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IntroductionOverconsumption of energy dense, nutrient poor foods and beverages is a major problem globally. This study describes what and how Australian adults consume and are willing to change their intake in terms of discretionary food and beverage categories.MethodsCross-sectional data were collected via the CSIRO Junk Food Analyser. This online tool contains short questions on discretionary food and beverage consumption, and items relating to stage of and willingness and strategies to reduce discretionary food and beverage intake. Analyses focussed on describing discretionary intake, adherence to guidelines and the prediction of willingness to change discretionary food intake amongst those exceeding guidelines.ResultsIn 2021, 41,109 Australian adults completed the CSIRO Junk Food Analyser. Participants were mostly female (73.1%) and aged 31–70 years (78.9%). Most participants exceeded dietary guidelines for discretionary food and beverage intake (67.4%, 27,694/41,109) with 40% reporting actively trying to reduce intake. Most people exceeding guidelines did so in categories of alcohol (39.3%) and cakes and biscuits (21.0%). Yet, willingness to change intake was lowest for alcohol (median, IQR of 3, 2:4 out of 5). Almost half of the participants were willing to try ‘having a few days off per week’ (46.0%), while only 13.4% were willing to try to ‘eliminate’ their highest ranked category.DiscussionAustralian adults are willing to reduce their discretionary food and beverage intake, but simply targeting the foods and beverages consumed most may not be the best place to start. Messages encouraging days off frequently consumed discretionary foods and beverages may be well received.

One of the aims of the United Nations Sustainable Development Goals (SDG) is to end hunger and ensure access by all people to safe, nutritious, and sufficient food all year round. An obvious synergy exists between the second SDG “Zero Hunger” and SDG target 12.3 which focuses on halving food waste and reducing food losses. In addition to helping improve global food security, reducing food waste provides financial and environmental benefits. Upcycling food is a technical solution for food waste reduction that retains the nutritional and financial value of food by-products. However, many of the upcycled foods produced are discretionary foods such as biscuits, crackers, and other snack food that are not part of a healthy dietary pattern, and should only be eaten sometimes in small amounts. Given the importance of ensuring a sustainable healthy diet, this paper discusses opportunities for upcycled food manufacturers to produce more nutritious products.

Introduction: Overconsumption of energy dense, nutrient poor foods and beverages is a major problem globally. This study describes what and how Australian adults consume and are willing to change their intake in terms of discretionary food and beverage categories., Methods: Cross-sectional data were collected via the CSIRO Junk Food Analyser. This online tool contains short questions on discretionary food and beverage consumption, and items relating to stage of and willingness and strategies to reduce discretionary food and beverage intake. Analyses focussed on describing discretionary intake, adherence to guidelines and the prediction of willingness to change discretionary food intake amongst those exceeding guidelines., Results: In 2021, 41,109 Australian adults completed the CSIRO Junk Food Analyser. Participants were mostly female (73.1%) and aged 31-70 years (78.9%). Most participants exceeded dietary guidelines for discretionary food and beverage intake (67.4%, 27,694/41,109) with 40% reporting actively trying to reduce intake. Most people exceeding guidelines did so in categories of alcohol (39.3%) and cakes and biscuits (21.0%). Yet, willingness to change intake was lowest for alcohol (median, IQR of 3, 2:4 out of 5). Almost half of the participants were willing to try 'having a few days off per week' (46.0%), while only 13.4% were willing to try to 'eliminate' their highest ranked category., Discussion: Australian adults are willing to reduce their discretionary food and beverage intake, but simply targeting the foods and beverages consumed most may not be the best place to start. Messages encouraging days off frequently consumed discretionary foods and beverages may be well received., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mauch, Brindal and Hendrie.)

Objective: Agriculture accounts for around 70 % of global freshwater withdrawals. As such, the food system has been identified as a critical intervention point to address water scarcity. Various studies have identified dietary patterns that contribute less to water scarcity. However, it is unclear what level of reduction is necessary to be considered sustainable. The pursuit of unnecessarily aggressive reductions could limit dietary diversity. Our objective was to assess the sustainability of water use supporting Australian dietary habits and the adequacy of current dietary guidelines.Design: Dietary intake data were obtained from the National Nutrition and Physical Activity component of the Australian Health Survey. For each individual daily diet, the water scarcity footprint was quantified, following ISO14046:2014, as well as a diet quality score. Water scarcity footprint results were compared with the planetary boundary for freshwater use downscaled to the level of an individual diet.Setting: Australia.Participants: 9341 adults participating in the Australian Health Survey.Results: Dietary water scarcity footprints averaged 432·6 L-eq (95 % CI 432·5, 432·8), less than the 695 litres/person per d available to support the current global population of 7·8 billion, and the 603 litres/person per d available for a future population of 9 billion. Diets based on the Australian Dietary Guidelines required 521 L-eq/d, or 379 L-eq/d with lower water scarcity footprint food choices.Conclusions: Diets based on the Australian Dietary Guidelines were found to be within the freshwater planetary boundary. What is needed in Australia is greater compliance with dietary guidelines. [ABSTRACT FROM AUTHOR]

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.

Background: Ultra-processed food consumption is a risk factor for obesity and has a negative environmental impact. Food companies spend billions of dollars on advertisements each year to increase the consumption of ultra-processed food. In Australia, USA, and New Zealand, most food advertisements around schools and in train stations promote ultra-processed food, but no similar studies have been conducted in Sweden. The aim of this study was to explore the proportion of ultra-processed food advertisements in two districts of Stockholm, Sweden with low vs. high socioeconomic status (SES).Methods: Two independent researchers (per area) mapped all advertisements, including storefronts, in two Stockholm districts. During consecutive days, all advertisements were photographed in Skärholmen (low SES district), and Östermalmstorg (high SES district), on the streets inside and outside the subway stations, as well as inside and outside of local shopping malls. Advertisements promoting food products were identified and a trained dietician categorized whether they promoted ultra-processed foods. Chi-Square test was conducted to test for differences in the proportion of ultra-processed food advertisements between the two study areas.Results: In total, 4092 advertisements were photographed in Skärholmen (n = 1935) and Östermalm (n = 2157). 32.8% of all advertisements promoted food, while 65.4% of food advertisements promoted ultra-processed foods. A significantly higher proportion of ultra-processed food advertisements out of total food advertisements was identified in the low SES area, irrespective of the researcher taking the pictures (74.6% vs. 61.8%, p < 0.001 and 70.4% vs. 54.8%, p = 0.001). There was no significant difference in the proportion of food advertisements out of total advertisements between the two areas.Conclusions: This study provides initial evidence about the scale and the differences in exposure to food advertisements across areas in Stockholm. The observed high proportion of ultra-processed food advertisements is concerning and is in sharp contrast to the Swedish dietary guidelines that recommend reduced consumption of such foods. Based on our results, residents in low SES areas might be more exposed to ultra-processed food advertisements than those in high SES areas in Stockholm. If such findings are confirmed in additional areas, they should be considered during the deployment of food advertisement regulatory actions. [ABSTRACT FROM AUTHOR]

Planetary boundaries are an important sustainability concept, defining absolute limits for resource use and emissions that need to be respected to avoid major and potentially irreversible earth system change. To remain within the safe operating space for humanity, there is a need for urgent adoption of climate-neutral diets, which make no additional contribution to warming. In the first study of its kind, a new climate metric, the Global Warming Potential Star (GWP*), was used to assess greenhouse gas (GHG) emissions associated with 9341 Australian adult diets obtained from the Australian Health Survey. Dietary climate footprints averaged 3.4 kg CO2-equivelent per person per day, with total energy intake explaining around one quarter of the variation. Energy-dense and nutrient-poor discretionary foods contributed around one third. With lower climate footprint food choices, a diet consistent with current Australian dietary guidelines had a 42% lower climate footprint. Currently, it is not possible to define a climate-neutral dietary strategy in Australia because there are very few climate-neutral foods in the Australian food system. To bring Australian diets into line with the climate stabilization goals of the Paris Agreement, the most important need is for innovation across the agricultural and food processing industries to expand the range of climate-neutral foods available.

Understanding the determinants of early introduction of sugar sweetened beverages (SSBs) may assist in designing effective public health interventions to prevent childhood weight related conditions (obesity). This study explores the relationship between family/infant characteristics and the early introduction of SSBs among infants in Sydney, Australia. Mothers (n = 934) from an ongoing birth cohort study were interviewed at 8, 17, 34, and 52 weeks postpartum. Multivariable logistic regression analysis was used to identify family/infant factors independently associated with the likelihood of early introduction of SSBs (n = 399) of infants were introduced to SSBs before 52 weeks. Mothers who were born in Vietnam (adjusted Odds Ratio (AOR) = 2.14; 95% confidence interval (CI) 1.33, 3.47), other Asian countries (AOR = 1.62; 95% CI 1.02, 2.58) as well as single mothers (AOR = 3.72; 95% CI 2.46, 5.62) had higher odds of introducing SSBs early to their infants. Mothers from highly advantaged socioeconomic background (AOR = 0.43; 95% CI 0.28, 0.68), those who breastfed their baby for 17–25 weeks (AOR = 0.60; 95% CI 0.37, 0.99), 26–51 weeks (AOR = 0.65; 95% CI 0.45, 0.94), and 52 weeks or more (AOR = 0.62; 95% CI 0.43, 0.90); and those who introduced solids between 17–25 weeks (AOR = 0.58; 95% CI 0.36, 0.91) and 26 weeks or more (AOR = 0.55; 95% CI 0.34, 0.91) had reduced odds of introducing SSBs early. Tailoring health promotion programs for these vulnerable groups may delay the introduction of SSBs.

Food systems vitally depend on croplands, which are a scarce natural resource. Croplands are also heterogeneous, differing in productive capability and in environmental context. Some are in regions of high biodiversity conservation importance, others in regions vulnerable to food insecurity. In this study, life cycle assessment was used to quantify cropland scarcity footprints, cropland biodiversity footprints and cropland malnutrition footprints for 9341 individual Australian adult daily diets. Dietary cropland scarcity footprints averaged 7.1 m2yr-e person−1 day−1, exceeding a target of 6.1 m2yr-e person−1 day−1, consistent with the proposed global cropland planetary boundary of 15% of the ice-free land area. Discretionary foods, which are energy-dense and nutrient-poor foods high in saturated fat, added sugars and salt, and alcohol and are not essential to a healthy diet, made the largest contribution, followed by fresh meats and alternatives, breads and cereals, fruit, dairy and alternatives and vegetables. Around 45% of the variation in cropland footprint between individuals was explained by differences in total dietary energy intake. Diets characterised by higher diet quality and lower cropland scarcity footprint required only 4.2 m2yr-e person−1 day−1 and recommended diets based on the food choices of this subgroup required 5.9 m2yr-e person−1 day−1. Eating within the global cropland planetary boundary appears realistic if Australians greatly reduce their intake of discretionary foods and moderate their food choices within the “meat and alternatives” food group.

Objective: The present research aimed to investigate the impact of the physical activity calorie equivalent (PACE) front-of-pack label on consumption, prospective consumption and liking of familiar and unfamiliar discretionary snack foods.Design: In a within-subject randomised design, participants tasted and rated liking (9-point hedonic scale) and prospective consumption (9-point category scale) of four different snack foods with four different labels (i.e. blank, fake, PACE, PACE doubled) and four control snack foods. The twenty snack foods were presented during two 45 min sessions (i.e. ten snack foods per session) which were separated by one week. The amount participants sampled of each snack food was measured.Setting: The study was conducted in the Centre for Advanced Sensory Sciences laboratory at Deakin University, Australia.Subjects: The participants were 153 university students (126 females, twenty-seven males, mean age 24·3 (sd 4·9) years) currently enrolled in an undergraduate nutrition degree at Deakin University.Results: When the PACE label was present on familiar snack foods, participants sampled 9·9 % (22·8 (sem 1·4) v. 25·3 (sem 1·5) g, P=0·03) less than when such label was not present. This was in line with a decreased prospective snack food consumption of 9·1 % (3·0 (sem 0·2) v. 3·3 (sem 0·2) servings, P=0·03). Such pattern was not seen in unfamiliar snacks.Conclusions: The PACE label appears to be a promising way to decrease familiar discretionary snack food consumption in young, health-minded participants. [ABSTRACT FROM AUTHOR]

There is widespread interest in dietary strategies that lower environmental impacts. However, various forms of malnutrition are also widely prevalent. In a first study of its kind, we quantify the water-scarcity footprint and diet quality score of a large (>9000) population of self-selected adult daily diets. Here, we show that excessive consumption of discretionary foods—i.e., energy-dense and nutrient-poor foods high in saturated fat, added sugars and salt, and alcohol—contributes up to 36% of the water-scarcity impacts and is the primary factor differentiating healthier diets with lower water-scarcity footprint from poorer quality diets with higher water-scarcity footprint. For core food groups (fruits, vegetables, etc.), large differences in water-scarcity footprint existed between individual foods, making difficult the amendment of dietary guidelines for water-scarcity impact reduction. Very large reductions in dietary water-scarcity footprint are possible, but likely best achieved though technological change, product reformulation and procurement strategies in the agricultural and food industries.

Excessive salt intake has negative effects on health and persists as a dietary problem in Spanish children. However, the analysis of dietary sodium sources has not been extensively studied. A group of 321 children between 7 and 11 years old from five Spanish regional communities was studied. A three-day dietary record was used to determine the contribution of food and beverages to dietary sodium intake. The food consumed was classified based on the level of processing (NOVA classification) and the nutritional profile. Boys consumed more dietary sodium and sodium from ultra-processed food (UPF) than girls (p < 0.05). The main sources of dietary sodium from discretionary food were meat and meat products (25.1%), some ready-to-eat and pre-cooked dishes (7.4%) and sugars and sweets (6.3%). More than 4/5 of the total dietary sodium consumed came from processed foods (PF) and UPF. Ready-to-eat and pre-cooked dishes (14.4%), meat and meat products (10.6%), and cereals (10.2%) were the most relevant UPF. These results demonstrate that a key point for Spanish children is a reduction in the sodium content in PF and UPF, whether these foods are for basic or discretionary consumption. Furthermore, a decrease in the frequency and the quantity of discretionary food consumption should be encouraged.

Objective: Excessive consumption of discretionary foods/beverages in the Australian population has been identified, increasing the risk of obesity and chronic disease. The present study aimed to examine the associations between demographic, anthropometric and dietary factors and the consumption of discretionary foods, discretionary beverages and discretionary foods/beverages combined.Design: Discretionary food/beverage consumption reported in two 24 h recalls was analysed, stratified by gender, age, socio-economic status, country of birth, BMI, waist circumference, and fruit and vegetable intakes.Setting: 2011-12 National Nutrition and Physical Activity Survey.Subjects: Australian adults (n 7873) aged 19 years or above.Results: Mean discretionary food and beverage consumption was 631 g (28 % by weight from foods; 72 % from beverages), providing 2721 kJ of energy intake (72 % from foods; 28 % from beverages). Total discretionary food/beverage consumption was higher in younger age groups (P<0·001), those in lower socio-economic categories (P<0·001), those born in Australia (P<0·001), those with higher BMI (P<0·001) and those with lower fruit (P<0·001) or vegetable intake (P<0·001). Discretionary beverage consumption (β=6·6, P<0·001) was more strongly associated with BMI than discretionary food consumption (β=0·5, P=0·01).Conclusions: Total discretionary food/beverage consumption as well as discretionary foods alone and discretionary beverages alone were associated with BMI in Australian adults. In addition, high intakes were associated with younger age, lower socio-economic status, and lower consumption of fruit and vegetables. [ABSTRACT FROM AUTHOR]

Minimising environmental impacts and prioritising the production of nutritious foods are essential qualities of a sustainable food system. Ultra-processed foods (UFPs) are potentially counterproductive to these objectives. This review aims to summarise the magnitude and types of environmental impacts resulting from each stage of the UPF supply chain and to develop a conceptual framework to display these impacts. It also aims to identify the terms used to describe UPFs in the sustainability literature, and the methods used to measure the associated environmental impacts. A narrative review approach with a systematic search strategy was used. Fifty-two studies were included that either described or quantified the environmental impacts of UPFs. This review found that UPFs are responsible for significant diet-related environmental impacts. Included studies reported that UPFs accounted for between 17 and 39% of total diet-related energy use, 36–45% of total diet-related biodiversity loss, up to one-third of total diet-related greenhouse gas emissions, land use and food waste and up to one-quarter of total diet-related water-use among adults in a range of high-income countries. These results varied depending on the scope of the term used to describe UPFs, stages of the lifecycle included in the analyses and country. Studies also identified that UPF production and consumption has impacts on land degradation, herbicide use, eutrophication and packaging use, although these impacts were not quantified in relation to dietary contribution. The findings highlight that environmental degradation associated with UPFs is of significant concern due to the substantial resources used in the production and processing of such products, and also because UPFs are superfluous to basic human needs. The conceptual framework and findings presented can be used to inform food policy and dietary guideline development, as well as provide recommendations for future research. • Ultra-processed food production uses significant finite environmental resources. • Ultra-processed foods are responsible for significant environmental degradation. • Environmental impacts are driven by intense production methods & overconsumption. • Environmental impacts are avoidable; ultra-processed foods are not nutritionally essential. • The framework developed can inform food policies and future research. [ABSTRACT FROM AUTHOR]

One of the aims of the United Nations Sustainable Development Goals (SDG) is to end hunger and ensure access by all people to safe, nutritious, and sufficient food all year round. An obvious synergy exists between the second SDG "Zero Hunger" and SDG target 12.3 which focuses on halving food waste and reducing food losses. In addition to helping improve global food security, reducing food waste provides financial and environmental benefits. Upcycling food is a technical solution for food waste reduction that retains the nutritional and financial value of food by-products. However, many of the upcycled foods produced are discretionary foods such as biscuits, crackers, and other snack food that are not part of a healthy dietary pattern, and should only be eaten sometimes in small amounts. Given the importance of ensuring a sustainable healthy diet, this paper discusses opportunities for upcycled food manufacturers to produce more nutritious products., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Thorsen, Skeaff, Goodman-Smith, Thong, Bremer and Mirosa.)

Objectives: This study aimed to explore psychological distress, lifestyle, and demographic factors, as well as their relationship to discretionary choices in women of reproductive age during the coronavirus disease 2019 pandemic in Australia., Methods: Reproductive-aged women (18-50 y) in Australia participated in a national online survey. Psychological distress score (using a validated 10-item Kessler Psychological Distress Scale questionnaire) was the primary exposure of interest, and key outcomes were frequencies of discretionary choices (sugar-sweetened beverages [SSBs], alcohol, and discretionary foods). Sociodemographic and physical activity data were also collected. Logistic regression was used to report adjusted odds ratio (aOR) and 95% confidence interval to predict SSBs (less than weekly; most days/daily), total discretionary foods (none/&lt;2 times/d; ≥3 times/d), and alcohol use (never/less than monthly; most weeks/daily)., Results: A total of 1005 women were included in the study, of whom 40% had a high level of psychological distress. Women with high psychological distress (aOR: 1.96; 95% CI, 1.32-2.91) and those who gained weight during the pandemic (aOR: 1.71; 95% CI, 1.10-2.65) were more likely to consume discretionary foods ≥3 times/d. There was no association between psychological distress and SSB intake or alcohol; however, Australian, New Zealander, or Pacific Islander background (aOR: 1.68; 95% CI, 1.21-2.33) and more hours of sitting time (aOR: 1.88; 95% CI, 1.07-3.29) were associated with SSB consumption on most days/daily. Older age (aOR: 1.70; 95% CI, 1.00-2.89), higher household income (aOR: 1.44; 95% CI, 1.08-1.92), and moderate or high physical activity (aOR: 1.75; 95% CI, 1.10-2.80) were associated with alcohol intake on most weeks/daily., Conclusions: Public health messaging to promote healthy eating should take into account the effect of psychological distress on health behavior. Messages aimed at maintaining a positive relationship between food intake and mental wellbeing, particularly among vulnerable groups, are warranted., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Knowledge is needed about effective tools that reach public health objectives focused on reducing the intake of sugar-rich foods and drinks. The purpose of this study was to assess the parental acceptability, use and motivational potential of intervention components developed in the randomized family-based trial 'Are you too sweet?' aimed at reducing the intake of sugar-rich foods and drinks among children (5-7 y). Intervention components included guidance on sugar-rich foods and drinks at a school health nurse consultation, a box with home-use materials and a digital platform. The methods used were a questionnaire among intervention families ( n = 83) and semi-structured interviews with parents in selected intervention families ( n = 24). Results showed the good acceptability and usefulness of the components, with reported frequencies of use of materials ranging from 48% to 94% and a high satisfaction rate with the school health nurse consultation. Personalized feedback and guidance from the school health nurse seemed to be a motivational trigger, and components that were compatible with existing practices were most frequently used. However, the components were not considered engaging by all families. Overall, intervention components were well received and hold the potential for enhancing parental knowledge and parenting practices regarding limiting the intake of sugar-rich foods and drinks.

Background Since resources are limited, selecting the most promising targets for obesity interventions is critical. We examined the relative associations of physical activity, fruit and vegetable consumption and 'junk food' consumption with BMI and the prevalence of relevant policies in school, work, food outlets and health-care settings. Methods We conducted intercept surveys in three low-income, high-minority California communities to assess fruit, vegetable, candy, cookie, salty snacks and sugar-sweetened beverage consumption and self-reported height, weight and physical activity. We also assessed relevant policies in selected worksites, schools and health-care settings through key informant interviews. Results Data were collected from 1826 respondents, 21 schools, 40 worksites, 14 health-care settings and 29 food outlets. The average intake of salty snacks, candy, cookies and sugar-sweetened beverages was estimated at 2226 kJ (532 kcal) daily, 88% higher than the US Department of Agriculture/Department of Health and Human Services guidelines recommend. Energy from these sources was more strongly related to BMI than reported physical activity, fruit or vegetable consumption. Policies to promote healthy eating and physical activity were limited in worksites. Fruits and vegetables were less salient than junk food in community food outlets. Conclusion Targeting consumption of salty snacks, candy cookies and sugar-sweetened beverages appeared more promising than alternative approaches. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objectives: We sought to develop and evaluate the relative validity of a dietary diversity questionnaire (DDQ) that reflects food-group diversity, food variety, and micronutrient adequacy among New Zealand women., Methods: A cross-sectional study included New Zealand women (Auckland based; ages 16-45 y, n = 101), completing a 7-d DDQ and 4-d weighed food record (reference method). The relative validity of the DDQ was evaluated by correlating nutritious and discretionary dietary diversity scores (DDSs; number of food groups) and food-variety scores (number of foods), calculated from both methods. The dietary mean adequacy ratio (MAR; micronutrient intakes relative to estimated average requirements) was calculated from the weighed food record and correlated to dietary diversity and food-variety scores from the DDQ to assess construct validity. Cross-tabulation was used to explore dietary diversity measures versus adequacy ratios. Significance was set at P < 0.05., Results: The median (interquartile range) DDSs (maximum 25) from the DDQ-23 (21-23)-and the weighed food record-18 (17-19)-were significantly correlated (r s  = 0.33, P < 0.001), as were the food-variety scores (maximum 237)-respectively, 75 (61-87) and 45 (37-52) (r s  = 0.22, P < 0.03). A mean (± SD) MAR of 0.94 ± 0.04 suggested a near-adequate diet, but one-third of foods consumed were from discretionary sources. Nutritious DDS was significantly correlated with MAR for micronutrients (r s  = 0.20, P ≤ 0.05). An inverse trend was observed between discretionary DDS and MAR., Conclusions: The DDQ is a quick, low-burden tool for describing nutritious and discretionary dietary diversity reflecting micronutrient adequacy in high-income settings. It requires further validation across different time frames, population groups, and settings., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

Planetary boundaries are an important sustainability concept, defining absolute limits for resource use and emissions that need to be respected to avoid major and potentially irreversible earth system change. To remain within the safe operating space for humanity, there is a need for urgent adoption of climate-neutral diets, which make no additional contribution to warming. In the first study of its kind, a new climate metric, the Global Warming Potential Star (GWP*), was used to assess greenhouse gas (GHG) emissions associated with 9341 Australian adult diets obtained from the Australian Health Survey. Dietary climate footprints averaged 3.4 kg CO2-equivelent per person per day, with total energy intake explaining around one quarter of the variation. Energy-dense and nutrient-poor discretionary foods contributed around one third. With lower climate footprint food choices, a diet consistent with current Australian dietary guidelines had a 42% lower climate footprint. Currently, it is not possible to define a climate-neutral dietary strategy in Australia because there are very few climate-neutral foods in the Australian food system. To bring Australian diets into line with the climate stabilization goals of the Paris Agreement, the most important need is for innovation across the agricultural and food processing industries to expand the range of climate-neutral foods available. [ABSTRACT FROM AUTHOR]

Understanding the determinants of early introduction of sugar sweetened beverages (SSBs) may assist in designing effective public health interventions to prevent childhood weight related conditions (obesity). This study explores the relationship between family/infant characteristics and the early introduction of SSBs among infants in Sydney, Australia. Mothers (n = 934) from an ongoing birth cohort study were interviewed at 8, 17, 34, and 52 weeks postpartum. Multivariable logistic regression analysis was used to identify family/infant factors independently associated with the likelihood of early introduction of SSBs (<52 weeks of age). Of the 934 mothers interviewed, 42.7% (n = 399) of infants were introduced to SSBs before 52 weeks. Mothers who were born in Vietnam (adjusted Odds Ratio (AOR) = 2.14; 95% confidence interval (CI) 1.33, 3.47), other Asian countries (AOR = 1.62; 95% CI 1.02, 2.58) as well as single mothers (AOR = 3.72; 95% CI 2.46, 5.62) had higher odds of introducing SSBs early to their infants. Mothers from highly advantaged socioeconomic background (AOR = 0.43; 95% CI 0.28, 0.68), those who breastfed their baby for 17–25 weeks (AOR = 0.60; 95% CI 0.37, 0.99), 26–51 weeks (AOR = 0.65; 95% CI 0.45, 0.94), and 52 weeks or more (AOR = 0.62; 95% CI 0.43, 0.90); and those who introduced solids between 17–25 weeks (AOR = 0.58; 95% CI 0.36, 0.91) and 26 weeks or more (AOR = 0.55; 95% CI 0.34, 0.91) had reduced odds of introducing SSBs early. Tailoring health promotion programs for these vulnerable groups may delay the introduction of SSBs. [ABSTRACT FROM AUTHOR]

Food systems vitally depend on croplands, which are a scarce natural resource. Croplands are also heterogeneous, differing in productive capability and in environmental context. Some are in regions of high biodiversity conservation importance, others in regions vulnerable to food insecurity. In this study, life cycle assessment was used to quantify cropland scarcity footprints, cropland biodiversity footprints and cropland malnutrition footprints for 9341 individual Australian adult daily diets. Dietary cropland scarcity footprints averaged 7.1 m2yr-e person−1 day−1, exceeding a target of 6.1 m2yr-e person−1 day−1, consistent with the proposed global cropland planetary boundary of 15% of the ice-free land area. Discretionary foods, which are energy-dense and nutrient-poor foods high in saturated fat, added sugars and salt, and alcohol and are not essential to a healthy diet, made the largest contribution, followed by fresh meats and alternatives, breads and cereals, fruit, dairy and alternatives and vegetables. Around 45% of the variation in cropland footprint between individuals was explained by differences in total dietary energy intake. Diets characterised by higher diet quality and lower cropland scarcity footprint required only 4.2 m2yr-e person−1 day−1 and recommended diets based on the food choices of this subgroup required 5.9 m2yr-e person−1 day−1. Eating within the global cropland planetary boundary appears realistic if Australians greatly reduce their intake of discretionary foods and moderate their food choices within the "meat and alternatives" food group. [ABSTRACT FROM AUTHOR]

Background: In Western countries, children's diets are often low in fruits and vegetables and high in discretionary foods. Diet in early life tends to track through childhood and youth and even into adulthood. Interventions should, therefore, be delivered in periods when habitual traits are established, as in toddlerhood when children adapt to their family's diet., Objective: In this study, we assessed the effect of the Food4toddlers eHealth intervention, which aimed to enhance toddlers' diets by shaping their food and eating environment., Methods: The Food4toddlers randomized controlled trial was conducted in Norway in 2017-2018. Parent-child dyads were recruited through social media. In total, 298 parents completed an online questionnaire at baseline (mean child age 10.9 months, SD 1.2). Postintervention questionnaires were completed immediately after the intervention (ie, follow-up 1; mean child age 17.8 months, SD 1.3) and 6 months after the intervention (ie, follow-up 2; mean child age 24.2 months, SD 1.9). The intervention was guided by social cognitive theory, which targets the linked relationship between the person, the behavior, and the environment. The intervention group (148/298, 49.7%) got access to the Food4toddlers website for 6 months from baseline. The website included information on diet and on how to create a healthy food and eating environment as well as activities, recipes, and collaboration opportunities. To assess intervention effects on child diet from baseline to follow-up 1 and from baseline to follow-up 2, we used generalized estimating equations and a time × group interaction term. Between-group differences in changes over time for frequency and variety of fruits and vegetables and frequency of discretionary foods were assessed., Results: At follow-up 1, a significant time × group interaction was observed for the frequency of vegetable intake (P=.02). The difference between groups in the change from baseline to follow-up 1 was 0.46 vegetable items per day (95% CI 0.06-0.86) in favor of the intervention group. No other significant between-group differences in dietary changes from baseline to follow-up 1 or follow-up 2 were observed. However, there is a clear time trend showing that the intake of discretionary foods increases by time from less than 1 item per week at baseline to more than 4 items per week at 2 years of age (P<.001), regardless of group., Conclusions: A positive intervention effect was observed for the frequency of vegetable intake at follow-up 1 but not at follow-up 2. No other between-group effects on diet were observed. eHealth interventions of longer duration, including reminders after the main content of the intervention has been delivered, may be needed to obtain long-terms effects, along with tailoring in a digital or a personal form., Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN) 92980420; https://doi.org/10.1186/ISRCTN92980420., (©Margrethe Røed, Anine C Medin, Frøydis N Vik, Elisabet R Hillesund, Wendy Van Lippevelde, Karen Campbell, Nina C Øverby. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.02.2021.)

A high consumption of sugar-rich discretionary food and drinks has several health implications, which have been traced from childhood into adulthood. Parents act as primary mediators shaping children's dietary habits, and interventions that engage parents have shown to result in positive outcomes. Further, collaboration with local school health nurses and dentists provides an effective structural frame to support behaviour change and anchor new initiatives. The multicomponent 3.5-month cluster randomised family-focused intervention "Are you too Sweet?" aims to evaluate the effectiveness of communicating new Danish guidelines for sugar-rich discretionary food and drinks for school starters (5-7 years). This paper describes the development, outcomes and process evaluation of the intervention that includes three main components: extended dialogue during a school health nurse consultation, a box with home-use materials, and a social media platform to facilitate interaction among participants. Children ( n = 160) and their parents were scheduled for a baseline interview at six different schools. The intervention was developed to increase self-efficacy, knowledge about guidelines, observational learning and reduce impediments for behavioural change. The desired primary outcome was a reduction in intake of sugar-rich food measured through a 7-day dietary record. The results contribute to the evidence on effective health promotion strategies.

There is widespread interest in dietary strategies that lower environmental impacts. However, various forms of malnutrition are also widely prevalent. In a first study of its kind, we quantify the water-scarcity footprint and diet quality score of a large (>9000) population of self-selected adult daily diets. Here, we show that excessive consumption of discretionary foods—i.e., energy-dense and nutrient-poor foods high in saturated fat, added sugars and salt, and alcohol—contributes up to 36% of the water-scarcity impacts and is the primary factor differentiating healthier diets with lower water-scarcity footprint from poorer quality diets with higher water-scarcity footprint. For core food groups (fruits, vegetables, etc.), large differences in water-scarcity footprint existed between individual foods, making difficult the amendment of dietary guidelines for water-scarcity impact reduction. Very large reductions in dietary water-scarcity footprint are possible, but likely best achieved though technological change, product reformulation and procurement strategies in the agricultural and food industries. [ABSTRACT FROM AUTHOR]

Excessive salt intake has negative effects on health and persists as a dietary problem in Spanish children. However, the analysis of dietary sodium sources has not been extensively studied. A group of 321 children between 7 and 11 years old from five Spanish regional communities was studied. A three-day dietary record was used to determine the contribution of food and beverages to dietary sodium intake. The food consumed was classified based on the level of processing (NOVA classification) and the nutritional profile. Boys consumed more dietary sodium and sodium from ultra-processed food (UPF) than girls (p < 0.05). The main sources of dietary sodium from discretionary food were meat and meat products (25.1%), some ready-to-eat and pre-cooked dishes (7.4%) and sugars and sweets (6.3%). More than 4/5 of the total dietary sodium consumed came from processed foods (PF) and UPF. Ready-to-eat and pre-cooked dishes (14.4%), meat and meat products (10.6%), and cereals (10.2%) were the most relevant UPF. These results demonstrate that a key point for Spanish children is a reduction in the sodium content in PF and UPF, whether these foods are for basic or discretionary consumption. Furthermore, a decrease in the frequency and the quantity of discretionary food consumption should be encouraged. [ABSTRACT FROM AUTHOR]