UNASSIGNED: To monitor trends toward healthy and sustainable diets, there is a need for feasible survey tools, with cross-cultural validity, low-cost, and low-expertise requirements.
UNASSIGNED: The objective of this research was to develop a method to gather data suitable for monitoring diet quality in the general population (women and men of all ages) that is feasible within multitopic surveys, low burden for both enumerators and respondents, valid at population level, and that captures the information necessary for understanding diet quality at global and local levels.
UNASSIGNED: A literature review was conducted to identify constructs of diet quality with existing consensus, indicators with existing global demand, and methods that may be feasible and valid. Results were presented to a technical advisory group for debate, resulting in consensus on a set of constructs to be measured, desired indicators, viable data collection platforms, and an approach for testing and piloting.
UNASSIGNED: Food group-based indicators and 24-h recall period were selected as the most feasible and valid approach for population-level monitoring. A 29-item Diet Quality Questionnaire (DQQ) was developed, where each yes/no question asks about the consumption of a distinct food group on the previous day or night. The food groups were selected for the purpose of deriving indicators to capture the constructs for which there was consensus: nutrient adequacy, and protection against noncommunicable diseases, including both positive and negative risk factors.
UNASSIGNED: The DQQ is low cost and feasible to administer in existing large-scale surveys, overcoming barriers to diet data collection that have precluded the routine monitoring of diet quality in the past. This novel approach has now been used across >85 countries in the Gallup World Poll and other surveys, generating the first nationally representative available datasets on Minimum Dietary Diversity for Women and complementary diet quality indicators.

Current food systems fail to provide equity, sustainability, and positive health outcomes, thus underscoring the critical need for their transformation. Intervening in food environments holds substantial promise for contributing to this much-needed transformation. Despite scholars and practitioners often recognizing the necessity for bottom-up approaches, there is a dearth of empirical investigations evaluating the potential of these approaches to contribute to food system transformations in low- and middle-income countries (LMICs). Our study aimed to address this research gap, providing a unique perspective in this regard. Drawing on evidence from two co-creation case studies conducted with small-scale informal fruit and vegetable vendors and poor consumers in Vietnam and Nigeria from January 2020 to December 2021, we explored the relevance of bottom-up community-engaged co-creation processes in intervening within LMICs\' food retail environments. Employing a mixed-methods approach that includes quantitative surveys, qualitative interviews, participatory workshops, and focus group discussions, we demonstrated that bottom-up co-creation processes involving marginalized socioeconomic groups can generate retail-level innovations that are tailored to informal retail contexts, whereas remaining aligned with established top-down theories and literature pertaining to food environments and healthy diets. We provided empirical evidence highlighting how both vendors and consumers respond positively to the co-created innovations. Expanding upon our results, we offered methodological insights applicable to interventions targeted at food environments in LMICs, and considerations for future research or development initiatives in this domain. Our findings revealed the capacity of vulnerable stakeholders to actively engage in public health initiatives and contribute to developing innovative solutions that are context-specific and conducive to the adoption of healthier dietary practices. These results confirm the potential of bottom-up, co-creation, real-world interventions within informal settings to contribute toward fostering inclusive transformation of food systems.

Recently developed cost and affordability of healthy diet (CoAHD) metrics have quickly become mainstream food security indicators. However, published research on the sensitivity of estimation methods is limited. This paper focuses on two important innovations in CoAHD measurement at the global level. First, we develop a demographic scaling factor to adjust healthy diet costs for cross-country differences in age structures, since younger populations generally require fewer calories than older populations. Second, we improve the way in which household expenditure available for purchasing food (\"food budgets\") are derived. In addition, we explore sensitivity of global CoAHD estimates to potential problems with the representativeness and food product coverage of global food price data and vary assumptions for activity levels that shape energy expenditure requirements. We apply these explorations to the EAT-Lancet reference diet in 137 countries using price data from 2017. Relative to the conventional methods, we find that demographic scaling and improved food budget derivation substantially reduces the estimated population who cannot afford a healthy diet, from 3.02 to 2.13 billion. Adjustments for low product coverage can lead to modest reductions for specific regions and food groups, while higher physical activity assumptions increase the share of people who cannot afford a healthy diet, though perhaps implausibly so. Methods clearly matter in CoAHD estimation, and more accurate and timelier CoAHD estimates have substantial scope to improve policy analysis, design and targeting.

In the dynamic landscape of agriculture and food science, incorporating emergent crops appears as a pioneering solution for diversifying agriculture, unlocking possibilities for sustainable cultivation and nutritional bolstering food security, and creating economic prospects amid evolving environmental and market conditions with positive impacts on human health. This review explores the potential of utilizing emergent crops in Mediterranean environments under current climate scenarios, emphasizing the manifold benefits of agricultural and food system diversification and assessing the impact of environmental factors on their quality and consumer health. Through a deep exploration of the resilience, nutritional value, and health impacts of neglected and underutilized species (NUS) such as quinoa, amaranth, chia, moringa, buckwheat, millet, teff, hemp, or desert truffles, their capacity to thrive in the changing Mediterranean climate is highlighted, offering novel opportunities for agriculture and functional food development. By analysing how promoting agricultural diversification can enhance food system adaptability to evolving environmental conditions, fostering sustainability and resilience, we discuss recent findings that underscore the main benefits and limitations of these crops from agricultural, food science, and health perspectives, all crucial for responsible and sustainable adoption. Thus, by using a sustainable and holistic approach, this revision analyses how the integration of NUS crops into Mediterranean agrifood systems can enhance agriculture resilience and food quality addressing environmental, nutritional, biomedical, economic, and cultural dimensions, thereby mitigating the risks associated with monoculture practices and bolstering local economies and livelihoods under new climate scenarios.

Aligning institutional food procurement with planetary health targets offers opportunities to improve nutrition and reduce food-related greenhouse gas (GHG) emissions. This study compared foods procured by 19 university dining programs in the U.S. in 2022 with the EAT-Lancet planetary health diet. Each university\'s procurement was then modeled to align with the EAT-Lancet planetary health diet, and changes to Healthy Eating Index (HEI) scores and GHG emissions were evaluated. For a subset of universities that provided cost data, changes in annual total food costs were also estimated. Universities in this study exceeded EAT-Lancet planetary health targets for beef (x- = 657% of target), pork (x- = 587%), poultry (x- = 379%), and eggs (x- = 293%). All universities failed to achieve planetary health targets for legumes and nuts (x- = 39% of the target) and vegetables (x- = 68%). Aligning food procurement with the planetary health diet would result in an estimated average 46.1% reduction in GHG emissions and a 19.7 point increase in HEI scores. Universities that provided cost data saw an average 9.7% reduction in food costs in the EAT-Lancet-aligned scenario. The procurement metrics assessed in this study can help university dining programs and other institutional food service organizations set goals and monitor progress toward planetary health targets.

Few young Japanese adults regularly consume a well-balanced diet composed of staples, main courses, and sides. We hypothesised that adopting the recommended planetary health diet with regular breakfast consumption would promote well-balanced diets among young Japanese male undergraduates. This study aimed to examine the structural association between the planetary health diet with regular breakfast consumption and a well-balanced diet intake. This cross-sectional study included 142 male engineering undergraduates who completed a 2022 online questionnaire via Google Forms at a public university in Hyogo Prefecture. The planetary health diet comprises the consumption of the recommended eight items. A covariance structure analysis was performed in a hypothetical model with factors (regular breakfast consumption and eight items) potentially associated with the intake of a well-balanced diet at least twice daily. After excluding chicken dishes and nuts from the eight recommended items of the planetary health diet, goodness-of-fit became acceptable. Frequent consumption of the remaining six recommended items (fish, eggs, soybeans/soybean products, dairy foods, vegetables, and fruits) was significantly positively correlated with regular breakfast consumption and a significant positive path to a well-balanced diet. Among male university students, regular breakfast consumption and the planetary health diet may lead to a well-balanced diet.

The affordability of nutritious food for \"all people, at all times\" is a critically important dimension of food security. Yet surprisingly, timely high-frequency indicators of food affordability are rarely collected in any systematic fashion despite price volatility emerging as major source of food insecurity in the 21st Century. The 2008 global food crisis prompted international agencies to invest heavily in monitoring domestic food prices in low and middle income countries (LMICs). However, food price monitoring is not sufficient for measuring changes in diet affordability; for that, one must also measure changes either in income or in an income proxy. We propose using the wages of unskilled workers as a cheap and sufficiently accurate income proxy, especially for the urban and rural non-farm poor. We first outline alternative measures of \"food wage\" indices, defined as wages deflated either by consumer food price indices or novel healthy diet cost indices. We then discuss the conceptual strengths and limitations of food wages. Finally, we examine patterns and trends in different types of real food wage series during well-known food price crises in Ethiopia (2008, 2011 and 2022), Sri Lanka (2022) and Myanmar (2022). In all these instances, food wages declined by 20-30%, often in the space of a few months. In Myanmar, the decline in real wages during 2022 closely matches declines in household disposable income. We strongly advocate tracking the wages of the poor as a timely, accurate and cost-effective means of monitoring food affordability for important segments of the world\'s poor.

BACKGROUND: The rates of obesity, undernutrition, and other non-communicable diseases are on the rise among Lebanese adults. Therefore, it is crucial to evaluate the food consumption habits of this population to understand diet quality, analyze consumption trends, and compare them to healthy diets known to reduce risks of non-communicable diseases.
OBJECTIVE: To evaluate the food consumption patterns, energy intake, as well as macro- and micro-nutrient intake among a nationally representative sample of Lebanese adults aged 18-64 years old.
METHODS: A cross-sectional study was carried out from May to September 2022 involving 444 participants from all eight Lebanese governorates. Sociodemographic and medical information was gathered through a questionnaire, food consumption was evaluated using a validated FFQ and 24 h recall, and anthropometric measurements were recorded.
RESULTS: There was a notable lack of adherence to three healthy diets (Mediterranean, EAT-Lancet, USDA) among Lebanese adults. Their dietary pattern is characterized by high energy, added sugars, sodium, and saturated fat intake while being low in healthy fats, vitamin A, D, and E. Adult women are falling short of meeting their daily calcium, vitamin D, iron, and vitamin B12 requirements, putting them at increased risk of anemia, osteoporosis, and other health issues. Grains and cereals were the most consumed food groups, and most participants were found to be overweight or obese.
CONCLUSIONS: In conclusion, the results highlight the need for public health policies and interventions aimed at encouraging Lebanese adults to make healthier food choices and transition towards diets like the Mediterranean, EAT-Lancet, or USDA diet. These diets have been shown to promote overall health and wellbeing.

OBJECTIVE: Legume and pulse consumption is currently recommended for health and sustainability purposes, but barriers to consumption can include low enjoyment and poor sensory properties. This work aimed to investigate the relative importance of a number of barriers and facilitators towards legume, including pulse, consumption with a specific focus on enjoyment, sensory properties and a possible role for perceived cooking abilities in these relationships.
METHODS: A cross-sectional questionnaire study assessed legume and pulse consumption, agreement and disagreement with statements relating to enjoyment, sensory properties, cooking abilities, practical aspects, healthiness, upbringing, social influences and quality issues, and four demographic characteristics. Complete responses were gained from 633 respondents with a mix of genders, ages, usual cooking responsibilities and usual eating habits.
METHODS: UK, March 2021 - September 2022.
METHODS: General UK adult population.
RESULTS: Using multiple regression analyses, enjoyment and cooking abilities were found to be important for both legume and pulse consumption (smallest beta = 0·165, P < 0·01), and the sensory properties of these foods were also important for the consumption of pulses (beta = 0·099, P = 0·04). Perceived cooking abilities also reduced the importance of enjoyment and sensory properties for consumption, mitigated effects due to upbringing and practical aspects and increased the value of perceived health benefits (smallest beta = 0·094, P = 0·04).
CONCLUSIONS: These findings demonstrate a clear role for enjoyment, sensory properties and perceived cooking abilities in legume and pulse consumption and suggest benefits for increasing cooking abilities for improved legume and pulse consumption, as result of both direct and indirect effects.

The aim was to identify indices of diet quality and health that could be applied to the environmental assessment of foods in order to provide metrics that collectively assess nutritional, health and environmental dimensions.
The review identified five major groups of indices: nutrient-food quantity-based; guideline-based; diversity-based; nutrient quality-based; health-based. Nutrient-food quantity-based and guideline type indices were the most frequently used to evaluate diet quality. Scaled assessment using a nutritional functional unit is the most common integration of diet quality with the environmental analysis of foods. There are fewer indices that measure the heath impacts of foods, but epidemiological dietary risk factors seem a promising approach to integrate diet and health impacts into the environmental assessment of foods. Five groups of nutritional and health indices were identified that can be applied when performing an environmental assessment of foods. This review proposes different methodological insights when doing such assessments to ensure transparency and comparability of the results.