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Sustainable Nutrition—Healthy People

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (24 April 2023) | Viewed by 56386

Special Issue Editors


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Guest Editor
1. Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, MI, Italy
2. Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
Interests: food allergy/intolerance; immunomodulation and nutrition; gut–brain axis; nutritional psychiatry; inflammaging; food histamine; food proteins; diet; nutrition; eating disorders; immunity
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Nutritional Sciences and Dietetics, International Hellenic University (IHU), 57400 Thessaloniki, Greece
Interests: nutrition information systems; ICT-assisted energy intake and physical activity assessment; nutrition databases; ontologies; semantic web; online social networks; digital/online nutrition and lifestyle interventons

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Guest Editor
Department of Nutritional Sciences and Dietetics, International Hellenic University (IHU), 57400 Thessaloniki, Greece
Interests: dietary assessment; nutritional evaluation; dietary treatment of obese patients; cardiometabolic diseases; childhood obesity

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Guest Editor
Department of Nutritional Sciences and Dietetics, International Hellenic University (IHU), 57400 Thessaloniki, Greece
Interests: bioinorganic chemistry; metall complexes with pesticides; anti-microbial and NSAID’s; antioxidant; anti-inflammatory; anticoagular activity

Special Issue Information

Dear Colleagues,

Global evidence strongly indicates the need for a substantial shift from current diets to healthier, more sustainable ones. Modern local and global food systems should operate within planetary boundaries, considering climate change and ever-dwindling natural resources. As such, diets should maintain a balance of environmental sustainability and optimum health outcomes for the consumers; however, to achieve the wide adoption of such diets, they must also be socioculturally and economically acceptable. The shift towards sustainable nutrition, facilitated by a digital world and economy, might halt the epidemic of several NCDs, such as obesity, cardiovascular disease, neurological and immune-related diseases, but this is yet to be extensively investigated.

This Special Issue encourages authors to submit original research articles or reviews addressing all dimensions of sustainability and healthy diets in Nutritional Sciences and Dietetics, including cross-sectoral and interdisciplinary aspects.  The Issue will work in collaboration with the 1st International Conference of Nutritional Sciences and Dietetics (1st ICONSD 2022, www.iconsd.org). Abstracts submitted to the conference for oral or poster presentations will have the opportunity for evaluation; the speaker with the best presentation will be able to publish their manuscript in this Special Issue with the publication fee waived. Any other conference participants will be offered a 15% discount if they wish to submit their paper to this Special Issue.

Dr. Emilia Vassilopoulou
Dr. Ioannis Pagkalos
Prof. Dr. Maria Hassapidou
Prof. Dr. Athanasios Papadopoulos
Guest Editors

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Keywords

  • nutrition
  • public health
  • non communicable disease and diet
  • gut-brain axis
  • immune-related disease, diet and environment
  • biodiversity, environment, climate
  • social values of foods and nutrition
  • accessibility
  • eco-friendly, local seasonal foods
  • economy and food supply
  • nutrition informatics
  • healthy digital food environments
  • IT platforms for monitoring dietary patterns

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Published Papers (18 papers)

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Editorial

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2 pages, 194 KiB  
Editorial
Special Issue “Sustainable Nutrition—Healthy People”
by Emilia Vassilopoulou
Nutrients 2023, 15(14), 3199; https://doi.org/10.3390/nu15143199 - 19 Jul 2023
Viewed by 1436
Abstract
Food security is defined as the situation in which all people have access to their preferred food, [...] Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)

Research

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16 pages, 653 KiB  
Article
Maternal Bonding as a Protective Factor for Orthorexia Nervosa Risk in Dietetics Students
by Dafni Athanasaki, John Lakoumentas, Gregorio Paolo Milani, Carlo Agostoni, Florian Berghea, Marcela Daniela Ionescu and Emilia Vassilopoulou
Nutrients 2023, 15(16), 3577; https://doi.org/10.3390/nu15163577 - 14 Aug 2023
Viewed by 1701
Abstract
This study aimed to determine the prevalence of the risk of orthorexia nervosa (ON) in dietetics students in Greece, and its relationship with diet, risk of eating disorder (ED), body mass index (BMI), body image flexibility, and parental attachment. The participants were 132 [...] Read more.
This study aimed to determine the prevalence of the risk of orthorexia nervosa (ON) in dietetics students in Greece, and its relationship with diet, risk of eating disorder (ED), body mass index (BMI), body image flexibility, and parental attachment. The participants were 132 dietetics students, with a mean age of 22.94 ± 3.5 years, who completed a series of questionnaires that recorded sociodemographic, clinical, and anthropometric characteristics; adherence to the Mediterranean diet (MedDiet); ON indicators as determined by the ORTO-15 questionnaire; body image flexibility, with the Body Image-Acceptance and Action Questionnaire (BI-AAQ-5); the risk for ED as assessed using the EAT-26; anxiety level according to the STAIT 6 instrument; and recollection of their parents’ attitudes towards them during the first 16 years of life, with the Parental Bonding Instrument (PBI). ON risk appeared to be significantly associated with BMI (p = 0.002), exercise frequency (p = 0.023), anxiety level (p = 0.002), risk of ED (p < 0.001), body image inflexibility (p < 0.001), and inversely with the affectionate constraint of maternal bonding (p = 0.036). In conclusion, disordered eating behaviors and body shape concerns are prevalent among dietetics students, with parental attachment to the mother influencing their occurrence. Identification of potential ON and development of prevention mechanisms during childhood could help eliminate these concerns and improve the lives of dietetics students. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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15 pages, 498 KiB  
Article
Nutrient Intake and Risk Factors for Metabolic Syndrome in Christian Orthodox Church Religious Fasters
by Anna Kokkinopoulou, Niki Katsiki, Ioannis Pagkalos, Nikolaos E. Rodopaios, Alexandra-Aikaterini Koulouri, Eleni Vasara, Sousana K. Papadopoulou, Petros Skepastianos, Emmanouil Dermitzakis, Maria Hassapidou and Anthony G. Kafatos
Nutrients 2023, 15(11), 2468; https://doi.org/10.3390/nu15112468 - 25 May 2023
Cited by 4 | Viewed by 2113
Abstract
Objective: Studies regarding health effects of religious fasting have been increased during the last decade. Our aim was to investigate the impact of adherence to the periodic Christian Orthodox Church (COC) fasting on nutrient intake, body composition, and risk factors for metabolic syndrome [...] Read more.
Objective: Studies regarding health effects of religious fasting have been increased during the last decade. Our aim was to investigate the impact of adherence to the periodic Christian Orthodox Church (COC) fasting on nutrient intake, body composition, and risk factors for metabolic syndrome (MetS). Methods: Four-hundred individuals aged 42.6 ± 17.0 years participated in this cross-sectional study. Two-hundred subjects followed the COC fasting since childhood or at least the last twelve consecutive years, and two-hundred subjects did not follow the COC fasting regimes or any other restrictive dietary pattern. Socioeconomic data, lifestyle habits, and physical activity data were collected. Nutritional assessment was performed via two 24 h recalls and a food frequency questionnaire. Anthropometric data and biochemical parameters were also measured. Results: Fasters had a significantly lower daily intake of calories (1547 vs. 1662 kcals, p = 0.009), protein (52 vs. 59 g, p = 0.001), fat (82 vs. 89 g, p = 0.012), and cholesterol (147 vs. 178 g, p = 0.001) compared with non-fasters. Furthermore, fasters reported a healthier way of living, with lower rates of smoking and alcohol consumption (p < 0.001 and 0.002, respectively). Insulin and magnesium levels were significantly higher, whereas levels of urea, transaminases, glucose, and phosphorus were significantly lower, as was DBP in fasters versus non-fasters. Furthermore, MetS prevalence was non-significantly higher in non-faster compared with fasters. Conclusion: During a non-fasting period, individuals following the COC fasting recommendations reported lower intake of calories, protein, fat, and cholesterol compared with non-fasters. Fasters tended to have a healthier lifestyle pattern and a lower risk for MetS versus non-fasters. Some biochemical parameters also significantly differed between the two study groups. Further research is warranted to establish the long-term clinical impact of these findings. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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11 pages, 843 KiB  
Article
Insight into the Sustainability of the Mediterranean Diet: The Water Footprint of the Recommended Italian Diet
by Alessandra Bordoni
Nutrients 2023, 15(9), 2204; https://doi.org/10.3390/nu15092204 - 5 May 2023
Cited by 3 | Viewed by 1920
Abstract
At present, as we face climate change and natural resource scarcity, one of the major challenges linking humans and the environment is to ensure sufficient, nutritious, safe, and affordable food for a rapidly growing world population. In a nutshell, “feed the world without [...] Read more.
At present, as we face climate change and natural resource scarcity, one of the major challenges linking humans and the environment is to ensure sufficient, nutritious, safe, and affordable food for a rapidly growing world population. In a nutshell, “feed the world without destroying it”. The water footprint (WF), i.e., the withdrawals of fresh water necessary to produce one kilogram of food product, is one of the key indicators of the environmental impact of diets. In this work, the WF of the food patterns suggested by the Italian Food Based Dietary Guidelines, considered a model of the Mediterranean Diet, was evaluated for the first time. The data reported here clearly demonstrate that the suggested Italian dietary patterns have a low WF, the reduction of which by replacing animal foods with plant foods is limited because the suggested consumption of meat is already low. Consumer choice in the consumption of specific products within a food group could further reduce the WF of the diet, underlining the need to provide correct information not only to consumers but also to farmers and producers to encourage them to make water-saving choices. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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14 pages, 1013 KiB  
Article
Associations between Maternal Nutrition and the Concentrations of Human Milk Oligosaccharides in a Cohort of Healthy Australian Lactating Women
by Caren Biddulph, Mark Holmes, Trong D. Tran, Anna Kuballa, Peter S. W. Davies, Pieter Koorts and Judith Maher
Nutrients 2023, 15(9), 2093; https://doi.org/10.3390/nu15092093 - 26 Apr 2023
Cited by 5 | Viewed by 2717
Abstract
Human milk oligosaccharides (HMOs) are complex glycans associated with positive infant health outcomes. The concentrations of HMOs in the milk of lactating women are associated with substantial intra- and inter-individual differences and may be influenced by maternal physiological and/or nutrition-related factors. The primary [...] Read more.
Human milk oligosaccharides (HMOs) are complex glycans associated with positive infant health outcomes. The concentrations of HMOs in the milk of lactating women are associated with substantial intra- and inter-individual differences and may be influenced by maternal physiological and/or nutrition-related factors. The primary aim of this study was to explore potential influences of short-term maternal diet and current body composition on HMO profiles in mature human milk. Milk samples were collected at 3–4 months postpartum from 101 healthy Australian women using standardised procedures, and analysed for macronutrients (lactose, fat, and protein). In addition, HMO concentrations were analysed using liquid-chromatography mass-spectrometry (LC-MS). Maternal dietary data were collected using three validated 24-h dietary recalls, and the body composition of a subgroup of mothers was assessed by DEXA scans (n = 30). Most (79%) of the women were secretor-positive. Individual nutrients were not significantly correlated with HMO concentrations after correction for multiple comparisons (p > 0.05), except for dietary folate intake. DEXA scans revealed no associations between HMO profiles and maternal body composition during established lactation. The study findings suggest a lack of clear and consistent associations between maternal nutrition and HMO concentrations in mature human milk from healthy lactating women with adequate dietary intake. The prevailing influence of genetic variation in lactating mothers may overshadow any impact of maternal nutritional and/or physiological status on HMO composition in mature human milk. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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18 pages, 617 KiB  
Article
Patterns and Determinants of Weight Gain among People Who Use Drugs Undergoing Treatment for Recovery in Lebanon
by Nadine Mahboub, Rana Rizk, Cynthia George Farsoun and Nanne de Vries
Nutrients 2023, 15(4), 990; https://doi.org/10.3390/nu15040990 - 16 Feb 2023
Cited by 2 | Viewed by 2208
Abstract
Substance use disorder compromises the nutritional status and the eating habits of drug users, often leading to malnutrition. Once referred for treatment, hyperphagia and poor lifestyle practices leading to weight gain are observed. This study aimed to examine the patterns and extent of [...] Read more.
Substance use disorder compromises the nutritional status and the eating habits of drug users, often leading to malnutrition. Once referred for treatment, hyperphagia and poor lifestyle practices leading to weight gain are observed. This study aimed to examine the patterns and extent of weight change as well as the determinants of weight gain in a sample of drug users who were receiving treatment in Lebanon. A total of 172 male participants undergoing either rehabilitation or opioid substitution treatment (OST) were included. Multivariate regression analysis was applied to assess the effect of different variables on weight gain while adjusting for potentially confounding variables. Approximately two-thirds (65.1%) of the participants gained weight (OST: 54.3%, rehabilitation: 78.2%; p < 0.05). The mean weight gain was 5.9 kg and was mainly reported among participants in the underweight, normal, and overweight pre-treatment categories and accentuated in the rehabilitation group (OST: 2 kg, Rehabilitation: 10.6 kg). Around half of the participants moved from the normal weight category to the overweight and obese categories during treatment. Weight gain was negatively associated with the number of previous treatment attempts (Odds Ratio = 0.86; Confidence Interval: 0.74–0.99), duration of current treatment (Odds Ratio = 0.98; Confidence Interval: 0.96–0.99), and pre-treatment body mass index (BMI) (Odds Ratio = 0.88; Confidence Interval: 0.80–0.96). Investigating other nutrition and lifestyle practices, neither nutrition knowledge, food addiction, physical activity level, nor sleep quality were associated with weight gain. Treatment through drug use was associated with meaningful weight gain that might lead to health risk factors. Developing health promotion programs is crucial to enhance treatment and decrease the risk of relapse. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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14 pages, 1680 KiB  
Article
Assessment of the Environmental Impact of Food Consumption in Ireland—Informing a Transition to Sustainable Diets
by Laura B. Kirwan, Janette Walton, Albert Flynn, Anne P. Nugent, John Kearney, Nicholas M. Holden and Breige A. McNulty
Nutrients 2023, 15(4), 981; https://doi.org/10.3390/nu15040981 - 16 Feb 2023
Cited by 2 | Viewed by 4208
Abstract
Dietary changes are required to mitigate the climatic impact of food consumption. Food consumption databases can support the development of sustainable food based dietary guidelines (SFBDG) when linked to environmental indicators. An improved knowledge base is crucial to the transition to sustainable diets, [...] Read more.
Dietary changes are required to mitigate the climatic impact of food consumption. Food consumption databases can support the development of sustainable food based dietary guidelines (SFBDG) when linked to environmental indicators. An improved knowledge base is crucial to the transition to sustainable diets, and multiple environmental indicators should be considered to ensure this transition is evidence based and accounts for trade-offs. The current study aimed to quantify the environmental impact of daily diets across population groups in Ireland. Nationally representative food consumption surveys for Irish children (NCFSII; 2017–2018), teenagers (NTFSII; 2019–2020), and adults (NANS; 2008–2010) were used in this analysis. Blue water use (L) and greenhouse gas emissions (GHGe; kgCO2eq) were assigned at food level to all surveys. Cropland (m2), nitrogen (kgN/t), and phosphorous use (kgP/t) were assigned at the agricultural level for adults. Multiple linear regressions, Spearman correlations, and ANCOVAs with Bonferroni corrections were conducted. Higher environmental impact diets were significantly associated with demographic factors such as age, education status, residential location, and sex, but these associations were not consistent across population groups. The median greenhouse gas emissions were 2.77, 2.93, and 4.31 kgCO2eq, and freshwater use per day was 88, 144, and 307 L for children, teenagers, and adults, respectively. The environmental impact of the Irish population exceeded the planetary boundary for GHGe by at least 148% for all population groups, however the boundary for blue water use was not exceeded. Meat and meat alternatives (27–44%); eggs, dairy, and dairy alternatives (15–21%); and starchy staples (10–20%) were the main contributors to GHGe. For blue water use, the highest contributors were meat and meat alternatives in children; savouries, snacks, nuts, and seeds in teenagers; and eggs, dairy, and dairy alternatives in adults (29–52%). In adults, cropland use, nitrogen use, and phosphorous use exceeded planetary boundaries by 277–382%. Meat, dairy, and grains were the main contributors to cropland, nitrogen, and phosphorous use (79–88%). The quantified environmental impact of Irish diets provides a baseline analysis, against which it will be possible to track progress towards sustainable diets, and the basis for the development of Sustainable Food Based Dietary Guidelines in Ireland. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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11 pages, 898 KiB  
Article
The Prevalence of Orthorexia Nervosa among Greek Professional Dancers
by Dafni Athanasaki, John Lakoumentas, Gavriela Feketea and Emilia Vassilopoulou
Nutrients 2023, 15(2), 379; https://doi.org/10.3390/nu15020379 - 12 Jan 2023
Cited by 3 | Viewed by 2767
Abstract
The aim of this study was to determine the prevalence of orthorexia nervosa (ON) among professional dancers in Greece, as well as its relationship with nutrition, body mass index (BMI), body image flexibility, and parental bonding. The participants were 96 professional dancers, with [...] Read more.
The aim of this study was to determine the prevalence of orthorexia nervosa (ON) among professional dancers in Greece, as well as its relationship with nutrition, body mass index (BMI), body image flexibility, and parental bonding. The participants were 96 professional dancers, with a mean age of 23.41 ± 5.13 years, who completed a battery of questionnaires recording sociodemographic, clinical, and anthropometric characteristics; adherence to the Mediterranean diet (MedDiet); indications of ON, as determined by the ORTHO-15 questionnaire; body image flexibility, using the body image-acceptance and action questionnaire (BI-AAQ-5); and their recollection of their parents’ attitudes towards them during the first 16 years of life, with the parental bonding instrument (PBI). The study population was classified into two groups, based on BMI: normal weight, and underweight. ON was shown to be significantly correlated with BMI (p = 0.006)-present in normal weight subjects- and body image inflexibility (p < 0.001). Parental body image inflexibility was significantly correlated with a low bonding relationship as perceived in childhood. In conclusion, disordered eating attitudes and body shape concerns are prevalent among professional dancers and appear to be associated with their parental relationship during childhood. Identification of potential ON and development of preventive mechanisms could help to eliminate such concerns and improve the nutrition of professional dancers. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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17 pages, 376 KiB  
Article
Prevalence, Determinants, and Consumer Stance towards Dietary Supplements According to Sex in a Large Greek Sample: A Cross-Sectional Study
by Panagiotis-David Soukiasian, Zacharenia Kyrana, Konstantina Gerothanasi, Efstratios Kiranas and Lambros E. Kokokiris
Nutrients 2022, 14(23), 5131; https://doi.org/10.3390/nu14235131 - 2 Dec 2022
Cited by 8 | Viewed by 2737
Abstract
A stratified random sampling technique was used in order to explore the prevalence of and the factors influencing dietary supplement (DS) use and the consumer stance towards DS by Greeks (n = 28,491, ≥15 years) according to sex. Additionally, we performed a [...] Read more.
A stratified random sampling technique was used in order to explore the prevalence of and the factors influencing dietary supplement (DS) use and the consumer stance towards DS by Greeks (n = 28,491, ≥15 years) according to sex. Additionally, we performed a Pearson’s chi-square to test within DS users for the dependence between sex and the examined factors, and binary logistic regression to create predictive DS user profiles. A history of DS use accounted for 55.5% and was more prevalent in women (58.4% vs. 52.3%, p < 0.001); multivitamins were the most popular DS used. The significant predictors for DS use for both sexes were age, education, employment status, exercise, and following a special diet, while BMI and monthly income were significant for women and men, respectively. The women and men DS users had mostly illness-health and fitness-related goals, respectively. Substantial proportions of the respondents had false beliefs about DS. A noticeable percentage of DS users displayed imprudent behavior regarding DS use, e.g., one out of five did not know the definition or did not take into consideration the recommended daily allowance. While several factors seemed to impact DS use, with certain differences between the sexes, the considerable lack of knowledgeable and responsible use of DS, with few differences between the sexes, observed can point state authorities and health professionals towards appropriate countermeasures. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
12 pages, 1919 KiB  
Article
How to Decide the Iodine Content in Salt for a Country—China as an Example
by Lijun Fan, Yang Du, Fangang Meng, Lixiang Liu, Ming Li, Peng Liu and Dianjun Sun
Nutrients 2022, 14(21), 4606; https://doi.org/10.3390/nu14214606 - 1 Nov 2022
Cited by 5 | Viewed by 2781
Abstract
Globally, many countries have implemented universal salt iodization to prevent and control iodine deficiency disorders. Therefore, it is important to determine the optimal iodine content in salt and to adjust it in a timely manner. This article aims to establish a process for [...] Read more.
Globally, many countries have implemented universal salt iodization to prevent and control iodine deficiency disorders. Therefore, it is important to determine the optimal iodine content in salt and to adjust it in a timely manner. This article aims to establish a process for selecting, deciding, and evaluating the iodine content in salt for China and, if possible, providing references for other countries. Information on salt intake, water iodine, and iodine stability in salt was collected. A field investigation was carried out in different populations in four provinces. Iodine intake was calculated and the appropriate iodine content for salt preliminarily obtained, then verified for suitability with 2020 China National Iodine Deficiency Disorders Surveillance data. In total, 2837 children, 1660 adults, and 2145 pregnant women were enrolled, and their iodine intake from food was 3.7–96.1, 60.0–156.0 and 65.0–112.0 µg/d, respectively. After calculation, when the iodine content in salt was 20, 25 and 30 mg/kg, for children and adults, the total iodine intake ranged from 173.4 to 253.5 µg/d and 230.3 to 379.8 µg/d, respectively. When the iodine content in salt was 30 and 35 mg/kg, for pregnant women, the total iodine intake was 296.8–408.9 µg/d, which was between the recommended nutrient intake and tolerable upper intake level. Therefore, in China, the iodine content in salt in the general population can be preset as 20, 25 and 30 mg/kg, and that in pregnant women 30 and 35 mg/kg, with a variation of ±5 mg/kg based on the automatic spraying technique used in the salt processing plant. Iodine nutritional status was then evaluated according to the preset iodine content in the salt, and it reached the appropriate level for the different populations. The iodine content in salt in China was decided and verified, and the procedure of selecting the iodine content in salt was established for the reference of different countries. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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17 pages, 484 KiB  
Article
Consumer Attitudes and Purchase Intentions in Relation to Animal Welfare-Friendly Products: Evidence from Taiwan
by Min-Yen Chang and Han-Shen Chen
Nutrients 2022, 14(21), 4571; https://doi.org/10.3390/nu14214571 - 31 Oct 2022
Cited by 9 | Viewed by 3984
Abstract
Animal welfare, environmental sustainability, and food safety have become topics of international concern. With the rise of friendly rearing and green consumption consciousness, consumers can use animal welfare certification labels as references to make purchase decisions. This study adopts the theory of planned [...] Read more.
Animal welfare, environmental sustainability, and food safety have become topics of international concern. With the rise of friendly rearing and green consumption consciousness, consumers can use animal welfare certification labels as references to make purchase decisions. This study adopts the theory of planned behavior (TPB) as its core and incorporates variables, such as moral affection, health consciousness, and trust in certification, to discuss the thoughts of Taiwanese consumers on buying animal welfare-friendly products and the factors that affect their purchase decisions. This study will be conducive in clarifying the consumption behavioral pattern of animal welfare-friendly products, which previous literature has mentioned but not tested, thereby filling this literature gap. This study collects 653 valid questionnaires and uses the partial least square-structural equation modeling to analyze the correlations between various variables. The research findings indicate the following. (1) Consumers’ attitudes, subjective norms, and perceived behavioral control have significant and positive influences on the behavioral intention of purchasing fresh milk with animal welfare labels. (2) Moral affection positively influences customers’ behavioral intention toward fresh milk with an animal welfare label through attitudes, subjective norms, and perceived behavioral control. (3) Trust in certifications will enhance moral cognition and positive attitudes toward fresh milk with animal welfare labels. According to the research findings of this study, we recommend that businesses strengthen the promotion of dairy products in line with friendly rearing, environmental sustainability, and other ethical consumption concepts to generate market segregation elements. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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14 pages, 469 KiB  
Article
Nutritional Composition and Environmental Impact of Meals Selected in Workplace Canteens before and after an Intervention Promoting the Adherence to the Mediterranean Diet
by Alice Rosi, Beatrice Biasini, Elisa Monica, Valeria Rapetti, Valeria Deon and Francesca Scazzina
Nutrients 2022, 14(21), 4456; https://doi.org/10.3390/nu14214456 - 23 Oct 2022
Cited by 11 | Viewed by 2924
Abstract
Enhancing healthy and sustainable food systems is one of the key goals of the current European Commission policy. In this light, the creation of a food environment where people are properly informed about the healthiness and sustainability of food choices is essential. This [...] Read more.
Enhancing healthy and sustainable food systems is one of the key goals of the current European Commission policy. In this light, the creation of a food environment where people are properly informed about the healthiness and sustainability of food choices is essential. This study aimed to evaluate the nutritional profile and the environmental impact of meals consumed in a workplace canteen in Italy in the presence of a nudge (i.e., the Double Pyramid logo) combined with a web-based application promoting the Mediterranean Diet. Energy and nutrient contents and the carbon, water, and ecological footprints of 29,776 meals were compared across three subsequent periods (from June to April) through one-way ANOVA. Although the choice of dishes labelled with the Double Pyramid logo was comparable across periods, the selection of fish- and plant-based dishes increased from +2% (fish, vegetables) up to +17% (whole-grain cereals), with a concurrent reduction of meat-based options (−2%). Although the consumption of healthy items increased (p < 0.001), they were not added as a replacement for alternative options, leading to a higher content in energy (p < 0.001) and nutrients (p < 0.001) and worse environmental footprints, contrarily to what was observed when data were adjusted for energy. The intervention significantly improved food choices; however, as the higher selection of desired dishes was not adequately compensated for, it was not fully effective. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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18 pages, 1118 KiB  
Article
Adherence to the EAT–Lancet Diet: Unintended Consequences for the Brain?
by Hayley Anne Young
Nutrients 2022, 14(20), 4254; https://doi.org/10.3390/nu14204254 - 12 Oct 2022
Cited by 14 | Viewed by 5844
Abstract
In January 2019, the EAT–Lancet Commission defined a universal reference diet to promote human and environmental health. However, in doing so, the potential consequences for brain health were not considered. Whilst plant-based diets are generally associated with better cognitive and affective outcomes, those [...] Read more.
In January 2019, the EAT–Lancet Commission defined a universal reference diet to promote human and environmental health. However, in doing so, the potential consequences for brain health were not considered. Whilst plant-based diets are generally associated with better cognitive and affective outcomes, those that severely limit animal products are not. Therefore, the potential ramifications of the EAT–Lancet diet on cognition, mood, and heart rate variability were considered (N = 328). Adherence to the Alternative Healthy Eating Index (AHEI) was associated with having a better mood, focused attention, working and episodic memory, and higher heart rate variability. However, when the EAT–Lancet diet was considered, the effects were either smaller or not significant. Cluster analysis identified a dietary style characterised by a strong adherence to the EAT–Lancet recommendation to limit meat intake, representing a sixth of the present sample. This group had a lower Mean Adequacy Ratio (MAR); did not meet the Recommended Nutrient Intake (RNI) for a range of nutrients including protein, selenium, zinc, iron, and folate; and reported a poorer mood. These data highlight the potential unintended consequences of the EAT–Lancet recommendations for nutritional adequacy and affective health in some individuals. There is a need to better optimise the EAT–Lancet diet to support brain health. As we move towards more sustainable diets, these findings emphasise the need to consider how such diets might affect the brain. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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12 pages, 307 KiB  
Article
Association between Serum Vitamin D and Irritable Bowel Syndrome Symptoms in a Sample of Adults
by Myriam Abboud, Suzan Haidar, Nadine Mahboub, Dimitrios Papandreou, Fatme Al Anouti and Rana Rizk
Nutrients 2022, 14(19), 4157; https://doi.org/10.3390/nu14194157 - 6 Oct 2022
Cited by 4 | Viewed by 2222
Abstract
Vitamin D may be associated with irritable bowel syndrome (IBS) pathways. This cross-sectional study evaluated the associations between serum Vitamin D and IBS symptoms in a sample of Lebanese adults. Participants (n = 230; mean (SD) age: 43.36 (16.05) years, 62.9% females) [...] Read more.
Vitamin D may be associated with irritable bowel syndrome (IBS) pathways. This cross-sectional study evaluated the associations between serum Vitamin D and IBS symptoms in a sample of Lebanese adults. Participants (n = 230; mean (SD) age: 43.36 (16.05) years, 62.9% females) were adults, free of diseases affecting Vitamin D metabolism, and recruited from a large university and the surrounding community. Serum Vitamin D (25-hydroxyvitamin D) was assessed using an automated chemiluminescence micro-particle immunoassay kit. The Birmingham IBS Symptom Questionnaire total scale, and pain, constipation, and diarrhea subscales were used to study IBS symptoms. Four linear regression analyses were performed, taking respectively the total scale and each of the subscales as the dependent variable. Vitamin D was forced into each model. Covariates included sociodemographic and medical variables, fluid intake, physical activity, sleep quality, stress, and adherence to the Mediterranean diet. Mean (SD) serum Vitamin D was 17.53 (12.40) ng/mL and mean (SD) Birmingham IBS Symptom Questionnaire was 16.98 (15.16) (pain: 20.75 (23.63), constipation: 25.06 (29.99), diarrhea: 9.88 (13.37)). Serum Vitamin D was not associated with the total score, nor with any of the subscales (p > 0.05 for the four regression analyses). Serum Vitamin D was not associated with IBS symptoms in a sample of Lebanese adults, adding to the controversy in this field. Further understanding of the pathophysiological mechanisms involved in Vitamin D and IBS is warranted. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
10 pages, 649 KiB  
Article
Pre-Pregnancy Excess Weight Association with Maternal Sociodemographic, Anthropometric and Lifestyle Factors and Maternal Perinatal Outcomes
by Dimitrios Papandreou, Maria Mantzorou, Stefanos Tyrovolas, Eleni Pavlidou, Georgios Antasouras, Evmorfia Psara, Efthymios Poulios, Georgios K. Vasios and Constantinos Giaginis
Nutrients 2022, 14(18), 3810; https://doi.org/10.3390/nu14183810 - 15 Sep 2022
Cited by 12 | Viewed by 1972
Abstract
Background: Pre-pregnancy excess weight is an important factor for adverse maternal perinatal outcomes; however, data for Greek women remain limited. Therefore, the aim of the present work was to evaluate the relation between pre-pregnant weight status and sociodemographic, anthropometric and lifestyle factors and [...] Read more.
Background: Pre-pregnancy excess weight is an important factor for adverse maternal perinatal outcomes; however, data for Greek women remain limited. Therefore, the aim of the present work was to evaluate the relation between pre-pregnant weight status and sociodemographic, anthropometric and lifestyle factors and maternal perinatal outcomes. Methods: In the present cross-sectional study, 5133 healthy women were enrolled from nine different Greek regions after applying specific inclusion and exclusion criteria. Validated questionnaires were used to assess the sociodemographic characteristics and certain lifestyle factors of the study population. Anthropometric and clinical data were retrieved from medical history files of the women, including measured weight in the first weeks of pregnancy and right before delivery, and maternal perinatal outcomes. Women’s weights and heights were also measured 2–5 years postpartum by trained nutritionists. Non-adjusted and adjusted statistical analysis was performed to assess whether pre-pregnancy weight status was associated with sociodemographic, anthropometric and lifestyle factors and maternal perinatal outcomes. Results: In pre-pregnancy, 17.5% of the women were overweight, and 4.9% were classified as obese. These rates were increased 2–5 years postpartum, reaching 21.0% for overweight and 9.6% for obese women. Pre-pregnancy overweight/obesity were associated with older maternal age, higher prevalence of overweight/obesity at 2–5 years postpartum and nonexclusive breastfeeding, as well as increased rates for preterm birth and pregnancy-induced hypertension after multiple adjustments. Conclusions: Overweight and obesity rates were high among women of childbearing age in Greece. These findings highlight the urgent need for healthy lifestyle promotion and targeted obesity prevention and intervention schemes among women of reproductive age. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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12 pages, 1032 KiB  
Article
The Chilean Diet: Is It Sustainable?
by Teresita Gormaz, Sandra Cortés, Ornella Tiboni-Oschilewski and Gerardo Weisstaub
Nutrients 2022, 14(15), 3103; https://doi.org/10.3390/nu14153103 - 28 Jul 2022
Cited by 8 | Viewed by 4986
Abstract
Food systems are one of the main contributors to climate change. Sustainable diets are one strategy to mitigate climate change. Assessments and estimations at a national level are lacking, especially in the Global South, probably due to a lack of national surveys of [...] Read more.
Food systems are one of the main contributors to climate change. Sustainable diets are one strategy to mitigate climate change. Assessments and estimations at a national level are lacking, especially in the Global South, probably due to a lack of national surveys of food consumption and a limited interest in sustainable diets information. The objective of this study is to estimate and describe the carbon and water footprint of the Chilean population’s diet in an overall estimation desegregated by region, age, sex, socioeconomic level and their main characterizations. This study is based on a secondary data analysis from the National Survey of Food Consumption made in 2010. The carbon and water footprint of the food subgroups/person/day were estimated. The results are compared by sex, age group, socioeconomic level, and macro zone. A carbon footprint of 4.67 kg CO2eq and a water footprint of 4177 L, both per person/day, were obtained. Animal-sourced foods, such as dairy and red meat, were responsible for 60.5% of the total carbon footprint and 52.6% of the water footprint. The highest values for both footprints were found in the following groups: men, adolescents, young adults, people with a higher socioeconomic level, and residents in the southern area of the country. The carbon footprint and water footprint values in Chile generated by food consumption would be above the world averages. Transforming the Chilean food system into a more sustainable one with changes in eating patterns is urgently required to attain this transformation. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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Review

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24 pages, 1104 KiB  
Review
Mediterranean-Type Diets as a Protective Factor for Asthma and Atopy
by Emilia Vassilopoulou, George V. Guibas and Nikolaos G. Papadopoulos
Nutrients 2022, 14(9), 1825; https://doi.org/10.3390/nu14091825 - 27 Apr 2022
Cited by 21 | Viewed by 4279
Abstract
We are currently riding the second wave of the allergy epidemic, which is ongoing in affluent societies, but now also affecting developing countries. This increase in the prevalence of atopy/asthma in the Western world has coincided with a rapid improvement in living conditions [...] Read more.
We are currently riding the second wave of the allergy epidemic, which is ongoing in affluent societies, but now also affecting developing countries. This increase in the prevalence of atopy/asthma in the Western world has coincided with a rapid improvement in living conditions and radical changes in lifestyle, suggesting that this upward trend in allergic manifestations may be associated with cultural and environmental factors. Diet is a prominent environmental exposure that has undergone major changes, with a substantial increase in the consumption of processed foods, all across the globe. On this basis, the potential effects of dietary habits on atopy and asthma have been researched rigorously, but even with a considerable body of evidence, clear associations are far from established. Many factors converge to obscure the potential relationship, including methodological, pathophysiological and cultural differences. To date, the most commonly researched, and highly promising, candidate for exerting a protective effect is the so-called Mediterranean diet (MedDi). This dietary pattern has been the subject of investigation since the mid twentieth century, and the evidence regarding its beneficial health effects is overwhelming, although data on a correlation between MedDi and the incidence and severity of asthma and atopy are inconclusive. As the prevalence of asthma appears to be lower in some Mediterranean populations, it can be speculated that the MedDi dietary pattern could indeed have a place in a preventive strategy for asthma/atopy. This is a review of the current evidence of the associations between the constituents of the MedDi and asthma/atopy, with emphasis on the pathophysiological links between MedDi and disease outcomes and the research pitfalls and methodological caveats which may hinder identification of causality. MedDi, as a dietary pattern, rather than short-term supplementation or excessive focus on single nutrient effects, may be a rational option for preventive intervention against atopy and asthma. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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Other

16 pages, 1105 KiB  
Systematic Review
Focus of Sustainable Healthy Diets Interventions in Primary School-Aged Children: A Systematic Review
by Elena Patra, Anna Kokkinopoulou and Ioannis Pagkalos
Nutrients 2023, 15(11), 2460; https://doi.org/10.3390/nu15112460 - 25 May 2023
Cited by 4 | Viewed by 3138
Abstract
Research and public policy interest regarding Sustainable Healthy Diets (SHDs) have increased during the last decades, as nutrition recommendations and diet practices should align with growing environmental concerns. SHDs encompass sociocultural, economic and environmental components of nutrition and health and raising awareness across [...] Read more.
Research and public policy interest regarding Sustainable Healthy Diets (SHDs) have increased during the last decades, as nutrition recommendations and diet practices should align with growing environmental concerns. SHDs encompass sociocultural, economic and environmental components of nutrition and health and raising awareness across all these dimensions, as well as providing relevant education, especially to young children, is important for adopting SHD practices. Primary school students (5–12 years old) are often the target population for interventions, as they are considered agents of change for educating the community. The objective of this systematic review is to map the SHD indicators addressed by such interventions in order to identify gaps and opportunities for future interventions in this population. Scopus, PubMed and Web of Science were searched for available publications, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020) methodology. After screening for eligibility, thirteen intervention studies were included and reviewed. Results showed that indicator definitions and measuring methods were not harmonized across research efforts. Implemented SHD interventions address predominantly food waste and diet quality, while social and economic indicators are underrepresented. The standardization of SHD, focusing on measurable harmonized indicators, should be a priority for policy actors in order to enable impactful research efforts. Future interventions should incorporate clear SHD indicators to raise awareness and consider the application of composite tools or indexes to evaluate outcomes and maximize impact in the community. Full article
(This article belongs to the Special Issue Sustainable Nutrition—Healthy People)
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