foods and, more specifically, new proteins such as plant-based ones and their biological and chemical modification.

Dietary Greenhouse Gas Emissions and Diet Quality in a Cross-Sectional Study of Swedish Adolescents

BACKGROUND

Interventions to improve dietary intake and reduce dietary greenhouse gas emissions (dGHGE) are urgently needed. Adolescence presents a unique time in life to promote sustainable diets. Detailed dietary data are needed to inform public health strategies aiming at improving adolescents' diet quality and reducing dGHGE.

OBJECTIVE

This study aimed to describe dGHGE in Swedish adolescents' diets by socio-demographic characteristics, evaluate how food groups contribute to dGHGE, and examine dGHGE in relation to diet quality.

METHODS

Data come from the national, school-based, cross-sectional dietary survey Riksmaten Adolescents 2016-17 of 3099 females and males attending school grades 5 (11-12 y old), 8 (14-15 y old) and 11 (17-18 y old). Participants completed 2 web-based 24-h recalls and questionnaires on lifestyle factors. dGHGE was estimated based on life cycle assessment data. Diet quality was estimated using NRF11.3 (Nutrient Rich Food Index) and SHEIA15 (Swedish Healthy Eating Index for Adolescents 2015).

RESULTS

dGHGE were higher in males than females (medians 4.2 versus 3.8 kg CO2e/10 MJ, P < 0.001). In females, dGHGE were highest in grade 5 (4.0 kg CO2e/10MJ), whereas in males, emissions were highest in grade 11 (4.4 kg CO2e/10MJ), P < 0.001 for the sex/grade interaction. Overweight/obesity was positively associated with CO2e/10MJ, but parental education, birthplace, and degree of urbanization were not. In females, the proportion of dGHGE from animal-based foods was lowest in grade 11, whereas the proportions from plant-based foods and sweet foods/beverages were highest. In males, these proportions were similar across grades. NRF11.3 was not associated with CO2e/10MJ, whereas healthier eating, according to SHEIA15, was inversely associated with CO2e/10MJ.

CONCLUSIONS

Food choices and dGHGE per calorie differ by sex in adolescents. Thus, intervention strategies to improve dietary sustainability need to be tailored differently to females and males. Diet quality should also be considered when promoting reduced GHGE diets.

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

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

Toward a More Climate-Sustainable Diet: Possible Deleterious Impacts on Health When Diet Quality Is Ignored

BACKGROUND

Nutritional quality, and health and climate impacts are important considerations in the design of sustainable diets.

OBJECTIVES

To investigate the association between diets varying in nutrient density and climate impact and MI and stroke HRs.

METHODS

Dietary data of 41,194 women and 39,141 men (35-65 y) who participated in a Swedish population-based cohort study were employed. Nutrient density was calculated using the Sweden-adapted Nutrient Rich Foods 11.3 index. Dietary climate impact was calculated with data from life cycle assessments, including greenhouse gas emissions from primary production to industry gate. HRs and 95% CIs for MI and stroke were assessed with multivariable Cox proportional hazards regression, comparing a least-desirable diet scenario reference group (lower nutrient density, higher climate impact) with three diet groups that varied with respect to higher/lower nutrient density and higher/lower climate impact.

RESULTS

Median follow-up time from the baseline study visit to MI or stroke diagnosis was 15.7 y for women and 12.8 y for men. The MI hazard was significantly higher for the men with diets of lower nutrient density and lower climate impact (HR: 1.19; 95% CI: 1.06, 1.33; P = 0.004), compared with the reference group. No significant association with MI was observed for any of the diet groups of women. No significant association with stroke was observed among any of the diet groups of women or men.

CONCLUSIONS

The results among men suggest some adverse health effects for men when diet quality is not considered in the pursuit of more climate-sustainable diets. For women, no significant associations were detected. The mechanism underlying this association for men needs further investigation.

Differences in Environmental Impact between Plant-Based Alternatives to Dairy and Dairy Products: A Systematic Literature Review

A large body of research suggests a more plant-based diet, including a switch to plant-based alternatives to dairy, is needed for lowering human-induced climate change as well as land and water use. With the help of a systematic literature review, we analyzed data from 21 peer-reviewed articles about the differences in emissions and resources used between various plant-based alternatives to dairy and dairy products. Emissions included were greenhouse gases, acidifying, eutrophicating, and ozone-depleting substances, and resource use included water, energy, and land. The results are presented as the quotients of the ratios of plant-based alternatives to dairy and dairy products. The comparison shows that the plant-based dairy alternatives have lower, or much lower, impacts in almost all cases, with two exceptions: water use for almond drinks (several studies) and emissions of ozone-depleting substances for margarine (one study). There is a lack of data concerning impacts other than greenhouse gas emissions for plant-based cheese alternatives; and in general, emissions of greenhouse gases are more highly covered than other impacts. In the quest for a swift transition to a low carbon economy, however, there is already enough evidence to proceed with a dietary change involving switching dairy products to plant-based alternatives.

Towards a Water-Energy-Food (WEF) nexus index: A review of nutrient profile models as a fundamental pillar of food and nutrition security

The Water-Energy-Food (WEF) nexus approach should be promoted as a tool for sustainable management of resources through the interconnection of these three fundamental pillars. Particularly, food security must ensure healthy and balanced diets for everyone, but selecting individual indicators to assess all slants covered by this element is not an easy task. Hence, the objective of this paper is two-fold, to review nutrient profiling (NP) models that allow to categorize foods and evaluate diets based on their nutritional quality, and to choose the most appropriate model to be used within a WEF nexus index. To address this issue, a total of 159 documents were assessed, appraising the geographic distribution, and time evolution of the publications, as well as the characteristics and potential applications of the NP systems. The review concludes that the NRF9.3. model is the most liable option to be used in a WEF nexus index, presenting the best characteristics by means of the definition of scores and thresholds, and the use of an 'across-the-board' criteria and a reference quantity of 100 kcal, alongside offering higher ability to assess diets and foods than the other competitive model (HEI) through the evaluation of nutrients to encourage instead of foods. A secondary outcome of the review is the identification of the NP models as a useful tool to enable institutions with information to establish policies in the field of public health and facilitating the decision-making process according to the current healthy claims.

Identifying barriers to decreasing meat consumption and increasing acceptance of meat substitutes among Swedish consumers

A key lifestyle change people could make to reduce their environmental impact is to reduce their meat consumption. However, meat is still a staple in many people's diet, and some consumers are reluctant to cut down. Meat substitutes, if accepted as adequate replacements for meat, may offer a suitable alternative without leaving consumers feeling dissatisfied. The aim of the present study was to identify psychological barriers to reducing meat consumption and increasing use of meat substitutes among Swedish consumers. Participants engaged in focus group discussions around purchasing, preparing, and consuming meat and meat substitutes. Four main themes were identified through thematic analysis: uncertainty, scepticism, health, and identity. These are discussed in relation to previous work on the barriers to reducing meat consumption. Strategies to communicate the environmental impact of meat to consumers and effect change through behavioural interventions are considered.

Sustainability Indicators for Foods Benefiting Climate and Health

New methods for combined evaluation of nutritional and environmental aspects of food products are needed to enable a transformation of dietary guidelines integrating both health and environmental perspectives. We evaluated two sustainability aspects; nutrition and climate impact, of foods commonly consumed in Sweden and the implications of using parallel or integrated assessments of these two aspects, also discussing the usability and suitability of these food sustainability indicators in relation to Swedish dietary guidelines, industry food product development, and consumer communication. There were large differences in both nutrient density and climate impact among the different foods. The parallel assessment easily visualized synergies and trade-offs between these two sustainability aspects for the different foods. Coherence with dietary guidelines was good, and suitability and usability deemed satisfying. The integrated indicator showed better coherence with dietary guidelines than indicators based solely on nutrient density or climate impact; however, the difficulty to interpret the score limits its usability in product development and consumer communication. With both methods, advantageous as well as less advantageous plant-based and animal-based food alternatives were suggested. The two alternative methods evaluated could serve as useful tools to drive individual and societal development towards more sustainable food production and consumption.