The dilemma of healthy eating and environmental sustainability: the case of fish

AbstractObjectiveDespite widespread concern over exploitation of the European Union's fish stocks, dietary guidelines in the UK continue to recommend two portions of fish per week. The present study sought to investigate whether health and/or sustainability are motivating factors when purchasing and consuming fish and whether there are sociodemographic trends.DesignA structured, self-completion postal questionnaire exploring consumers’ attitudes towards purchasing fish, their dietary intake, stated purchasing behaviour and sociodemographic information.SettingNottinghamshire, UK.SubjectsAdults from 842 households randomly selected from the electoral register.ResultsOver half of the participants (57·0 %) were aware of the health benefits of fish consumption and reported health as a primary motivator for purchasing fish; however, only 26·8 % actively sought to purchase fish from a sustainable source (e.g. Marine Stewardship Council (MSC) certified fish). Only 30·6 % of participants met current dietary recommendations for fish intake. Older respondents (>60 years of age) were more likely to report purchasing fish for health reasons and to buy MSC fish. Participants were significantly less likely to report MSC purchases if they agreed with the statement ‘I am confused about which type of fish I should be eating to protect fish stocks’ (P< 0·001).ConclusionsThe number of consumers purchasing fish for health reasons was more than those seeking sustainably sourced fish; yet, they still failed to meet the recommended intake set by the Food Standards Agency. Dietary advice to the public to increase consumption of fish conflicts with the prevailing pressure on fish stocks. Clear advice should be communicated enabling consumers to meet nutritional needs while protecting fish stocks.

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Clues for the development of food-based dietary guidelines: how are dietary targets being achieved by UK consumers?

British Journal Of Nutrition ◽

10.1017/s0007114599000963 ◽

1999 ◽

Vol 81 (S1) ◽

pp. S119-S126 ◽

Cited By ~ 26

Author(s):

Steven J. Wearne ◽

Michael J. L. Day

Keyword(s):

Eating Habits ◽

Food Selection ◽

Saturated Fat ◽

Population Based ◽

Dietary Guidelines ◽

Dietary Advice ◽

Study Population ◽

Total Fat ◽

The Uk ◽

Starchy Foods

Expert scientific advice to the UK Government has been translated into eight general dietary guidelines, which form the core of population-based dietary advice in the UK and are supplemented by a food selection guide showing the types and proportions of foods needed for a balanced and healthy diet. Data from the Dietary and Nutritional Survey of British Adults were used to identify statistically significant differences between subgroups of the study population that met, or failed to meet, population nutritional goals for intakes of total fat, saturated fat and dietary fibre. Several eating habits — including greater consumption of starchy foods (particularly wholemeal varieties), greater consumption of fruit and the substitution of reduced-fat milk for whole-fat milk — were shared by the subgroups that met each of the nutritional goals. This analysis provides clues for any future refinement of food-based dietary guidelines.

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Association Between the EAT-Lancet Diet Pattern and Risk of Type 2 Diabetes: A Prospective Cohort Study

Frontiers in Nutrition ◽

10.3389/fnut.2021.784018 ◽

2022 ◽

Vol 8 ◽

Author(s):

Chenjie Xu ◽

Zhi Cao ◽

Hongxi Yang ◽

Yabing Hou ◽

Xiaohe Wang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Waist Circumference ◽

Environmental Sustainability ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Dietary Guidelines ◽

Related Factors ◽

Diet Pattern ◽

The Uk

Background:The EAT-Lancet Commission has promulgated a sustainable dietary guideline and recommended that it was designed to improve the human health and support environmental sustainability.Objective:This research was designed to explore the association between this healthy diet pattern (EAT-Lancet diet pattern, EAT-LDP) and risk of type 2 diabetes (T2D).Methods:Between 2006 and 2010, a total of 59,849 participants from the UK Biobank without diabetes, cardiovascular disease, or cancers were included at baseline. The EAT-LDP score was constructed on the sum of 14 food components and then categorized into three tertiles. Multivariable Cox proportional hazards regression models were conducted to explore the association between EAT-LDP score and the risk of incident T2D. A mediation analysis was also implemented to disentangle the role of body mass index (BMI) and waist circumference in the relationship between EAT-LDP score and T2D.Results:During a median follow-up of 10 years, 2,461 incident T2D cases were recorded. In analyses that compared tertile 3 of the EAT-LDP score (highest) with tertile 1 (lowest), the hazard ratio (HR) for T2D was 0.81 (95% CI: 0.72–0.90) after adjusting for sociodemographic status and health-related factors. Participants who reported a one-point increase in the diet score were associated with a 6% decrease in risk of T2D (HR: 0.94, 95% CI: 0.91–0.97). A significant indirect association was observed between the EAT-LDP score and T2D (β: 0.66, 95% CI: 0.65–0.67), indicating that 44% of the association of EAT-LDP score with T2D was mediated by BMI. Additionally, 40% of the association of EAT-LDP score with T2D was mediated by waist circumference was also observed.Conclusions:Our findings indicate that a higher adherence to EAT-LDP contributes to lower risk of T2D. Further independent validation is needed to be conducted before applying the EAT-LDP to inform dietary guidelines.

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Are the Eatwell Guide and Nutrient Profiling Models Consistent in the UK?

Nutrients ◽

10.3390/nu13082732 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2732

Author(s):

Ana-Catarina Pinho-Gomes ◽

Asha Kaur ◽

Peter Scarborough ◽

Mike Rayner

Keyword(s):

Dietary Guidelines ◽

Dietary Advice ◽

Nutrition Surveys ◽

The Public ◽

Dietary Index ◽

Nutrient Profiling ◽

Food Policies ◽

The Uk ◽

Dietary Score ◽

Good Agreement

A nutrient profiling model (NPM) was developed in 2005 in the UK to regulate the marketing of foods to children. It was revised in 2018, but the new version has not been finalised. The Eatwell Guide (EWG) is the UK’s official food-based dietary guidelines. The aim of this study was to evaluate the agreement between the 2005 and 2018 versions of the NPM and the EWG. Using recent National Diet and Nutrition Surveys, we estimated the healthiness of individual diets based on an EWG dietary score and a NPM dietary index. We then compared the percentage of agreement and Cohen’s kappa for each combination of the EWG score and NPM index across the range of observed values for the 2005 and 2018 versions. A total of 3028 individual diets were assessed. Individuals with a higher (i.e., healthier) EWG score consumed a diet with, on average, a lower (i.e., healthier) NPM index both for the 2005 and 2018 versions. Overall, there was good agreement between the EWG score and the NPM dietary index at assessing the healthiness of representative diets of the UK population, when a low cut-off for the NPM dietary index was used, irrespective of the version. This suggests that dietary advice to the public is broadly aligned with NPM-based food policies and vice-versa.

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Dietary beliefs and recommendations in inflammatory bowel disease: a national survey of healthcare professionals in the UK

Frontline Gastroenterology ◽

10.1136/flgastro-2020-101723 ◽

2020 ◽

pp. flgastro-2020-101723

Author(s):

Benjamin Crooks ◽

John McLaughlin ◽

Jimmy Limdi

Keyword(s):

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Healthcare Professionals ◽

Gastrointestinal Symptoms ◽

Red Meat ◽

Dietary Advice ◽

Dietary Recommendations ◽

Inflammatory Bowel ◽

Dietary Components ◽

The Uk

BackgroundThe role of diet in inflammatory bowel disease (IBD) remains incompletely understood. Knowledge around the actual dietary advice healthcare professionals provide to individuals with IBD is scarce. Our objective was to describe the dietary beliefs of healthcare professionals and dietary recommendations made to people with IBD.MethodologyAn online survey regarding IBD-related dietary beliefs and advice provided to patients was distributed to gastroenterologists, dietitians and IBD nurses in the UK.ResultsTwo-hundred and twenty-three eligible healthcare professionals participated: 107 (48%) believed that diet was involved in IBD development. The most frequently implicated dietary components were processed foods (78%), additives/preservatives (71%), sweet/sugary foods (36%), red meat (36%) and fatty foods (31%). Views were broadly consistent across professions, however, gastroenterologists were significantly more likely to believe red meat and additives/preservatives initiated IBD. One hundred and thirteen participants (53%) believed that diet could trigger disease relapse and 128 (61%) recommended limiting specific foodstuffs to reduce this risk, most commonly high fibre foods. Forty-six (23%) considered recommending a low Fermentable Oligo-, Di- and Monosaccharides and Polyols diet to reduce relapse risk. IBD nurses and healthcare professionals with <5 years experience were most likely to recommend this. Dietitians felt most comfortable providing dietary advice for functional gastrointestinal symptoms in quiescent IBD.ConclusionDietary advice in IBD is inconsistent reflecting uncertainty among healthcare professionals. While some consensus exists regarding dietary components implicated in IBD development and relapse, dietary recommendations varied. Future research is required to disentangle these complex relationships, alongside better training and education.

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A Global Review of Food-Based Dietary Guidelines

Advances in Nutrition ◽

10.1093/advances/nmy130 ◽

2019 ◽

Vol 10 (4) ◽

pp. 590-605 ◽

Cited By ~ 58

Author(s):

Anna Herforth ◽

Mary Arimond ◽

Cristina Álvarez-Sánchez ◽

Jennifer Coates ◽

Karin Christianson ◽

...

Keyword(s):

Environmental Sustainability ◽

Fruits And Vegetables ◽

Fats And Oils ◽

Food Group ◽

Dietary Guidelines ◽

Sociocultural Factors ◽

Dietary Recommendations ◽

Country Level ◽

The Pacific ◽

Global Guidance

ABSTRACT The objective of this review is to provide a concise, descriptive global review of current food-based dietary guidelines (FBDG), and to assess similarities and differences in key elements of a healthy diet articulated across countries. Information was sourced from the FBDG repository of the FAO, which catalogs FBDG for all countries where they are available, including a description of the food guide (the graphic representation of the dietary guidelines), a set of key messages, and downloadable documents provided by the countries. FBDG are currently available for 90 countries globally: 7 in Africa, 17 in Asia and the Pacific, 33 in Europe, 27 in Latin America and the Caribbean, 4 in the Near East, and 2 in North America. The year of publication of current versions ranges from 1986 to 2017 (mean 2009). This review provides summaries of the key messages and food guides that are used to communicate national dietary guidance, organized by food group, and evaluates the extent to which each set of FBDG includes existing recommendations articulated by the WHO. Some guidance appears nearly universally across countries: to consume a variety of foods; to consume some foods in higher proportion than others; to consume fruits and vegetables, legumes, and animal-source foods; and to limit sugar, fat, and salt. Guidelines on dairy, red meat, fats and oils, and nuts are more variable. Although WHO global guidance encourages consumption of nuts, whole grains, and healthy fats, these messages are not universally echoed across countries. Future frontiers in FBDG development include the incorporation of environmental sustainability and increased attention to sociocultural factors including rapidly changing dietary trends. Steps toward regional and global dietary recommendations could be helpful for refinement of country-level FBDG, and for clear communication and measurement of diet quality both nationally and globally.

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Costs of a healthy diet: analysis from the UK Women's Cohort Study

Public Health Nutrition ◽

10.1017/s1368980099000683 ◽

1999 ◽

Vol 2 (4) ◽

pp. 505-512 ◽

Cited By ~ 119

Author(s):

Janet Cade ◽

Hendrike Upmeier ◽

Claire Calvert ◽

Darren Greenwood

Keyword(s):

Cohort Study ◽

Postal Questionnaire ◽

Diet Group ◽

Healthy Diet ◽

Diet Analysis ◽

Dietary Recommendations ◽

Home Shopping ◽

The Difference ◽

The Uk ◽

Food Budget

AbstractObjective:To investigate the direct and indirect cost differences associated with eating a ‘healthy’ or ‘unhealthy’ diet.Design:Analysis of data from a baseline postal questionnaire for the UK Women's Cohort Study, including a detailed food frequency questionnaire (FFQ), supplemented by a telephone interview on a sub-sample.Subjects:The first 15 191 women who responded to the questionnaire, aged 35–69 years with similar numbers of meat eaters, fish eaters and vegetarians.Results:A healthy diet indicator (hdi), with values from 0 (lowest) to 8 (highest) was developed based on the WHO dietary recommendations. Direct monetary cost of the diet was calculated using prices from the 1995 National Food Survey and the Tesco home shopping catalogue. Women in the healthy diet group were almost four times as likely to be vegetarian and have a higher educational level. For direct costs, the difference between the most extreme hdi groups was £1.48 day−1 (equivalent to £540 year−1), with fruit and vegetable expenditure being the main items making a healthy diet more expensive. Forty-nine per cent of the food budget was spent on fruit and vegetables in hdi group 8 compared to 29% in hdi group 0. Interestingly, 52% of those questioned in both extreme hdi groups did not think that it was difficult to eat healthily.Conclusions:To achieve a particularly healthy diet independent predictive factors were spending more money, being a vegetarian, having a higher energy intake, having a lower body mass index (BMI) and being older.

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Sociodemographic Factors Associated with Adherence to Dietary Guidelines in Women with Gestational Diabetes: A Cohort Study

Nutrients ◽

10.3390/nu13061884 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1884

Author(s):

Sara Mustafa ◽

Jane Harding ◽

Clare Wall ◽

Caroline Crowther

Keyword(s):

New Zealand ◽

Gestational Diabetes ◽

Previous History ◽

Sociodemographic Factors ◽

Dietary Guidelines ◽

Dietary Advice ◽

Dietary Adherence ◽

Dietary Recommendations ◽

Maternal Characteristics ◽

Factors Associated

Dietary advice is the cornerstone of care for women with gestational diabetes mellitus (GDM). However, adherence to this advice is variable. We aimed to identify the proportion of women with GDM who adhere to the New Zealand nutrition guideline recommendations and assess the sociodemographic factors linked to dietary adherence. We assessed dietary intake at 36 weeks’ gestation in a cohort of 313 women with GDM and compared this with the dietary recommendations for the management of GDM. Associations between maternal characteristics and dietary adherence were assessed using ANOVA, chi square, logistic regression, and linear regression tests. Women with GDM had an average adherence score of 6.17 out of 10 to dietary recommendations, but no one adhered to all the recommendations. Adherence to recommendations was lowest for saturated fat, and wholegrain breads and cereals. While 85% visited a dietitian, only 28% of women achieved their recommended weight gain. Maternal factors associated with lower dietary adherence were primiparity, no previous history of GDM, being underweight, and smoking. Adherence to the dietary recommendations by women with GDM in New Zealand for the management could be improved. Further research is needed to identify ways for women with GDM to improve their dietary adherence.

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Integration of various dimensions in food-based dietary guidelines via mathematical approaches Report of a DGE/FENS Workshop in Bonn, Germany, 23-24 September 2019

British Journal Of Nutrition ◽

10.1017/s0007114520004857 ◽

2020 ◽

pp. 1-18

Author(s):

Anne Carolin Schäfer ◽

Annemarie Schmidt ◽

Angela Bechthold ◽

Heiner Boeing ◽

Bernhard Watzl ◽

...

Keyword(s):

Population Based ◽

Dietary Guidelines ◽

Dietary Recommendations ◽

Mathematical Methods ◽

Trade Offs ◽

Simultaneous Integration ◽

Joint Workshop ◽

Different Dimensions ◽

Diverse Data ◽

Mathematical Optimisation

Abstract In the past, food-based dietary guidelines (FBDGs) were derived nearly exclusively by using systematic reviews on diet-health-relationships and translating dietary reference values for nutrient intake into foods. This approach neglects many other implications that dietary recommendations have on society, the economy and environment. In view of pressing challenges, such as climate change and the rising burden of diet-related diseases, the simultaneous integration of evidence-based findings from different dimensions into FBDGs is required. Consequently, mathematical methods and data processing are evolving as powerful tools in nutritional sciences. The possibilities and reasons for the derivation of FBDGs via mathematical approaches were the subject of a joint workshop hosted by the German Nutrition Society (DGE) and the Federation of European Nutrition Societies (FENS) in September 2019 in Bonn, Germany. European scientists were invited to discuss and exchange on the topics of mathematical optimisation for the development of FBDGs and different approaches to integrate various dimensions into FBDGs. We concluded that mathematical optimisation is a suitable tool to formulate FBDGs finding trade-offs between conflicting goals and taking several dimensions into account. We identified a lack of evidence for the extent to which constraints and weights for different dimensions are set and the challenge to compile diverse data that suit the demands of optimisation models. We also found that individualisation via mathematical optimisation is one perspective of FBDGs to increase consumer acceptance, but the application of mathematical optimisation for population-based and individual FBDGs requires more experience and evaluation for further improvements.

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The healthiness and sustainability of national and global food based dietary guidelines: modelling study

BMJ ◽

10.1136/bmj.m2322 ◽

2020 ◽

pp. m2322 ◽

Cited By ~ 7

Author(s):

Marco Springmann ◽

Luke Spajic ◽

Michael A Clark ◽

Joseph Poore ◽

Anna Herforth ◽

...

Keyword(s):

Global Health ◽

Greenhouse Gas Emissions ◽

Greenhouse Gas ◽

National Level ◽

Premature Mortality ◽

Dietary Guidelines ◽

National Guidelines ◽

Gas Emissions ◽

Paris Climate Agreement ◽

The Uk

AbstractObjectiveTo analyse the health and environmental implications of adopting national food based dietary guidelines (FBDGs) at a national level and compared with global health and environmental targets.DesignModelling study.Setting85 countries.ParticipantsPopulation of 85 countries.Main outcome measuresA graded coding method was developed and used to extract quantitative recommendations from 85 FBDGs. The health and environmental impacts of these guidelines were assessed by using a comparative risk assessment of deaths from chronic diseases and a set of country specific environmental footprints for greenhouse gas emissions, freshwater use, cropland use, and fertiliser application. For comparison, the impacts of adopting the global dietary recommendations of the World Health Organization and the EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems were also analysed. Each guideline’s health and sustainability implications were assessed by modelling its adoption at both the national level and globally, and comparing the impacts to global health and environmental targets, including the Action Agenda on Non-Communicable Diseases, the Paris Climate Agreement, the Aichi biodiversity targets related to land use, and the sustainable development goals and planetary boundaries related to freshwater use and fertiliser application.ResultsAdoption of national FBDGs was associated with reductions in premature mortality of 15% on average (95% uncertainty interval 13% to 16%) and mixed changes in environmental resource demand, including a reduction in greenhouse gas emissions of 13% on average (regional range −34% to 35%). When universally adopted globally, most of the national guidelines (83, 98%) were not compatible with at least one of the global health and environmental targets. About a third of the FBDGs (29, 34%) were incompatible with the agenda on non-communicable diseases, and most (57 to 74, 67% to 87%) were incompatible with the Paris Climate Agreement and other environmental targets. In comparison, adoption of the WHO recommendations was associated with similar health and environmental changes, whereas adoption of the EAT-Lancet recommendations was associated with 34% greater reductions in premature mortality, more than three times greater reductions in greenhouse gas emissions, and general attainment of the global health and environmental targets. As an example, the FBDGs of the UK, US, and China were incompatible with the climate change, land use, freshwater, and nitrogen targets, and adopting guidelines in line with the EAT-Lancet recommendation could increase the number of avoided deaths from 78 000 (74 000 to 81 000) to 104 000 (96 000 to 112 000) in the UK, from 480 000 (445 000 to 516 000) to 585 000 (523 000 to 646 000) in the USA, and from 1 149 000 (1 095 000 to 1 204 000) to 1 802 000 (1 664 000 to 1 941 000) in China.ConclusionsThis analysis suggests that national guidelines could be both healthier and more sustainable. Providing clearer advice on limiting in most contexts the consumption of animal source foods, in particular beef and dairy, was found to have the greatest potential for increasing the environmental sustainability of dietary guidelines, whereas increasing the intake of whole grains, fruits and vegetables, nuts and seeds, and legumes, reducing the intake of red and processed meat, and highlighting the importance of attaining balanced energy intake and weight levels were associated with most of the additional health benefits. The health results were based on observational data and assuming a causal relation between dietary risk factors and health outcomes. The certainty of evidence for these relations is mostly graded as moderate in existing meta-analyses.

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Green business models in the construction sector: an analysis of outcomes and benefits

Construction Innovation ◽

10.1108/ci-07-2016-0041 ◽

2018 ◽

Vol 18 (1) ◽

pp. 20-42 ◽

Cited By ~ 9

Author(s):

Amal Abuzeinab ◽

Mohammed Arif ◽

Mohd. Asim Qadri ◽

Dennis Kulonda

Keyword(s):

Environmental Sustainability ◽

Business Models ◽

Dominant Role ◽

Business Case ◽

Essential Elements ◽

Construction Sector ◽

Structured Interviews ◽

Content Type ◽

Green Business ◽

The Uk

Purpose Green business models (GBMs) in the construction sector represent the logic of green value creation and capture. Hence, the call to examine GBMs is growing ever louder. The aim of this paper is to identify benefits of GBMs by adopting five essential elements of the GBM from the literature: green value proposition; target group; key activities; key resources (KR); and financial logic. Design/methodology/approach In all, 19 semi-structured interviews are conducted with construction sector practitioners and academics in the UK. Thematic analysis is used to obtain benefits of GBMs. Further, the interpretive ranking process (IRP) is used to examine which elements of the GBM have a dominant role in providing benefits to construction businesses. Findings The benefits are grouped into three themes: credibility/reputation benefits; financial benefits; and long-term viability benefits. The IRP model shows that the element of KR is the most important when evaluated against these three benefit themes. Practical implications Linking GBM elements and benefits will help companies in the construction sector to analyse the business case of embracing environmental sustainability. Originality/value This research is one of the few empirical academic works investigating the benefits of GBMs in the construction sector. The IRP method is a novel contribution to GBMs and construction research.

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