Search Results (29)

In this study, menus created by considering different food categories by the Mediterranean diet (MD) and Western diet (WD) were evaluated in terms of healthy nutrition, and their environmental footprints were comprehensively compared with life cycle analysis (LCA). The analysis was modeled using SimaPro 9.6, and the EcoInvent 3.10 and Agri-footprint 6.3 databases were used as secondary data sources. In 12 of the 15 environmental impact categories examined, MD had lower environmental impacts than WD. The climate change impact was estimated as 2.19 kg CO₂-eq for MD, while it was 3.53 kg CO₂-eq for WD. Similarly, freshwater ecotoxicity was 103 CTUe for MD and 418 CTUe for WD. However, MD showed 72% higher human toxicity (cancer) (ΔHTC), 32.5% higher water use (ΔWU), and 12.7% higher mineral-metal resource use (ΔRUM). The findings suggest that MD supports environmental sustainability because of its plant-based structure, whereas WD creates a greater environmental burden due to its high animal-derived content. Full article

Background: Nutrition problems among primary school children increase the risk of illness, reduce school attendance, and impair academic performance. The Indonesian national school feeding program (ProGAS—Program Gizi Anak Sekolah) was developed to address these issues through the provision of healthy breakfast, nutrition education, and character building. Methods: This study employed a mixed-methods design involving 454 primary school students aged 8–14 years from 24 schools across four provinces. Data collection included structured questionnaires, 24 h dietary recalls, and anthropometric measurements. In-depth interviews with school principals, teachers, cooking teams, parents, students, nutritionists, and district education office staff were conducted to capture experiences and opinions on the ProGAS implementation. Results: ProGAS significantly improved students’ dietary diversity, meal frequency, handwashing with soap, and nutrition knowledge, alongside a positive trend in school attendance. Improvements included higher mean dietary diversity, increased proportion of students eating ≥3 meals/day, greater correct responses on balanced nutrition, and higher rates of handwashing before meals (all p < 0.01). Children also developed positive behaviors such as praying before meals, queuing, and taking responsibility for cleaning dishes. However, students’ breakfast habits did not significantly improve, the delivery of nutrition education was suboptimal, and no significant changes were observed in nutrient intakes or nutritional status based on BMI-for-age. While the energy and protein contributions of the ProGAS menu met the recommended 25–30% of daily requirements for breakfast, its micronutrient contributions remained below the recommended levels. Key management gaps include the delivery of nutrition education to students and the monitoring of implementation by local and national authorities. Conclusions: ProGAS demonstrated positive impacts on some dietary and hygiene practices as well as learning environment. To achieve greater improvements in breakfast habits, nutrient intake and nutritional status, it is recommended to strengthen the school feeding menus not only for dietary diversity but also for nutrient density, enhance capacity building for teachers, deliver regular and engaging nutrition education, and reinforce program monitoring. Full article

Background/Objectives: Military Service Members (SMs) require optimal nutrition to support health, readiness, and job performance. However, they often fall short of meeting nutrition guidelines. This study aimed to determine the impact and feasibility of implementing the U.S. Marine Corps (USMC) “Fueled to Fight^®” (F2F) nutrition program in non-appropriated fund (NAF) food venues. Objectives included evaluating changes in Military Nutrition Environment Assessment Tool (mNEAT) scores, feasibility of implementing and maintaining F2F strategies, and influence on customer purchasing patterns. Methods: Researchers conducted a pre-post interventional study from January to December 2024 at three NAF food venues across two USMC bases. F2F strategies, including identifying items using a stoplight color coding system (Green = healthy, Yellow = less healthy, Red = least healthy), menu revisions, food placement, promotion, and marketing, were implemented. Data included mNEAT assessments, sales reports, and stakeholder focus groups. Generalized Estimating Equations models were used to analyze sales data. Results: mNEAT scores increased across all venues post-intervention. Availability and sales of Green items increased, while sales of Red items decreased in some venues. Profit increased at all three food venues. Focus groups revealed feasibility and provided insights for future interventions. Conclusions: F2F interventions in NAF food venues are feasible and can positively impact the food environment and customer purchasing patterns without negatively affecting profit. This study highlights the importance of integrating nutrition programs into all military food venues, not just government-funded dining facilities, to support the nutritional fitness and readiness of SMs. Full article

School meals play a critical role in supporting students’ biopsychosocial growth, development, learning, academic performance, and the establishment of healthy eating habits. In public institutions, food procurement is conducted through formal public procurement processes. However, emphasizing cost-effectiveness in bidding criteria, such as prioritizing the lowest product price, may inadvertently encourage the acquisition of foods high in critical nutrients. In Brazil, specific guidelines for public school food procurement have been introduced to improve the nutritional quality of foods included in school menus. Objective: To evaluate the impact of legislative measures and regulations implemented during the COVID-19 pandemic on the nutritional composition of school meals provided by federal high schools in Rio Grande do Norte, located in northeastern Brazil. It also compared the composition and origin of foods procured before and after the pandemic. Methods: This is a longitudinal observational panel study conducted across 20 federal schools. Procurement documents from 2019 (pre-pandemic) and 2021 (post-pandemic) were analyzed to assess changes in the nutritional profile of procured foods. Results: Post-pandemic, the procurement of natural and minimally processed and processed foods increased, representing 73.39% and 10.34%, respectively, of the total approved foods. There was also a 39% reduction in ultra-processed foods compared to 2019, in addition to a reduction in culinary ingredients. Additionally, the proportion of foods containing excessive levels of critical nutrients declined. A significant shift was observed in the origin of procured foods, with a notable increase in the purchase of locally sourced items. Conclusions: The findings indicate a positive shift in the nutritional quality of foods procured after the COVID-19 pandemic, with a decrease in ultra-processed food purchases and an increase in the procurement of natural and minimally processed options. Nonetheless, the continued presence of ultra-processed foods and items with excessive critical nutrients highlights the need for further improvements in public procurement practices to fully align with nutritional guidelines. Full article

Global warming poses a significant threat to our planet, with the food sector contributing up to 37% of total greenhouse gas emissions. This study aimed to assess the climate change impact and healthiness of menus in a long-term care facility in Italy. We analyzed two 28-day cyclical menus using the carbon footprint (CF) and the Modified EAT-Lancet Diet Score (MELDS) to evaluate adherence to the Planetary Health Diet (PHD). Monte Carlo simulations were employed to explore 20,000 daily menu permutations. Results showed that the mean GHGEs of spring/summer and autumn/winter daily menus were 2.64 and 2.82 kg of CO₂eq, respectively, with 99% of menus exceeding the 2.03 kg of CO₂eq benchmark. Only 22% of menus were adherent to the PHD, with MELDSs ranging from 12 to 29. A strong inverse association between the CF and adherence to the PHD was observed. These findings suggest significant potential for reducing the CFs of meals served in nursing homes while promoting adherence to a planetary diet, presenting an opportunity to set new standards in caregiving and environmental sustainability. Full article

Background and objectives: Increasing rates of adult overweight (60.7% population) and diet-related cardiovascular diseases (52% population) in Serbia alarmingly call for a change in dietary patterns. To be able to identify problems and solutions, harmonized and comparable food consumption data are needed. The European Food Safety Authority (EFSA) provided support and guidance, through the EU Menu program, for conducting the Serbian National Food Consumption Survey on adults from 10 to 74 years old, including pregnant women and vegetarians in the period of 2017–2022. This work gives an overview of the quantity, energy intake, and distribution across different food groups, which are all basic parameters of dietary patterns, aiming at comparing the actual diet with recommendations—the EAT Lancet Commission Report. Methods: Food consumption data were collected from 3018 participants: 856 adolescents aged 10–17 years, 1155 adults aged 18–64 years, 581 elderly subjects aged 65–74 years, 145 pregnant women, and 281 vegetarians, using two inconsecutive days repeated 24 h dietary recall. The advanced nutritional software, Diet Assess and Plan (DAP), was applied for data storage, processing, and reporting, while the Serbian Food composition database was used as a resource for food composition information of the foods and recipes consumed in the survey. Results: In the adult population, quantitatively, the most consumed foods are as follows: vegetable and vegetable products (312 g/day), milk and milk products (247.7 g/day), fruit and fruit products (245.7 g/day), grain and grain products (215.8 g/day), and meat and meat products (166.08 g/day). Liquids—water and non-milk beverages—were consumed 1511 g/day on average. However, the mean distribution of energy intake differs significantly. The main source of energy comes from grain and grain products (637.5 kcal/day (29.3%TE)), meat and meat products (355.4 kcal/day (16.3%TE)), fats and oils (271 kcal/day (12.4%TE)), and milk and milk products (261.3 kcal/day (12%TE)). Discussion: The energy distribution and consumed quantities of some food groups indicate that actual diet, comprised of processed grains, meat, and fatty food, is not meeting reference healthy diet recommended in EAT Lancet Commission Report, and present a risk factor for the development of overweight, obesity, and diet-related cardiovascular diseases in the Serbian population. Full article

Dietary fibre is an essential part of healthy human nutrition. However, due to the changes in the definition of dietary fibre in 2009, we are still struggling to update the data about dietary fibre content as data obtained with methods that include all dietary fibre components are scarce. This problem is transferred to nutritional studies worldwide and impairs the quality of monitoring the dietary intake of dietary fibre. The aim of our work was to develop a simple yet acceptably accurate model for dietary fibre intake based on analytical data. Based on the national study SI.Menu 2017/2018 we collected the frequency of food items eaten in the food groups that contribute the most to dietary fibre intake. From these groups, the most frequent foods were selected and analysed for dietary fibre content using AOAC methods 991.41 and 2011.25. After obtaining the results, the data were used in our “forced choice” model. The model was created on the data of food intake for 392 people. The cumulative intake of six food groups (vegetables, fruits, grains and grain products, potato and potato products, legumes and nuts) was known; therefore, we could calculate the share of each food selected to the total food group intake. Having calculated the daily intake for each food, analytical data were applied. This allowed us to calculate the daily intake of dietary fibre. The calculated daily intake was 17.6 g/day using data obtained with the AOAC 991.43 method. The daily intake estimated with data obtained with the AOAC 2011.25 method was 34.3 g/day. In order to evaluate our model, the daily intake of dietary fibre was compared with that in another study based on the same population. Our estimation based on 45 food items was only 10.6% lower than the estimation based on all food items reported by people included in the other study. Therefore, we conclude that our simple model can provide a rough estimate based on analytical data and can serve as a good tool to update research on the daily intake of dietary fibre. Full article

The consumption of out-of-home meals is increasing. This study is aimed at assessing the effect of an intervention on healthy offerings and the management of food allergies and intolerances. Ten (control group) and eight restaurants (intervention group) were randomized in a 12-month parallel controlled trial. The outcomes were changes regarding adherence to the Mediterranean diet (AMed) and gluten management (SMAP) criteria, the traffic light rating category, nutrients, and gluten- and allergen-free content of dishes. After 12 months, and compared with baseline, there was an improvement of ≥25% in four items of the AMed criteria in the intervention group, whereas an increase in the offer of dairy desserts without added sugar, and a decrease in the first course offerings of vegetables and/or legumes were observed in the control group (p < 0.05). Also, after 12 months, there was an improvement of ≥50% in four SMAP criteria (p < 0.05) and in the mean average of all SMAP criteria (p = 0.021) compared with baseline in the intervention group, in which intra- and inter-group improvements for desserts in traffic light ratings, nutrients, and allergens were observed (p < 0.05). Therefore, the intervention showed beneficial effects, improving the quality of menus toward the Mediterranean diet pattern and gluten and food allergy/intolerance management. Full article

Health disparities among people experiencing homelessness are likely exacerbated by limited access to healthy, fresh, and minimally processed foods. Soup kitchens and shelters serve as essential food safety nets for preventing hunger in this population, and community interest is growing in the potential of “food is medicine” interventions to improve the mental and physical wellbeing of people who receive meals from these providers. This study describes our two-phase approach to first identify and prioritize nutrition needs within an urban soup kitchen community and then test and implement new recipes and menu guidelines to help the standard soup kitchen menu better align with those priorities. We began by first conducting a nutrition needs assessment, including a collection of intercept surveys from a convenience sample of soup kitchen guests to better understand their nutrition-related health needs, dental issues, food preferences, and menu satisfaction (n = 112), as well as a nutrition analysis of the standard menu based on seven randomly selected meals. Most respondents reported at least one chronic health condition, with depressive disorders (50.9%) and cardiovascular diseases (49.1%) being the most common. Nearly all guests requested more fruits and vegetables at mealtimes, and results from the menu analysis revealed opportunities to lower meal contents of sodium, saturated fat, and added sugars and to raise micronutrient, fiber, and omega-3 content. We then applied these nutrition needs assessment findings to inform the second phase of the project. This phase included the identification of new food inventory items to help support cardiovascular and mental health-related nutrition needs, taste test sampling of new healthy menu items with soup kitchen guests, and hands-on culinary medicine training to kitchen staff on newly-developed “food is medicine” guidelines to support menu transformation. All taste tests of new menu items received over 75% approval, which exceeded satisfaction ratings of the standard menu collected during the phase 1 needs assessment. Findings from this community-based participatory research project confirm the great potential for hunger safety net providers to support critical nutrition needs within this vulnerable population through strategic menu changes. However, more research is needed on the longitudinal impacts of such changes on health indicators over time. Full article

The combination of ketogenic diet (KD) with intermittent fasting (IF) has, for years, aroused a great interest in the scientific world and among healthy lifestyle enthusiasts. Its importance is even greater when the study subjects are physically active individuals. The aim of the study was a determination of the effect of strict calculated ketogenic menu combined with IF and with caloric deficit on the selected biochemical markers and body composition in a 23-year-old man performing strength training. At the same time, we decided to conduct the first so-deeply investigated and controlled case study in this respect. The study protocol included a 13-week-long ketogenic diet with intermittent fasting (of delayed time-restricted eating 16:8 type) and caloric deficit. A detailed menu was designed and was used by the man throughout the whole study duration. A number of blood tests were performed before and after the implemented dietary intervention. Additionally, body composition was determined weekly and the concentrations of glucose and ketone bodies, as well as pulse rate and arterial pressure, were measured daily. The most important changes noted included a significant increase in testosterone and vitamin D concentrations and significant reduction in the HOMA-IR index and concentrations of hepatic enzymes, insulin, glucose, iron, urea, and free triiodothyronine (FT3). Moreover, a significant improvement of body composition occurred (the ratio of total body mass to the adipose and muscular tissue and water mass improved). Favourable changes were also noted in heart rate and arterial pressure values. In view of that, the KD with IF and caloric deficit exerted favourable effects on most biochemical parameters and on body composition and caused an almost twofold increase in serum testosterone concentration. Full article

Online food delivery (OFD) platforms have become increasingly popular due to advanced technology, which is changing the way consumers purchase food prepared outside of the home. There is limited research investigating the healthiness of the digital food environment and its influence on consumer choice and dietary behaviours. This study is the first to examine the nutritional quality and marketing attributes of menu items from popular independent and franchise restaurants and takeaway outlets on New Zealand’s market leading OFD platform (UberEATS^®). A total of 374 popular independent and franchise restaurants and takeaway outlets were identified to form a database of complete menus and marketing attributes. All 25,877 menu items were classified into 38 food and beverage categories based on the Australian Dietary Guidelines. Of complete menus, 73.3% (18,955/25,877) were discretionary. Thirty-six percent (9419/25,877) were discretionary cereal-based mixed meals, the largest of the 38 categories. Discretionary menu items were more likely to be categorized as most popular (OR: 2.0, 95% CI 1.7–2.2), accompanied by a photo (OR: 1.7, 95% CI 1.6–1.8), and offered as a value bundle (OR: 4.6, 95% CI 3.2–6.8). Two of the three discretionary mixed meal categories were significantly less expensive than their healthier counterparts (p < 0.001). The overwhelming availability and promotion of discretionary choices offered by restaurants and takeaway outlets on OFD platforms have implications for public health policy. Further research to explore direct associations between nutritional quality and consumers’ dietary choices is required. Full article

Through the Healthy, Hunger-Free Kids Act of 2010, USDA (US Department of Agriculture) made the first major changes in the CACFP (Child and Adult Care Food Program) meal and snack menu patterns. Childcare centers that serve low-income families qualify to participate and receive reimbursement for meals and snacks served. The purpose of this study was to assess what changes in children’s dietary behaviors occurred as a result of the new CACFP meal pattern requirements. This study evaluated these changes at childcare centers operating in Houston and San Antonio, Texas, USA, areas enrolled in the CACFP, pre- (Spring 2016) and post-implementation (Fall 2016–Spring 2017) of the new meal patterns. Dietary intake was assessed via observations of children, 3–5 years old, conducted at breakfast, lunch, and snack times. Results showed improvements in adjusted means of several nutrients and food groups consumption, post-implementation of new CACFP meal guidelines compared to baseline, specifically intake of whole grains, milk, and juice. Additional studies are needed to confirm the impact of the revised CACFP meal patterns along with strategies to assist providers in meeting the new standards to increase the access to and intake of items in accordance with the CACFP meal pattern requirements in childcare settings. Full article

Moving towards healthy sustainable diets which replace a proportion of animal with plant-based protein requires effective population-based strategies. A variety of strategies in food service settings can support this. This systematic review aimed to evaluate the effectiveness of strategies to decrease animal protein and/or increase plant protein in foodservice settings. Outcomes included uptake (primary outcome), satisfaction, financial, environmental, and dietary intake (secondary outcomes). Both quantitative and qualitative outcomes were included. Seven databases were searched to identify peer-reviewed studies conducted in commercial and institutional foodservices using any strategy to decrease beef, lamb, pork, poultry, eggs, fish or seafood and/or increase legumes/pulses, legume/pulse-based meat substitutes or nuts. Titles/abstracts then full texts were screened independently by two authors. Quality appraisal was completed using the Mixed Methods Appraisal Tool. From 20,002 records identified, 38 studies from 29 manuscripts met the eligibility criteria, of which 16% were high quality. Almost half the manuscripts were published in the last two years. Most took place in institutional settings (n = 30) and all were in Europe or the United States. Strategies included forced restriction (n = 4), menu re-design (n = 6), recipe re-design (n = 6), service re-design (n = 4), menu labelling (n = 7), prompt at point of sale (n = 7) and multi-pronged strategies (n = 4). Menu labelling and re-designing menus, recipes, and service increased uptake of target foods in most studies with the largest consistent changes with menu re-design. Most recipe and service re-design strategies had a positive or neutral effect on satisfaction. Few studies explored financial, dietary or environmental outcomes. Future meat reduction initiatives should focus on menu and recipe re-design as these do not appear to negatively impact consumer satisfaction. More studies are needed to evaluate financial, environmental, and dietary outcomes. Full article

Individuals from racial minority backgrounds, especially those in low income situations, are at increased risk for obesity. Family meals positively impact child nutritional health; however, there is limited evidence examining the impact on caregivers, particularly racial minority and income-restricted individuals. The objective of this intervention study was to determine the effect of Simple Suppers, a 10 week family meals program, on caregiver diet and nutrition outcomes. Intervention versus waitlist control participants were compared from baseline (T0) to post-intervention (T1). In addition, intervention participants were assessed at a 10 week follow-up time point (T2). This study was a two-group quasi-experimental intervention trial. Lessons (10 total) were delivered on a weekly basis for 90 min. Data were collected from intervention and waitlist control participants at T0 and T1, and intervention participants at T2. After baseline (T0) data collection, families enrolled in the immediate upcoming session of Simple Suppers (intervention group) or waited for 10 weeks (waitlist control group) to begin the program. Participants were caregivers of children ages 4–10 years. This study was conducted in a faith-based community center for underserved families in Columbus, Ohio. Primary outcomes were: diet quality assessed by Healthy Eating Index (HEI) total and component scores, and total energy intake (kcal/day); body mass index (BMI) (kg/m²), waist circumference (cm), systolic and diastolic blood pressure (BP) (mmHG); and self-efficacy for having healthy meals and menu planning (both scalar). The impact of the intervention (T0:T1) was assessed using generalized mixed-effects linear regression models. Maintenance of change in study outcomes among intervention participants (T1:T2) was examined with paired t-tests. 109 caregivers enrolled in this study. The retention rate at T1 was 90% (i.e., 98 participants). 56 of 68 intervention participants completed T2, resulting in a retention rate of 82%. Almost all (99%) were female, 61% were Black, and 50% were between 31 and 40 years old. In total, 40% had low income and 37% had low or very low food security. At T1, intervention vs. waitlist controls had a lower daily energy intake (p = 0.04), but an HEI-2010 component score for fatty acids (adequacy) that was lower indicating a lower dietary intake of fatty acids (p = 0.02), and a component score for empty calories (moderation) that was significantly lower indicating a higher intake of empty calorie foods (p = 0.03). At T1, intervention vs. waitlist controls also had a lower BMI (p < 0.001) and systolic BP (p = 0.04), and higher self-efficacy (p = 0.03). There were no group differences in other outcomes. At T2, intervention participants maintained the changes in daily energy intake, BMI, systolic BP, and self-efficacy that improved during the intervention period. There was no change (improvement) in the component score for fatty acids; however, the component score for empty calories significantly improved (p = 0.02). Engagement in the Simple Suppers program led to improvements in caregivers’ daily caloric intake, weight status, systolic blood pressure, and self-efficacy for family meals. Future research should further explore the dietary and nutritional health benefits of family meals among caregivers at the highest risk for obesity. Full article

Public procurement has been highlighted as an important strategic tool to drive sustainable development. The present study aimed at providing direction for decreasing greenhouse gas emissions (GHGE) by 25% for the food purchased by child-care centers in the City of Copenhagen while simultaneously providing nutritionally adequate, affordable and tasty menus. Baseline data were provided by compiling food purchase data with datasets matching each food item to a proxy food item and further with databases containing nutrient and GHGE information. For each food item, the edible amount was estimated in order to evaluate nutritional content and GHGE per 10 MJ. Two scenarios were modeled, i.e., a plant-rich diet and a lacto-ovo vegetarian diet directed at children two to five years old based on current purchase practice. Finally, the diets were translated into guidelines for menu planning. Amounts of pulses, nuts and seeds, as well as dark green vegetables and plant-based fats, were increased substantially in the two scenarios, while animal fat was decreased and the amount of meat was either reduced or eliminated in the plant-rich and lacto-ovo vegetarian diets, respectively. These kinds of changes in public food procurement have the power to significantly affect the transition toward a more healthy and sustainable food system. Full article