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Gupta N, Leapman MS, Loeb S. Plant-based diets, animal agriculture, and the connection with urological and planetary health. Curr Opin Urol 2024:00042307-990000000-00161. [PMID: 38832408 DOI: 10.1097/mou.0000000000001191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
PURPOSE OF REVIEW We summarize the latest evidence regarding the impact of plant-based diets on urological and planetary health to facilitate patient counseling and research regarding dietary intervention. RECENT FINDINGS Studies have highlighted the association of plant-based diets with a lower risk of multiple urological conditions including prostate cancer, erectile dysfunction, benign prostatic hyperplasia, and nephrolithiasis, as well as benefits for planetary health. SUMMARY Plant-based diets are associated with numerous benefits that co-promote urological and planetary health.
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Affiliation(s)
- Natasha Gupta
- Department of Urology
- Department of Population Health, New York University
- Department of Surgery/Urology, Manhattan Veterans Affairs, Manhattan, New York
| | - Michael S Leapman
- Department of Urology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Stacy Loeb
- Department of Urology
- Department of Population Health, New York University
- Department of Surgery/Urology, Manhattan Veterans Affairs, Manhattan, New York
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Renouf D, Wong MMY. From Prophecy to Plate: How to Actualize a Planetary Menu for Kidney Disease Nutrition. Can J Kidney Health Dis 2024; 11:20543581241244965. [PMID: 38712334 PMCID: PMC11072064 DOI: 10.1177/20543581241244965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/12/2024] [Indexed: 05/08/2024] Open
Affiliation(s)
- Dani Renouf
- Providence Health Care, Vancouver, BC, Canada
- BC Renal, Vancouver, Canada
| | - Michelle M. Y. Wong
- BC Renal, Vancouver, Canada
- Division of Nephrology, Department of Medicine, The University of British Columbia, Vancouver, Canada
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Pettigrew S, Taylor F, Hunnisett C, Hadjikakou M. Sustainable diets: Empowering consumers in the face of regulatory tardiness. Aust N Z J Public Health 2024:100151. [PMID: 38811251 DOI: 10.1016/j.anzjph.2024.100151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 05/31/2024] Open
Affiliation(s)
- Simone Pettigrew
- The George Institute for Public Health, University of New South Wales, Australia.
| | - Fraser Taylor
- The George Institute for Public Health, University of New South Wales, Australia
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Frank SM, Jaacks LM, Meyer K, Rose D, Adair LS, Avery CL, Taillie LS. Dietary quality and dietary greenhouse gas emissions in the USA: a comparison of the planetary health diet index, healthy eating index-2015, and dietary approaches to stop hypertension. Int J Behav Nutr Phys Act 2024; 21:36. [PMID: 38566176 PMCID: PMC10988877 DOI: 10.1186/s12966-024-01581-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The Planetary Health Diet Index (PHDI) measures adherence to the dietary pattern presented by the EAT-Lancet Commission, which aligns health and sustainability targets. There is a need to understand how PHDI scores correlate with dietary greenhouse gas emissions (GHGE) and how this differs from the carbon footprints of scores on established dietary recommendations. The objectives of this study were to compare how the PHDI, Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to (a) dietary GHGE and (b) to examine the influence of PHDI food components on dietary GHGE. METHODS We used life cycle assessment data from the Database of Food Recall Impacts on the Environment for Nutrition and Dietary Studies to calculate the mean dietary GHGE of 8,128 adult participants in the 2015-2016 and 2017-2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Poisson regression was used to estimate the association of (a) quintiles of diet score and (b) standardized dietary index Z-scores with dietary GHGE for PHDI, HEI-2015, and DASH scores. In secondary analyses, we used Poisson regression to assess the influence of individual PHDI component scores on dietary GHGE. RESULTS We found that higher dietary quality on all three indices was correlated with lower dietary GHGE. The magnitude of the dietary quality-dietary GHGE relationship was larger for PHDI [-0.4, 95% CI (-0.5, -0.3) kg CO2 equivalents per one standard deviation change] and for DASH [-0.5, (-0.4, -0.6) kg CO2-equivalents] than for HEI-2015 [-0.2, (-0.2, -0.3) kg CO2-equivalents]. When examining PHDI component scores, we found that diet-related GHGE were driven largely by red and processed meat intake. CONCLUSIONS Improved dietary quality has the potential to lower the emissions impacts of US diets. Future efforts to promote healthy, sustainable diets could apply the recommendations of the established DASH guidelines as well as the new guidance provided by the PHDI to increase their environmental benefits.
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Affiliation(s)
- Sarah M Frank
- Global Academy of Agriculture and Food Systems, Royal (DICK) School of Veterinary Studies, The University of Edinburgh, Edinburgh, Scotland
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W Franklin St, Room 2107, Chapel Hill, NC, 27514, USA
| | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Systems, Royal (DICK) School of Veterinary Studies, The University of Edinburgh, Edinburgh, Scotland
| | - Katie Meyer
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donald Rose
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Linda S Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W Franklin St, Room 2107, Chapel Hill, NC, 27514, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christy L Avery
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W Franklin St, Room 2107, Chapel Hill, NC, 27514, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, 123 W Franklin St, Room 2107, Chapel Hill, NC, 27514, USA.
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Unger AL, Beal T, Conrad Z, Pikosky MA, Brown K. Opportunities for Consistent and Holistic Metrics to Support Food Systems Transformation: A Summary of a Symposium Presented at Nutrition 2023. Curr Dev Nutr 2024; 8:102129. [PMID: 38559312 PMCID: PMC10981006 DOI: 10.1016/j.cdnut.2024.102129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
There is an urgent need for global food systems transformation to realize a future where planetary health reaches its full potential. Paramount to this vision is the ability of stakeholders across sectors to understand how foods and dietary patterns impact food systems inclusive of all domains of sustainability-environmental, nutrition/health, economic and social. This article is a synopsis of presentations by 3 food systems experts to share the latest science in a session entitled "How do you measure sustainability? Opportunities for consistent and holistic metrics to support food systems transformation" at the American Society for Nutrition's 2023 annual conference. As summarized here, global population data showing widespread malnutrition underscore the important role of dietary diversity through a balance of plant- and animal-source foods to achieve nutritionally adequate diets and reduce risk of noncommunicable diseases. Yet, recent international audits of countries, companies, and organizations and their sustainability targets largely demonstrate an underrepresentation of robust nutrition/health metrics to support public nutrition and health progress. Addressing limitations in diet-sustainability modeling systems provides a viable opportunity to accurately reflect the important contributions and trade-offs of diets across all domains of sustainability to ultimately support evidence-based decision making in advancing healthy food systems.
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Affiliation(s)
| | - Ty Beal
- Global Alliance for Improved Nutrition, Washington, DC, United States
| | - Zach Conrad
- Department of Kinesiology, William & Mary, Williamsburg, VA, United States
- Global Research Institute, William & Mary, Williamsburg, VA, United States
| | | | - Katie Brown
- National Dairy Council, Rosemont, IL, United States
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Wang DD, Li Y, Nguyen XM, Ho YL, Hu FB, Willett WC, Wilson PW, Cho K, Gaziano JM, Djoussé L. Red Meat Intake and the Risk of Cardiovascular Diseases: A Prospective Cohort Study in the Million Veteran Program. J Nutr 2024; 154:886-895. [PMID: 38163586 DOI: 10.1016/j.tjnut.2023.12.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Red meat consumption was associated with an increased risk of cardiovascular disease (CVD) in prospective cohort studies and a profile of biomarkers favoring high CVD risk in short-term controlled trials. However, several recent systematic reviews and meta-analyses concluded with no or weak evidence for limiting red meat intake. OBJECTIVES To prospectively examine the associations between red meat intake and incident CVD in an ongoing cohort study with diverse socioeconomic and racial or ethnic backgrounds. METHODS Our study included 148,506 participants [17,804 female (12.0%)] who were free of cancer, diabetes, and CVD at baseline from the Million Veteran Program. A food frequency questionnaire measured red meat intakes at baseline. Nonfatal myocardial infarction and acute ischemic stroke were identified through a high-throughput phenotyping algorithm, and fatal CVD events were identified by searching the National Death Index. RESULTS Comparing the extreme categories of intake, the multivariate-adjusted relative risks of CVD was 1.18 (95% CI: 1.01, 1.38; P-trend < 0.0001) for total red meat, 1.14 (95% CI: 0.96, 1.36; P-trend = 0.01) for unprocessed red meat, and 1.29 (95% CI: 1.04, 1.60; P-trend = 0.003) for processed red meat. We observed a more pronounced positive association between red meat intake and CVD in African American participants than in White participants (P-interaction = 0.01). Replacing 0.5 servings/d of red meat with 0.5 servings/d of nuts, whole grains, and skimmed milk was associated with 14% (RR: 0.86; 95% CI: 0.83, 0.90), 7% (RR: 0.93; 95% CI: 0.89, 0.96), and 4% (RR: 0.96; 95% CI: 0.94, 0.99) lower risks of CVD, respectively. CONCLUSIONS Red meat consumption is associated with an increased risk of CVD. Our findings support lowering red meat intake and replacing red meat with plant-based protein sources or low-fat dairy foods as a key dietary recommendation for the prevention of CVD.
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Affiliation(s)
- Dong D Wang
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Broad Institute of MIT and Harvard, Cambridge, MA, United States.
| | - Yanping Li
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Xuan-Mai Nguyen
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Yuk-Lam Ho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States
| | - Frank B Hu
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Walter C Willett
- The Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Peter Wf Wilson
- Atlanta VA Medical Center, Atlanta, GA, United States; Emory Clinical Cardiovascular Research Institute, Atlanta, GA, United States
| | - Kelly Cho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - J Michael Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Luc Djoussé
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, United States; Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
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Frank SM, Jaacks LM, Adair LS, Avery CL, Meyer K, Rose D, Taillie LS. Adherence to the Planetary Health Diet Index and correlation with nutrients of public health concern: an analysis of NHANES 2003-2018. Am J Clin Nutr 2024; 119:384-392. [PMID: 38309827 PMCID: PMC10884610 DOI: 10.1016/j.ajcnut.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 10/10/2023] [Accepted: 10/19/2023] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND The Planetary Health Diet Index (PHDI) is a novel measure adapted to quantify alignment with the dietary evidence presented by the EAT-Lancet Commission on Food, Planet, Health. OBJECTIVES To examine how population-level health and sustainability of diet as measured by the PHDI changed from 2003 to 2018, and to assess how PHDI correlated with inadequacy for nutrients of public health concern (iron, calcium, potassium, and fiber) in the United States. METHODS We estimated survey-weighted trends in PHDI scores and median intake of PHDI components in a nationally representative sample of 33,859 adults aged 20+ y from 8 cycles (2003-2018) of the National Health and Nutrition Examination Survey with 2 d of dietary recall data. We used the National Cancer Institute method to examine how PHDI correlated with inadequate intake of iron, calcium, potassium, and fiber. RESULTS Out of a theoretical range of 0-140, the median PHDI value increased by 4.2 points over the study period, from 62.7 (95% confidence interval [CI]: 62.0, 63.4) points in 2003-2004 to 66.9 (66.2, 67.7) points in 2017-2018 (P-trend < 0.001), although most of this change occurred before 2011-2012 and plateaued thereafter. For adequacy components that are encouraged for consumption, nonstarchy vegetable intake significantly decreased over time, whereas whole grains, nuts and seeds, and unsaturated oils increased. For moderation components with recommended limits for consumption, poultry and egg intake increased, but red and processed meat, added sugars, saturated fats, and starchy vegetables decreased over time. Higher PHDI values were associated with a lower probability of iron, fiber, and potassium inadequacy. CONCLUSIONS Although there have been positive changes over the past 20 y, there is substantial room for improving the health and sustainability of the United States diet. Shifting diets toward EAT-Lancet recommendations would improve nutrient adequacy for iron, fiber, and potassium. Policy action is needed to support healthier, more sustainable diets in the United States and globally.
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Affiliation(s)
- Sarah M Frank
- Global Academy of Agriculture and Food Security, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, United Kingdom; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lindsay M Jaacks
- Global Academy of Agriculture and Food Security, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, United Kingdom
| | - Linda S Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Christy L Avery
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Katie Meyer
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, NC, United States
| | - Donald Rose
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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Frank SM, Jaacks LM, Avery CL, Adair LS, Meyer K, Rose D, Taillie LS. Dietary quality and cardiometabolic indicators in the USA: A comparison of the Planetary Health Diet Index, Healthy Eating Index-2015, and Dietary Approaches to Stop Hypertension. PLoS One 2024; 19:e0296069. [PMID: 38198440 PMCID: PMC10781024 DOI: 10.1371/journal.pone.0296069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/05/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The Planetary Health Diet Index (PHDI) measures adherence to the sustainable dietary guidance proposed by the EAT-Lancet Commission on Food, Planet, Health. To justify incorporating sustainable dietary guidance such as the PHDI in the US, the index needs to be compared to health-focused dietary recommendations already in use. The objectives of this study were to compare the how the Planetary Health Diet Index (PHDI), the Healthy Eating Index-2015 (HEI-2015) and Dietary Approaches to Stop Hypertension (DASH) relate to cardiometabolic risk factors. METHODS AND FINDINGS Participants from the National Health and Nutrition Examination Survey (2015-2018) were assigned a score for each dietary index. We examined disparities in dietary quality for each index. We used linear and logistic regression to assess the association of standardized dietary index values with waist circumference, blood pressure, HDL-C, fasting plasma glucose (FPG) and triglycerides (TG). We also dichotomized the cardiometabolic indicators using the cutoffs for the Metabolic Syndrome and used logistic regression to assess the relationship of the standardized dietary index values with binary cardiometabolic risk factors. We observed diet quality disparities for populations that were Black, Hispanic, low-income, and low-education. Higher diet quality was associated with improved continuous and binary cardiometabolic risk factors, although higher PHDI was not associated with high FPG and was the only index associated with lower TG. These patterns remained consistent in sensitivity analyses. CONCLUSIONS Sustainability-focused dietary recommendations such as the PHDI have similar cross-sectional associations with cardiometabolic risk as HEI-2015 or DASH. Health-focused dietary guidelines such as the forthcoming 2025-2030 Dietary Guidelines for Americans can consider the environmental impact of diet and still promote cardiometabolic health.
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Affiliation(s)
- Sarah M. Frank
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Midlothian, United Kingdom
| | - Lindsay M. Jaacks
- Global Academy of Agriculture and Food Systems, University of Edinburgh, Midlothian, United Kingdom
| | - Christy L. Avery
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Linda S. Adair
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Katie Meyer
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, United States of America
| | - Donald Rose
- Tulane Nutrition, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Los Angeles, United States of America
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Woodside JV, Lindberg L, Nugent AP. Harnessing the power on our plates: sustainable dietary patterns for public and planetary health. Proc Nutr Soc 2023; 82:437-453. [PMID: 37905409 DOI: 10.1017/s0029665123004809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Globally, diet quality is poor, with populations failing to achieve national dietary guidelines. Such failure has been consistently linked with malnutrition and poorer health outcomes. In addition to the impact of diet on health outcomes, it is now accepted that what we eat, and the resulting food system, has significant environmental or planetary health impacts. Changes are required to our food systems to reduce these impacts and mitigate the impact of climate change on our food supply. Given the complexity of the interactions between climate change, food and health, and the different actors and drivers that influence these, a systems-thinking approach to capture such complexity is essential. Such an approach will help address the challenges set by the UN 2030 Agenda for sustainable development in the form of the sustainable development goals (SDG). Progress against SDG has been challenging, with an ultimate target of 2030. While the scientific uncertainties regarding diet and public and planetary health need to be addressed, equal attention needs to be paid to the structures and systems, as there is a need for multi-level, coherent and sustained structural interventions and policies across the full food system/supply chain to effect behaviour change. Such systems-level change must always keep nutritional status, including impact on micronutrient status, in mind. However, benefits to both population and environmental health could be expected from achieving dietary behaviour change towards more sustainable diets.
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Affiliation(s)
- Jayne V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Leona Lindberg
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
| | - Anne P Nugent
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, UK
- Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
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Lauterbach KW. Evidence-based policy-making - epidemiology as a key science for quality of life in society. Eur J Epidemiol 2023; 38:1205-1212. [PMID: 37940766 PMCID: PMC10757906 DOI: 10.1007/s10654-023-01056-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Karl W Lauterbach
- Minister of Health, Federal Ministry of Health, 11055, Berlin, Germany.
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11
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Dietz WH, Fanzo J. Mitigation of the U.S. agrifood sector's contribution to human and planetary health: a case study. Front Nutr 2023; 10:1297214. [PMID: 38035359 PMCID: PMC10687543 DOI: 10.3389/fnut.2023.1297214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023] Open
Abstract
The relationship of the United States (U.S.) agrifood sector to climate change is bidirectional; cattle production for beef consumption generates methane and nitrous oxide, both of which are potent greenhouse gases (GHGs). These gases contribute to global warming which in turn increase the frequency and strength of adverse catastrophic events, which compromise the food supply. Increased GHGs also affect crop yields and the micronutrient content of crops, which adversely affect the prevalence of food and nutrition insecurity, particularly in low- and middle-income countries. Because the U.S. is a major contributor to global warming, we have a special responsibility to reduce our contribution to the generation of GHGs. The dilemma is that beef is a highly nutritious and desirable food, with excess consumption in the U.S. and under consumption in other parts of the world, but a desirable source of nutrients in low- and middle-income countries (LMICs). Reductions in fossil fuels have been a major focus of concern, and the agrifood system has been largely ignored. Policy changes to reduce beef consumption have been resisted at the highest levels of government. Furthermore, shifts to more plant-based diets have been contentious. Successful reductions in beef consumption will require individual, institutional, municipal, and state initiatives. Building the political will for change will require a compelling communication campaign that emphasizes the unsustainable contribution of beef consumption to climate change and land and water use.
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Affiliation(s)
- William H. Dietz
- Global Food Institute, George Washington University, Washington, DC, United States
| | - Jessica Fanzo
- Columbia’s Climate School, Columbia University, New York, NY, United States
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Agarwal S, Fulgoni VL. Effect of Adding Pulses to Replace Protein Foods and Refined Grains in Healthy Dietary Patterns. Nutrients 2023; 15:4355. [PMID: 37892430 PMCID: PMC10610119 DOI: 10.3390/nu15204355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Pulses are dry seeds of legumes which are high in fiber and contain plant protein and several important macronutrients. Our aim was to model the nutritional effects of substituting servings of protein foods and/or refined grains with servings of beans and peas in the Healthy U.S.-Style Pattern identified in the Dietary Guidelines for Americans, 2020-2025. Dietary modeling was accomplished by substituting nutrients of protein foods and/or refined grains with nutrients of the USDA's beans and peas (pulses) composite in the 2000 kcal Healthy U.S.-Style Pattern. A 10% or more change was used as an indicator of meaningful differences. Cost implications were computed by adding the cost of pulses and subtracting the cost of protein foods/refined grains according to the modeling scenario. The substitution of 6-8 oz/week protein foods with 1.5-2.0 cups/week pulses increased fiber and decreased cholesterol. Higher amounts of pulses replacing refined grains or combinations of protein foods and refined grains generally increase fiber, iron, magnesium, potassium, and copper depending on the modeling scenarios. All modeling scenarios of substituting the servings of protein foods alone or in combination with refined grains with the servings of pulses were associated with cost savings. Our results suggest that encouraging increased pulse consumption may be an effective strategy for improving diet.
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Rosenfeld RM, Juszczak HM, Wong MA. Scoping review of the association of plant-based diet quality with health outcomes. Front Nutr 2023; 10:1211535. [PMID: 37637943 PMCID: PMC10447911 DOI: 10.3389/fnut.2023.1211535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction The association of plant-based dietary patterns with health outcomes has traditionally been assessed without considering nutritional value. The plant-based dietary index (PDI), first published in 2016, overcomes this limitation with both a healthful PDI (hPDI) and an unhealthful PDI (uPDI), based on the quality of plant foods consumed plus the frequency of animal foods. We sought to summarize the breadth of research using the hPDI and uPDI to gain insight into how the quality of plant-based dietary patterns might be associated with health outcomes. Methods Scoping review of studies that used the PDI, hPDI, or uPDI to report associations with health outcomes. Multiple databases were searched from 2010 through April 2023 with 2 authors independently assessing eligibility and extracting data. In addition to assessing the association of the indices to health outcomes, we determined the frequency of concordant or discordant findings for hPDI versus PDI and for hPDI versus uPDI. Results We included 95 articles (54% longitudinal, 37% cross-sectional, and 9% case-control) with a median sample size of 3,646. Higher hPDI levels were associated with favorable health outcomes in 36% of comparisons (most often for obesity, mortality, diabetes, cardiovascular disease, and psychiatric disorders), compared to 25% for the PDI and only 2% for the uPDI. Conversely, higher levels of the uPDI were associated with unfavorable health outcomes in 33% of comparisons, in contrast to under 1% for the hPDI and 2% for the PDI. When the hPDI association to an outcome was discordant with the uPDI or PDI, the significance and directionality always favored the hPDI over the uPDI, and nearly always favored the hPDI over the PDI. Discussion Dietary indices that account for the quality of plant foods can show health benefits that might be missed by a generic plant-based index. A greater focus on the quality of plant foods could improve nutrition guidelines, raise awareness about the benefits of adding unrefined plant foods to the diet, and empower consumers to make incremental additions of such foods to displace unhealthy foods. We anticipate increasing use of indices that address food quality in future research.
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Affiliation(s)
- Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States
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Conrad Z, Drewnowski A, Love DC. Greater adherence to the Dietary Guidelines for Americans is associated with lower diet-related greenhouse gas emissions but higher costs. Front Nutr 2023; 10:1220016. [PMID: 37599695 PMCID: PMC10433380 DOI: 10.3389/fnut.2023.1220016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Few studies have evaluated the sustainability of popular diet patterns in the US, which limits policy action and impedes consumer efficacy to make sustainable dietary changes. This study filled this gap by evaluating the relationship between diet quality, greenhouse gas emissions (GHGE), and diet cost for plant-based, restricted carbohydrate, low grain, low fat, and time restricted diet patterns. Methods Dietary data were retrieved from the National Health and Nutrition Examination Survey (2011-2018, n = 8,146) and linked with data on GHGE and food prices from publicly available databases. Diet quality was measured using the Healthy Eating Index-2015. The present study (1) compared the mean diet quality, GHGE, and diet cost between diet patterns, (2) evaluated the association of diet quality to GHGE and diet cost for each diet pattern, and (3) estimated the contribution of food sources to GHGE and diet cost for each diet pattern. Results Higher diet quality was associated with lower GHGE for the general population and for most diet patterns (p < 0.01) except for the plant-based and time restricted diet patterns (p > 0.05). Higher diet quality was associated with higher cost for the general population and for all dietary patterns (p < 0.01) except the time restricted diet pattern (p > 0.05). Protein foods, mostly beef, accounted for the largest share of GHGE (29-40%) and diet cost (28-47%) for all diet patterns except plant-based. Discussion Higher diet quality was associated with lower GHGE but was often accompanied by higher diet cost. These sustainability trade-offs can help inform major policy discussions in the US and shed light on further research needs in the area of food systems transformation.
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Affiliation(s)
- Zach Conrad
- Department of Kinesiology, William & Mary, Williamsburg, VA, United States
- Global Research Institute, William & Mary, Williamsburg, VA, United States
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, United States
| | - David C. Love
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Conrad Z, Drewnowski A, Belury MA, Love DC. Greenhouse gas emissions, cost, and diet quality of specific diet patterns in the United States. Am J Clin Nutr 2023:S0002-9165(23)46847-5. [PMID: 37075848 DOI: 10.1016/j.ajcnut.2023.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Major policy agendas are calling for accelerated investment in research that addresses the impact of diet patterns on multiple domains of sustainability. OBJECTIVE To evaluate the comparative greenhouse gas emissions, diet cost, and diet quality of plant-based, low grain, restricted carbohydrate, low fat, and time restricted diet patterns on a daily per capita basis. DESIGN Dietary data from the National Health and Nutrition Examination Survey (2013-2016, n=4,025) were merged with data on greenhouse gas emissions (GHGE) and food prices from multiple databases. The Healthy Eating Index-2015 was used to measure diet quality. RESULTS The plant-based diet pattern had the lowest GHGE (3.5 kg CO2eq, 95% CI: 3.3, 3.8 kg CO2eq) and among the lowest diet cost ($11.51, 95% CI: $10.67, $12.41), but diet quality (45.8, 95% CI: 43.3, 48.5) was similar (P>0.005) to most other diet patterns. All of the sustainability impacts of the low grain diet pattern were intermediate. The restricted carbohydrate diet pattern had the highest diet cost ($18.46, 95% CI: $17.80, $19.13) but intermediate diet quality (46.8, 95% CI: 45.7, 47.9) and moderate-to-high GHGE (5.7 kg CO2eq, 95% CI: 5.4, 5.9 kg CO2eq). The low fat diet pattern had the highest diet quality (52.0, 95% CI: 50.8, 53.1) and intermediate GHGE (4.4 kg CO2eq, 95% CI: 4.1, 4.6 kg CO2eq) and diet cost ($14.53, 95% CI: $13.73, $15.38). The time restricted diet pattern had among the lowest diet quality score (42.6, 95% CI: 40.8, 44.6), had GHGE similar to most other diet patterns (4.6 kg CO2eq, 95% CI: 4.2, 5.0 kg CO2eq), and low-to-moderate diet cost ($12.34, 95% CI: $11.38, $13.40). CONCLUSIONS Most diet patterns were associated with sustainability trade-offs. The nature of those trade-offs can help inform discussions on food and nutrition policy in the US, including the National Strategy on Hunger, Nutrition, and Health, and future Dietary Guidelines for Americans.
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Affiliation(s)
- Zach Conrad
- Department of Kinesiology, William & Mary, Williamsburg, VA 23185, USA; Global Research Institute, William & Mary, Williamsburg, VA 23185, USA.
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA.
| | - Martha A Belury
- Program of Human Nutrition, The Ohio State University, Columbus, OH 43221, USA.
| | - David C Love
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21202, USA; Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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Tachie C, Nwachukwu ID, Aryee ANA. Trends and innovations in the formulation of plant-based foods. FOOD PRODUCTION, PROCESSING AND NUTRITION 2023. [DOI: 10.1186/s43014-023-00129-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
AbstractGlobally, the production, distribution, sale and consumption of plant-based foods (PBFs) are on the increase due to heightened consumer awareness, a growing demand for clean label products, widespread efforts to promote and embrace sustainable practices, and ethical concerns over animal-derived counterparts. This has led to the exploration of several strategies by researchers and the food industry to develop alternative milk, cheese, meat, and egg products from various plant-based sources using technologies such as precision fermentation (PF), scaffolding, extrusion, and muscle fibre simulation. This work explores current alternative protein sources and PBFs, production trends, innovations in formulation, nutritional quality, as well as challenges restricting full utilization and other limitations. However, PBFs have several limitations which constrain their acceptance, including the beany flavour of legumes, concerns about genetically modified foods, cost, nutritional inadequacies associated micronutrient deficiencies, absence of safety regulations, and the addition of ingredients that are contrary to their intended health-promoting purpose. The review concludes that investing in the development of PBFs now, has the potential to facilitate a rapid shift to large scale consumption of sustainable and healthy diets in the near future.
Graphical Abstract
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Jarvis SE, Malik VS. Healthy and Environmentally Sustainable Dietary Patterns for Type 2 Diabetes: Dietary Approaches as Co-benefits to the Overlapping Crises. J Indian Inst Sci 2023. [DOI: 10.1007/s41745-023-00358-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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Romanos-Nanclares A, Eliassen AH. For breast cancer prevention, not all plant-based diets are created equal. Am J Clin Nutr 2023; 117:453-454. [PMID: 36872015 DOI: 10.1016/j.ajcnut.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 03/06/2023] Open
Affiliation(s)
- Andrea Romanos-Nanclares
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Jennings R, Henderson AD, Phelps A, Janda KM, van den Berg AE. Five U.S. Dietary Patterns and Their Relationship to Land Use, Water Use, and Greenhouse Gas Emissions: Implications for Future Food Security. Nutrients 2023; 15:215. [PMID: 36615871 PMCID: PMC9823774 DOI: 10.3390/nu15010215] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
The U.S. agri-food system is a driver of climate change and other impacts. In order to achieve environmental targets that limit global mean temperature rise ≤2 °C, a shift in American dietary patterns is critical. The purpose of this study was twofold: (1) to determine the environmental impact (i.e., land use, water use, and GHG emissions) related to consumption of five U.S. dietary patterns (i.e., Current U.S., the Healthy U.S., Mediterranean, Healthy Vegetarian, and Vegan), and (2) to determine the specific impact of each food group in each dietary pattern on the three environmental indicators. This study utilized existing datasets to synthesize information related to the study's environmental indicators and food production and connected these data to the current U.S. diet and the USDA-defined diets. Results indicate that the three omnivore diets contributed the greatest to GHG emissions, land use and water use. The Vegan diet scored the lowest across all indicators, although the water required for plant-based protein nearly offset other water gains. For the omnivore diets, red meat and dairy milk contributed the most to each environmental indicator. By considering sustainability as well as health outcomes in their recommendations in the Dietary Guidelines, the USDA can have a critical role in shifting diets necessary to alter climate change trends.
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Affiliation(s)
- Rose Jennings
- Michael & Susan Dell Center for Healthy Living, UTHealth Houston School of Public Health Austin Campus, Austin, TX 77030, USA
| | - Andrew D. Henderson
- Michael & Susan Dell Center for Healthy Living, UTHealth Houston School of Public Health Austin Campus, Austin, TX 77030, USA
- Eastern Research Group, Concord, MA 01742, USA
| | - Alexis Phelps
- Michael & Susan Dell Center for Healthy Living, UTHealth Houston School of Public Health Austin Campus, Austin, TX 77030, USA
| | - Kathryn M. Janda
- Michael & Susan Dell Center for Healthy Living, UTHealth Houston School of Public Health Austin Campus, Austin, TX 77030, USA
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76706, USA
| | - Alexandra E. van den Berg
- Michael & Susan Dell Center for Healthy Living, UTHealth Houston School of Public Health Austin Campus, Austin, TX 77030, USA
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Jakše B, Godnov U, Pinter S. Nutritional Status of Slovene Adults in the Post-COVID-19 Epidemic Period. Eur J Investig Health Psychol Educ 2022; 12:1729-1742. [PMID: 36547023 PMCID: PMC9777729 DOI: 10.3390/ejihpe12120122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Monitoring nutritional status data in the adult population is extremely important to mediate their health status. Unfortunately, for Slovenia (2.1 million European Union citizens), data on the body composition status of the general adult population are currently rare or nonexistent in scientific journals. Furthermore, dietary intake was last assessed several years before the COVID-19 epidemic period. Methods: We randomly recruited 844 adult Slovenes from all regions of Slovenia. The primary aim of the cross-sectional study was to examine body composition status (using a medically approved electrical bioimpedance monitor) during the post-COVID-19 epidemic period. In addition, we assessed dietary intake (using a standardized food frequency questionnaire) and compared the obesity propensity for both sexes separately using the body mass index (BMI) and body fat percentage (FAT%) obesity classification of the World Health Organization. Results: Regarding BMI classification, 43% of the whole sample was overweight (28%) or obese (15%), and there were more older adults than adults (64% vs. 42%, p < 0.001). The average FAT% of adult females and males was 26.9% and 19.5% (p < 0.001), respectively, while for older adult females and males, it was 32.7% and 23% (p < 0.001). In addition, a comparison of the proportions of obese people between the two cut-off obesity classifications (BMI vs. FAT%) showed a significantly underestimated proportion of obese female participants based on BMI classification (13% vs. 17%, p = 0.005). In terms of the dietary intake of the assessed nutrients in comparison with the national dietary reference values for energy and nutrient intake, the participants, on average, had lower intake than the recommended values for carbohydrates, fiber, vitamins C, D and E (for males) and calcium, and higher intake than the recommended values for total fat, saturated fatty acids, cholesterol, sodium and chloride (for males). Conclusions: The results urgently call for the need to not only improve the overall national nutritional status but also for regular national monitoring of body composition and dietary intake statuses.
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Affiliation(s)
- Boštjan Jakše
- Independent Researcher, 1230 Domžale, Slovenia
- Correspondence:
| | - Uroš Godnov
- Department of Computer Science, Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, 6000 Koper, Slovenia
| | - Stanislav Pinter
- Basics of Movements in Sport, Faculty of Sport, University of Ljubljana, 1000 Ljubljana, Slovenia
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