Toward Healthy Diets from Sustainable Food Systems

Perspective: The Place of Pork Meat in Sustainable Healthy Diets

The food systems sustainability framework has 4 domains: nutrition, economics, environment, and society. To qualify as sustainable, individual foods and total diets need to be nutrient-rich, affordable, environmentally friendly, and socially acceptable. Pork is the most consumed meat globally, providing high-quality protein and several priority micronutrients. With research attention focused on plant-based diets, it is time to assess the place of pork meat protein in the global sustainability framework. First, not all proteins are equal. The United States Department of Agriculture category of protein foods includes meat, poultry and fish, eggs, beans and legumes, and nuts and seeds. These protein sources have different protein digestibility profiles, different per-calorie prices, and different environmental footprints, measured in terms of greenhouse gas emissions. Second, most analyses of animal-source proteins combine beef, pork, and lamb into a single category of red meat. Beef, pork, and lamb have different nutrient profiles, different protein costs, and different impacts on the environment. Future analyses of nutrient density and monetary and carbon costs of alternative diets would do well to separate pork from beef, lamb, and chicken. There are also different profiles of global food demand. Prior analyses of global Food and Agriculture Organization Statistical Database food balance sheets joined with World Bank country incomes have consistently shown that rising incomes across lower- and middle-income countries (LMIC) create a growing demand for meat to replace traditional plant proteins. Most of the observed increase has been for pork and chicken rather than beef. This ongoing LMIC protein transition toward more animal proteins may be irreversible as long as incomes grow. The present analyses explore the place of pork in sustainable healthy diets worldwide, given the need for high-quality protein and the predictable patterns of global food demand.

The Future of Plant-Based Diets: Aligning Healthy Marketplace Choices with Equitable, Resilient, and Sustainable Food Systems

The future of plant-based diets is a complex public health issue inextricably linked to planetary health. Shifting the world's population to consume nutrient-rich, plant-based diets is among the most impactful strategies to transition to sustainable food systems to feed 10 billion people by 2050. This review summarizes how international expert bodies define sustainable diets and food systems and describes types of sustainable dietary patterns. It also explores how the type and proportion of plant- versus animal-source foods and alternative proteins relate to sustainable diets to reduce diet-related morbidity and mortality. Thereafter, we synthesize evidence for current challenges and actions needed to achieve plant-based sustainable dietary patterns using a conceptual framework with principles to promote human health, ecological health, social equity, and economic prosperity. We recommend strategies for governments, businesses, and civil society to encourage marketplace choices that lead to plant-rich sustainable diets within healthy, equitable, and resilient agroecological food systems.

Environmental sustainability of diets among children and adolescents in the German DONALD cohort study: age and time trends, and nutrient adequacy

BACKGROUND

Identifying diets beneficial for both human and planetary health has become increasingly important. However, to date, there is limited research on sustainable diets for children and adolescents, a vulnerable population group with specific nutritional needs.

OBJECTIVES

We aimed to identify 1) the main determinants; 2) age and time trends of greenhouse gas emissions (GHGE), land use (LU), and water use (WU) of diets of children and adolescents; and 3) analyze the associations of dietary GHGE, LU, and WU with nutrient adequacy.

METHODS

A total of 5510 3-d-weighted dietary records (n = 856; 6-17 y; 48% ♀) of the DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) study between 2000 and 2021 were analyzed. Values of GHGE (kgCO2eq), LU (m2 × year), and WU (L) determined by life cycle assessment were assigned to all recorded foods. For nutrient adequacy, the mean adequacy ratio (MAR = ∑(nutrient intake / recommended intake) / number of nutrients) was used. Data were analyzed using polynomial mixed-effects regression models.

RESULTS

The main contributors to GHGE and LU were meat products (GHGE: 25.6%; LU: 32.8%), dairy products (22.2%; 17.7%), and sweets and pastries (14.0%; 14.3%); to WU, nonalcoholic beverages (24.3%), meat products (18.9%), and vegetables and fruits (17.7%). GHGE, LU, and WU per 1000 kcal increased with age (P < 0.01). GHGE and LU per 1000 kcal increased between 2000 and 2010 and decreased after that in females (P < 0.01) and males (GHGE only: P = 0.02). No significant time trend was found for WU (P > 0.05). A higher MAR was directly associated with GHGE/1000 kcal (MAR: β: 0.011, 95% CI: 0.008, 0.013, P < 0.0001), LU/1000 kcal (MAR: β: 0.009, 95%CI: 0.005, 0.013, P < 0.0001), and WU/1000 kcal (MAR: β: 0.429, 95% CI: 0.325, 0.533, P < 0.0001).

CONCLUSIONS

Our findings underscore the further need and the capacity for change toward more environmentally sustainable diets. Yet, the tradeoff between environmental sustainability and nutrient adequacy in the diets of children and adolescents requires specific attention to dietary composition.

Perception of affordable diet is associated with pre-school children's diet diversity in Addis Ababa, Ethiopia: the EAT Addis survey

BACKGROUND

Despite improvements in food access and nutrition security over the last few decades, malnutrition remains a major public health problem. One of the significant contributors to these problems is affordability of nutritious food. This study aimed to examine the association between perceived food affordability and pre-school children's diet diversity in Addis Ababa, Ethiopia.

METHODS

Cross-sectional data from 2017 to 18 were used for the analysis. A 24-hour dietary recall assessment was done to assess children's dietary diversity (DD). We used a modified operational definition of affordability indicator called perceived affordability of dietary diversity (afford-DD) to evaluate the impact of the food environment in terms of affordability at the household level. A sample (n 4,898) of children aged 6-59 months representative of households in Addis Ababa was randomly selected using a multistage sampling procedure including all districts in the city. Mixed-effects linear regression models were used to assess the association between children's DD and afford-DD.

RESULTS

The survey revealed that the mean (standard deviation [SD]) of children's DD was 3.9 [± 1.4] while the mean [SD] of afford-DD was 4.6 [± 2.1]. Overall, 59.8% of children met the minimum dietary diversity (≥ 4 food groups). White roots and tubers were the most commonly consumed food groups regardless of their affordability. Considerable variations were observed between households that reported the food item affordable and not affordable in consumption of Vitamin A rich vegetables and fruits, meat and fish, egg, and dairy. The children's DD was positively associated with afford-DD after adjusting for maternal education, household wealth status and other relevant confounding. Higher maternal education modified the association between affordability and children's diet diversity.

CONCLUSIONS

This study suggests higher perceived food affordability was associated with better diet diversity in children. A higher level of maternal education had the potential to mitigate affordability challenges in meeting the children's dietary diversity needs. Our study emphasizes the need for inclusive food programs and nutrition interventions addressing social differences, intensifying efforts to make nutrient-rich diets affordable for the less privileged, and highlights the potential benefits of targeting maternal education in addressing child dietary diversity.

Quality Characteristics of Twelve Advanced Lines of Avena magna ssp. domestica Grown in Three Contrasting Locations in Morocco

The popularity of oats (Avena sativa) continues to increase in the cereal market due to their health benefits. The recent domestication of Avena magna, a Moroccan oat, presents an opportunity to enhance these benefits due to their higher nutritional composition. As the impact of microclimates on A. magna grain composition has not been explored, this study evaluates twelve A. magna ssp. domestica lines across three Moroccan locations, providing new data into microclimate effects on key grain characteristics. Significant variability is observed among lines and sites for nutrients, with mean protein, fat, and dietary fiber contents at 23.1%, 8.38%, and 7.23%, respectively. High protein levels, reaching 27.1% in Alnif and 26.5% in El Kbab, surpass the 'Avery' control (21.7% and 24.2%) in these environments. Groats from Bouchane exhibited elevated fat and fiber contents (10.2% and 9.94%) compared to the control (8.83% and 7.36%). While β-glucan levels remain consistent at 2.53%, a negative correlation between protein content, fat, and starch was observed. A. magna lines exhibited higher levels of iron (7.50 × 10-3 g/100 g DM) and zinc (3.40 × 10-3 g/100 g DM) compared to other cereals. Environmental conditions significantly influence grain quality, with El Kbab yielding higher protein and ash contents, as well as Bouchane having increased fat, fiber, and starch. Stability analysis indicates that fat content was more influenced by the environment, while 25% of protein variability is influenced by genetics. Lines AT3, AT5, AT6, AT13, and AT15 consistently exceeds both the mean for protein and fiber across all sites, emphasizing their potential nutritional value. This study highlights the potential of A. magna ssp. domestica to address nutritional insecurity, particularly for protein, iron, and zinc in domestic settings.

US Adults' Perceptions, Beliefs, and Behaviors towards Plant-Rich Dietary Patterns and Practices: International Food Information Council Food and Health Survey Insights, 2012-2022

Expert groups recommend that populations adopt dietary patterns higher in whole, plant-based foods and lower in red and processed meat as a high-impact climate action. Yet, there is limited understanding of populations' willingness to adopt plant-rich dietary patterns. This study examined United States (US) adults' perceptions, beliefs, and behaviors towards plant-rich dietary patterns and practices over a decade. Fifteen questions from the International Food Information Council's Food and Health Surveys (2012-2022) were analyzed across four sustainability domains (i.e., human health, environmental, social, and economic domains). Most respondents had favorable perceptions of environmentally sustainable food and beverages, but sustainability influenced less than half of consumers' purchase decisions. Plant-rich dietary pattern adherence increased across survey years (12.1% [2019] to 25.8% [2022], p < 0.001). One-quarter (28.1%) of Americans reported reducing their red meat intake over 12 months (2020-2022). Yet, another 15.5% reported greater red meat intake, and 18.8% reported greater plant-based meat alternative (PBMA) intake over 12 months. The percentage of respondents who reported greater red meat and PBMA consumption in the previous 12 months significantly increased across the years surveyed (2020-2022, p < 0.05). IFIC Survey findings highlight growing US consumer awareness of health, environmental, and social sustainability but low adoption of plant-rich dietary patterns and practices. Government leadership and coordinated actions by health professionals, civil society, and businesses are needed to educate and incentivize Americans to adopt plant-rich dietary behaviors, and greater industry transparency is needed to show how food and beverage products support human and planetary health.

Visualizing Data Interoperability for Food Systems Sustainability Research-From Spider Webs to Neural Networks

Food systems represent all elements and activities needed to feed the growing global population. Research on sustainable food systems is transdisciplinary, relying on the interconnected domains of health, nutrition, economics, society, and environment. The current lack of interoperability across databases poses a challenge to advancing research on food systems transformation. Crosswalks among largely siloed data on climate change, soils, agricultural practices, nutrient composition of foods, food processing, prices, dietary intakes, and population health are not fully developed. Starting with US Department of Agriculture FoodData Central, we assessed the interoperability of databases from multiple disciplines by identifying existing crosswalks and corresponding visualizations. Our visual demonstration serves as proof of concept, identifying databases in need of expansion, integration, and harmonization for use by researchers, policymakers, and the private sector. Interoperability is the key: ontologies and well-defined crosswalks are necessary to connect siloed data, transcend organizational barriers, and draw pathways from agriculture to nutrition and health.

Insights on cisgenic plants with durable disease resistance under the European Green Deal

Significant shares of harvests are lost to pests and diseases, therefore, minimizing these losses could solve part of the supply constraints to feed the world. Cisgenesis is defined as the insertion of genetic material into a recipient organism from a donor that is sexually compatible. Here, we review (i) conventional plant breeding, (ii) cisgenesis, (iii) current pesticide-based disease management, (iv) potential economic implications of cultivating cisgenic crops with durable disease resistances, and (v) potential environmental implications of cultivating such crops; focusing mostly on potatoes, but also apples, with resistances to Phytophthora infestans and Venturia inaequalis, respectively. Adopting cisgenic varieties could provide benefits to farmers and to the environment through lower pesticide use, thus contributing to the European Green Deal target.

A Feasible Approach to Developing Fiber-Enriched Bread Using Pomegranate Peel Powder: Assessing Its Nutritional Composition and Glycemic Index

The consumption of dietary fiber (DF) has been associated with a reduced incidence of non-communicable diseases. Despite various strategies implemented worldwide to increase DF intake, it remains low. Therefore, the development of new fiber-rich food products that are widely consumed could be a strategy to improve DF intake. In this study, an agro-industrial by-product, pomegranate peel powder (PPP), was used as an innovative source of DF and antioxidant. The objective was to develop a bread enriched with DF, antioxidants, and sensory characteristics by partially replacing wheat flour (WF) with PPP at levels of 0%, 2.5%, 5%, 7.5%, and 10%. Bread with 2.5% and 5% PPP was chosen for a clinical trial to evaluate glycemic response (GR) in healthy subjects and determine the bread's glycemic index (GI). As the percentage of PPP increased, both the DF and total polyphenol content increased significantly. The highest overall acceptability was achieved with bread containing up to 5% PPP. Consumption of bread with 2.5% and 5.0% PPP significantly reduced the GI compared to the control bread, while the decrease in GR was not significant. PPP could be a potential food and low-cost ingredient to improve the bread's nutritional quality through its contribution to DF and antioxidants.

Environmental Impact of Two Plant-Based, Isocaloric and Isoproteic Diets: The Vegan Diet vs. the Mediterranean Diet

Food consumption is one of the major causes of climate change, resource depletion, loss of biodiversity, and other kinds of environmental impact by modern households. According to evidence, a global change in dietary habits could be the single most effective and rapid intervention to reduce anthropic pressure on the planet, especially with respect to climate change. Our study applied Life Cycle Assessment (LCA) to investigate the total environmental impact of two plant-based diets: the Mediterranean and the Vegan diets, according to relevant Italian nutritional recommendations. The two diets share the same macronutrient rates and cover all the nutritional recommendations. Calculations were made on the basis of a theoretical one-week 2000 kcal/day diet. According to our calculations, the Vegan diet showed about 44% less total environmental impact when compared to the Mediterranean diet, despite the fact that the content of animal products of the latter was low (with 10.6% of the total diet calories). This result clearly supports the concept that meat and dairy consumption plays a critical role, above all, in terms of damage to human health and ecosystems. Our study supports the thesis that even a minimal-to-moderate content of animal foods has a consistent impact on the environmental footprint of a diet, and their reduction can elicit significant ecological benefits.

Novel Lines of Research on the Environmental and Human Health Impacts of Nut Consumption

Nuts have formed part of human diets throughout the ages. In recent decades, research has shown they are key foods in dietary patterns associated with lower chronic disease risk. The current state of climate change, however, has introduced an imperative to review the impact of dietary patterns on the environment with a shift to plant-based diets. Nuts emerge as a significant source of protein in plant-based diets and are a minimally processed and sustainable food. Research in this area is evolving to drive better production methods in varying climate conditions. Nevertheless, nut consumption remains an important contributor to human health. The mechanisms of action can be explained in terms of the nutrients they deliver. Studies of nut consumption have linked components such as monounsaturated fatty acids, plant omega-3 fatty acids, antioxidants, and plant sterols to improved lipoprotein profiles, lower blood pressure, and reduced cardiovascular disease risk. Preliminary research also indicates possible beneficial effects of nut consumption on reproductive health. In any case, the ultimate effects of foods on health are the results of multiple interactive factors, so where nuts fit within dietary patterns is a significant consideration for research translation. This has implications for research methodologies, including categorization within food groups and inclusion in Healthy Dietary Indices. The aim of this narrative review is to outline new focal points for investigation that examine the environmental and some novel human health impacts of nut consumption and discuss future directions for research.

Framing Food Transition: The Debate on Meat Production and Climate Change in Three European Countries

The link between meat production and climate change has fostered increasing social debate in recent years. Livestock is a major source of greenhouse gas emissions, among other global problems attached to the meat industry. However, this debate is often presented as one-dimensional, without a comprehensive approach. As the media plays a key role in shaping public perceptions of nutrition, this study aims to examine how the matter of food transition and climate change is addressed by three centre-left media outlets from Germany (Der Tagesspiegel), the United Kingdom (The Guardian) and Spain (El País). A search including the words *meat* and *climate change* in different languages, performed over one year (2021), resulted in a sample of available news items (N = 273). Using quantitative and qualitative methods, we analysed the coverage in terms of scope and use of frames. The results showed a scant number of news items combining climate change and meat consumption, though there were some differences indicating a greater awareness in the United Kingdom. Most of the news items from the three countries applied frames based on solutions from an environmental perspective. Media attention was discontinuous and sometimes determined by political debates, which made it difficult to reflect upon the underlying issues.

The importance of protein variety in a higher quality and lower environmental impact dietary pattern

OBJECTIVE

Eating a variety of nutritious foods is fundamental to good nutrition. However, this principle is challenged when recommendations seeking to improve the environmental sustainability of diets call for avoidance of foods considered to have a higher environmental footprint, such as animal-sourced foods. Our objective was to assess the implications for nutritional adequacy of protein choice across Australian adult diets preselected as having higher quality and lower environmental impact scores.

DESIGN

Each individual diet was assessed for variety of food choice within the 'Fresh meat and alternatives' food group defined in the Australian Dietary Guidelines, which includes protein-rich foods such as eggs, nuts, tofu and legumes in addition to animal meats. Diets were grouped according to variety score and whether they included only animal meats, only alternatives or a variety of meat and alternatives. Nutrient content was assessed relative to estimated average requirements (EAR).

SETTING

Australia.

PARTICIPANTS

1700 adults participating in the Australian Health Survey.

RESULTS

For diets with higher diet quality and lower environmental impact, the likelihood of achieving nutrient EAR significantly increased as variety of food choice in the 'Fresh meat and alternatives' food group increased (P < 0·001). Variety score and number of serves were also correlated (r = 0·52, P < 0·001) which is relevant since most diets did not meet the recommended minimum number of serves for this food group.

CONCLUSIONS

Greater variety within the 'Fresh meat and alternatives' food group is beneficial to meeting EAR and lower environmental impact diets can include three or more selections including foods of animal origin.

Diets with Higher Vegetable Intake and Lower Environmental Impact: Evidence from a Large Australian Population Health Survey

Increasing the consumption of vegetables is a public health nutrition priority in Australia. This must be achieved in the context of lowering dietary environmental impacts. In this study, a subgroup of 1700 Australian adult daily diets having a higher diet-quality score and a lower environmental impact score was isolated from Australian Health Survey data. These diets were primarily distinguished by their lower content of energy-dense/nutrient-poor discretionary foods. Among these diets, those with higher levels of vegetable intake were characterized by greater variety of vegetables eaten, lower intake of bread and cereal foods, and higher intake of red meat. These diets also had a greater likelihood of achieving recommended intakes for a range of vitamins and minerals. These findings highlighted the importance of considering the total diet in developing strategies to promote healthy and sustainable food consumption, as well as the need to understand the interrelationships between foods that exist in a local cultural context. As vegetables are usually eaten with other foods, higher vegetable consumption in Australia could be supported by encouraging more regular consumption of the types of meals that include larger quantities of vegetables. Our results showed that this was possible while also substantially lowering total dietary environmental impacts.

Is Eating Less Meat Possible? Exploring the Willingness to Reduce Meat Consumption among Millennials Working in Polish Cities

Reducing the consumption of meat constitutes an important part of the global shift towards more sustainable food systems. At the same time, meat is firmly established in the food culture of most human beings, and better understanding of individual behaviors is essential to facilitate a durable change in contemporary eating patterns. To determine the level and nature of attachment to meat among consumers, the Meat Attachment Questionnaire (MAQ) in relation to the phases of behaviour change in the meat consumption reduction process was utilised. Data collected through a survey carried out among Poles aged 25–40 years living in cities were analysed with the use of Spearman’s correlations and one-way ANOVA with Tukey’s post-hoc tests. The biggest share of the studied group of millennials (N = 317) never considered reducing their meat consumption (Phase 1–41%) and was described by the highest level of MAQ score in all its categories: hedonism, affinity, dependence, and entitlement. More than half of the respondents in Phase 2 participants (“planners”) declared a willingness to cut down meat consumption but had not yet put their intentions into practice. Respondents qualified in Phase 3 declared the highest willingness to reduce meat consumption and were significantly less attached to meat regarding all MAQ categories than respondents in Phase 1. The 9% of the study participants (Phase 4) had already limited the frequency of their meat consumption to “several times a week”, this however still remains insufficient compared to the ambitious goals of sustainable healthy diets. Results indicated that meat attachment categories, especially hedonism and dependence, were identified as predictors of willingness to reduce meat consumption. Research exploring the determinants of change and possibilities of effective communication about meat reduction on an individual level in different cultural settings are needed.

An Alternative Nutrient Rich Food Index (NRF-ai) Incorporating Prevalence of Inadequate and Excessive Nutrient Intake

Most nutrient profiling models give equal weight to nutrients irrespective of their ubiquity in the food system. There is also a degree of arbitrariness about which nutrients are included. In this study, an alternative Nutrient Rich Food index was developed (NRF-ai, where ai denotes adequate intake) incorporating prevalence of inadequate and excessive nutrient intake among Australian adults. Weighting factors for individual nutrients were based on a distance-to-target method using data from the Australian Health Survey describing the proportion of the population with usual intake less than the Estimated Average Requirement defined by the Nutrient Reference Values for Australia and New Zealand. All nutrients for which data were available were included, avoiding judgements about which nutrients to include, although some nutrients received little weight. Separate models were developed for females and males and for selected age groups, reflecting differences in nutrient requirements and usual intake. Application of the new nutrient profiling models is demonstrated for selected dairy products and alternatives, protein-rich foods, and discretionary foods. This approach emphasises the need to identify foods that are rich in those specific nutrients for which intake is below recommended levels and can be used to address specific nutrient gaps in subgroups such as older adults. In addition, the new nutrient profiling model is used to explore other sustainability aspects, including affordability (NRF-ai per AUD) and ecoefficiency (NRF-ai/environmental impact score).

Pesticide Toxicity Footprints of Australian Dietary Choices

Pesticides are widely used in food production, yet the potential harm associated with their emission into the environment is rarely considered in the context of sustainable diets. In this study, a life cycle assessment was used to quantify the freshwater ecotoxicity, human toxicity carcinogenic effects, and human toxicity noncarcinogenic effects associated with pesticide use in relation to 9341 individual Australian adult daily diets. The three environmental indicators were also combined into a pesticide toxicity footprint, and a diet quality score was applied to each diet. Energy-dense and nutrient-poor discretionary foods, fruits, and protein-rich foods were the sources of most of the dietary pesticide impacts. Problematically, a dietary shift toward recommended diets was found to increase the pesticide toxicity footprint compared to the current average diet. Using a quadrant analysis, a recommended diet was identified with a 38% lower pesticide toxicity footprint. This was achieved mainly through a reduction in the discretionary food intake and by limiting the choice of fresh fruits. As the latter contradicts dietary recommendations to eat a variety of fruits of different types and colors, we concluded that dietary change may not be the best approach to lowering the environmental impacts of pesticides in the food system. Instead, targeted action in the horticultural industry may be more effective. Consumers might encourage this transition by supporting growers that reduce pesticide use and apply less environmentally harmful active ingredients.

Sustainable Agri-Food Systems: Environment, Economy, Society, and Policy

Agri-food systems (AFS) have been central in the debate on sustainable development. Despite this growing interest in AFS, comprehensive analyses of the scholarly literature are hard to find. Therefore, the present systematic review delineated the contours of this growing research strand and analyzed how it relates to sustainability. A search performed on the Web of Science in January 2020 yielded 1389 documents, and 1289 were selected and underwent bibliometric and topical analyses. The topical analysis was informed by the SAFA (Sustainability Assessment of Food and Agriculture systems) approach of FAO and structured along four dimensions viz. environment, economy, society and culture, and policy and governance. The review shows an increasing interest in AFS with an exponential increase in publications number. However, the study field is north-biased and dominated by researchers and organizations from developed countries. Moreover, the analysis suggests that while environmental aspects are sufficiently addressed, social, economic, and political ones are generally overlooked. The paper ends by providing directions for future research and listing some topics to be integrated into a comprehensive, multidisciplinary agenda addressing the multifaceted (un)sustainability of AFS. It makes the case for adopting a holistic, 4-P (planet, people, profit, policy) approach in agri-food system studies.

Complementary and alternative medicine

Complementary and alternative medicine is used worldwide. The use of plant-based medicines for the prevention or treatment of disease is prevalent but not regulated or studied. Multiple countries are implementing pharmacovigilance systems to monitor the use and safety of dietary supplements. Reporting mechanisms continue to be sporadic and inconsistent, based mainly on consumer or healthcare provider reports outlining individual adverse effects (AEs) from dietary supplements. Supplement product ingredient lists may be inaccurate, claims biased, and Evidence-Based information regarding risks and benefits lacking. Healthcare providers should familiarize themselves with complementary medicine practices, the benefits and associated risks to best care for their patient populations.

A global pandemic marked 2020 with the emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A short review of vitamin and plant-based prevention, treatment, and associated ramifications with use of these products for coronavirus disease 2019 (COVID-19) is provided. Another world-wide dilemma is food security. Nutrieconomics and the socioeconomic ramifications of food are reviewed from a wider timeframe.

Reports and reviews from 2020 describe AEs of complementary and alternative medicine and herbal dietary supplements. These are listed alphabetically by plant or supplement name.

An Italian Innovative Small-Scale Approach to Promote the Conscious Consumption of Healthy Food

An unhealthy diet is considered to be one of the main causes for increases in obesity and chronic diseases. Food choices are frequently influenced by food systems and environments along with the availability and affordability of healthy and sustainable food. In this context, a major contemporary challenge lies in improving these aspects in order to support healthy dietary choices. Hence, to address this issue, here, we propose a small-scale approach called SANI (Italian for “healthy”) which involves experts in science and marketing. Two typical agri-foods of the Abruzzo area (center of Italy), tomato sauce and extra virgin olive oil, are characterized as high-quality products in terms of their nutrient content, absence of chemical contaminants (chromatographic, spectrophotometric, and magnetic resonance techniques), and ecological footprint (lifecycle assessment and carbon footprint). Hence, their consumption is promoted, with strict attention being paid to several aspects of the food system, such as production, processing, distribution, labeling, and promotion, as well as marketing strategies and dissemination activities. Overall, these SANI actions, especially labeling and dissemination, have proven to be a valuable learning tool for consumers moving toward more conscious consumption, which can be extended and applied to additional food products. Future applications of similar research strategies in a wider context could positively affect human and environmental health.

A View to the Future: Opportunities and Challenges for Food and Nutrition Sustainability

The challenges to achieving sustainability in food and nutrition are daunting. The present paper summarizes 3 individual papers that are part of this special collection. The lynchpin for synthesizing the papers is sustainability and food systems. Within each of these domains are embedded a myriad of factors, each of which are essential for the sustainable transformation of food systems. Controversies surrounding the concepts of a healthy diet, sustainable agricultural production, and maximizing the dietary impacts of food environments are discussed and evaluated in the context of the current food and nutrition landscape.