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This study aims to evaluate the nutrient profile, carbon footprint and water footprint of one-month menus presented in five hospitals in Turkey and compare their environmental impacts with that of the Mediterranean diet.

The energy and nutrient content of menus were compared with recommendations of the Turkey Dietary Guidelines (TUBER) 2022. Nutrient profiles of hospital menus were evaluated using Nutrient Rich Food 9.3 (NRF 9.3) and SAIN-LIM models. The carbon and water footprints of the menus were calculated and compared with those of the Mediterranean diet.

Menus’ energy and nutrient content did not conform with TUBER 2022. The SAIN-LIM score of Hospital A (5.7 ± 1.1) was significantly higher than that of Hospitals C (4.8 ± 0.7, p = 0.001) and E (5.1 ± 0.7, p = 0.025). The carbon footprint of Hospital A was significantly lower (2.6 ± 0.3 kg CO₂ eq/person/day) and that of Hospital D (4 ± 0.9 kg CO₂ eq/person/day) was significantly higher than those of others (p < 0.001). While other menus were similar (p > 0.05), the water footprint of Hospital A was significantly lower (3.5 ± 0.7 L/kg, p < 0.001). In addition, if the menus were suitable for the Mediterranean diet, a reduction of 2.2–23.4% in the carbon footprint and 37.5–58.6% in the water footprint could be achieved. Moreover, menus’ carbon and water footprints were negatively correlated with NRF 9.3 and SAIN-LIM scores.

The primary aim should be to ensure that the planned menus follow the dietary guidelines. In addition, it is an undeniable fact that sustainable nutrition is a complex process with many dimensions. However, it seems possible to improve the nutrient profiles of the menus and reduce their environmental footprint with minor changes to be made in food services.

It seems possible to improve the nutrient profiles of the menus and reduce their environmental footprint with minor changes. For both health and environmental impacts, food services should switch to menus suitable for the Mediterranean diet.

The findings provide new insights into hospital menus’ quality and environmental impact.

Background/Objectives: Protein-based meal replacements (MR) with viscous soluble fibre are known aids for weight loss. This study aims to compare the effects of new whey and vegan MR containing different amounts of PGX (PolyGlycopleX) on weight loss over 12 weeks, along with a calorie-restricted diet.

Subjects/Methods: Sixty-eight healthy adults of both sexes (53 women; 15 men; average age 47.1 years; BMI 31 ± 7.1 kg/m² and weight 85.05 ± 23.3 kg) were recruited. Participants consumed a whey or vegan MR twice/d (5–10 g/day PGX) with a low-energy diet (1,200 kcal/day), over 12 weeks. Weight, height, waist and hip circumference were recorded (four time periods).

Results: Forty-four participants completed the study. Results showed significant reductions in average body weight and at week 12, whey group was [−7.7 kg ± 0.9 (8.3%), p < 0.001] and vegan group was [−4.5 kg ± 0.8 (6.2%), p < 0.001)]. All participants (n = 44; BMI 27 to 33 kg/m²) achieved significant reductions in body measurements from baseline to week 12; p < 0.001. Conclusions: Supplementation of protein-based MR with PGX and a balanced, low-energy diet, appears to be an effective approach for short-term weight loss.

As the authors were evaluating if the MR as a whole (i.e. with PGX) caused weight loss from baseline over the 12 weeks, no comparators, i.e. just the MR without PGX, were used. Formulation of these new MRs resulted in a whey product with 5 g PGX and a vegan product with 2.5 g PGX. Only 2.5 g PGX could be formulated with the vegan protein due to taste and viscosity limitations. Study participants were not randomized and no control groups (e.g. no MR or MR without PGX but with energy restricted diet) were used. Furthermore, it is not clear whether the sort of protein alone or the combination with a higher amount of PGX (whey with 5 g PGX/serving vs vegan with 2.5 g PGX/serving) has contributed to these significant greater weight-loss effects. This was something the authors were testing, i.e. could only 2.5 g PGX/serving have an effect on weight loss for a vegan MR. These limitations would be somethings to evaluate in a subsequent randomized controlled study. Hence, the results of this study may serve as a good starting point for further sophisticated randomized controlled trials that can demonstrate causality – which the authors acknowledge as one of the fundamental limitations of an observational study design. Participants tracked their calories but adherence and compliance were self-assessed and they were encouraged to keep their exercise routine consistent throughout the study. Hence, these are further limitations. No control group was used in this study to observe the effect of the dietary intervention and/or physical activity on weight loss alone. However, a goal of the authors was to keep this study as close to a real-life situation as possible, where people would not be doing any of these measurements, to see if with minimal supervision or intervention, people can still lose weight and alter their body composition. Furthermore, differences in gender and the corresponding weight loss effects in response to MR-protein-based treatments could be evaluated in follow-up studies.

This study indicates that the consumption of protein-based (animal, whey or plant, pea protein) MR incorporating the highly soluble viscous PGX is beneficial for weight loss when combined with a healthy-balanced, calorie-restricted diet. MRs at either 2.5 g or 5 g per serving (RealEasy^TM with PGX) proved to be a highly effective as a short-term solution for weight loss. The observed results are encouraging, however, further long-term studies (i.e. randomized clinical trials RCT) are needed to confirm the clinical relevance. RCTs should focus on the individual effects of PGX and/or the different protein sources used in MRs, on weight loss and the maintenance of the reduced body weight, and should measure detailed blood parameters (lipid profiles, glucose etc.) as well as collect detailed exercise and food consumption diaries.

To the authors’ knowledge, this is the first study comparing a whey versus vegan, (as pea) protein-based MR that is supplemented with fibre PGX; thus, this work adds information to the already existing literature on fibre (such as PGX) and MRs regarding their combined weight loss effects. The purpose of this study was to observe if the novel protein-based (either whey or vegan versions) MR RealEasy^TM with PGX at 2.5 or 5 g in addition to a calorie-restricted diet (total of 1,200 kcal/day) would aid in weight loss in individuals over a 12-weeks period. Adding increasing amounts of whey protein and soluble fibre can help reduce subsequent ad libitum energy intake which could help adherence to energy restricted diets, but whether similar effects are seen with vegan protein is unclear – this study does aim to address this.

Studies on developed economies showed that imposing taxes on animal-based foods could effectively reduce agricultural greenhouse gas emissions (AGHGEs), while this taxation may not be appropriate in developing countries due to the complex nutritional status across income classes. Hence, this study aims to explore optimal tax rate levels considering both emission reduction and nutrient intake, and examine the heterogenous effects of taxation across various income classes in urban and rural China.

The authors estimated the Quadratic Almost Ideal Demand System model to calculate the price elasticities for eight food groups, and performed three simulations to explore the relative optimal tax regions via the relationships between effective animal protein intake loss and AGHGE reduction by taxes.

The results showed that the optimal tax rate bands can be found, depending on the reference levels of animal protein intake. Designing taxes on beef, mutton and pork could be a preliminary option for reducing AGHGEs in China, but subsidy policy should be designed for low-income populations at the same time. Generally, urban residents have more potential to reduce AGHGEs than rural residents, and higher income classes reduce more AGHGEs than lower income classes.

This study fills the gap in the literature by developing the methods to design taxes on animal-based foods from the perspectives of both nutrient intake and emission reduction. This methodology can also be applied to analyze food taxes and GHGE issues in other developing countries.

Dyslipidaemia is an established risk factor for cardiovascular diseases. Calorie restriction and adopting a heart-healthy diet like the Mediterranean diet are the main dietary interventions for dyslipidaemia. Other dietary behaviours, such as changes in meal frequency and timing, are not included in the major dietary advice guidelines despite the potential correlation between eating patterns and lipid metabolism. This overview of systematic reviews and meta-analyses aims to summarise the effect of meal timing and frequency on lipid profile and make possible recommendations on which meal timing pattern is superior in reducing lipid levels.

According to the protocol published on PROSPERO (CRD42021248956), five databases were searched for systematic reviews and meta-analyses investigating the effects of meal timing and frequency on lipid profile in adults.

Five reviews were included, with two reviews on breakfast skipping and meal frequency, respectively, and one review on night-time eating. Increasing meal frequency while maintaining the total calorie intake was reported to reduce total cholesterol and low-density lipoprotein (LDL) levels with low- to moderate-quality evidence. There was a correlation between breakfast skipping and an undesirable increase in LDL levels with low-quality evidence. However, there needs to be more high-quality evidence to conclude the effect of dietary behaviours on blood lipid levels.

This overview provides a comprehensive summary of evidence examining the effects of meal timing and frequency on adult lipid profiles. The current low- or moderate-quality evidence could not support the recommendation of alteration of meal frequency as an alternative to conventional non-pharmacological treatments for dyslipidaemia.

This study aims to assess the information-seeking behaviors, attitudes and beliefs about pregnancy-related nutrition, food-related myths and taboos and supplementation among pregnant women in different communities of Pakistan.

A cross-sectional quantitative survey method was used in this study, which included 150 pregnant women from various locations in Lahore and Faisalabad.

Most participants were between the ages of 25 and 29, having 14 years of education. Regardless of age or number of children, all selected women had the same dietary awareness. Regarding myths and taboos, highly significant values (p = 0.001) were found in various studied variables. No significant difference was observed in knowledge level between age and number of children. It was observed that food myths and taboos significantly (p = 0.001) impact pregnant women’s dietary choices.

This survey experienced limited representativeness; many participants provided incomplete food and nutritional information. This research was conducted in two major districts of Pakistan, i.e. Lahore and Faisalabad; therefore, the results can be generalized for a population of pregnant women living in the northeastern region of Pakistan.

This study can provide helpful insight for health-care professionals to improve pregnant women’s nutritional status and knowledge.

The outcomes of this study can help guide how pregnant women might be educated and have better nutritional awareness at domestic and professional levels.

In Pakistan, there is a lack of research on pregnant women’s nutritional knowledge, and this research can assist health-care professionals in providing diversified knowledge to promote maternal health.

Malaysia transitions from a pandemic to an endemic state, beginning on April 1, 2022. The dietary intake and physical activity of university students were altered during the COVID-19 pandemic confinement period, but there is limited information on this topic in the post-COVID-19 period. This cross-sectional study aims to understand gender differences in dietary intake and physical activity among university students and investigate the factors influencing their body mass index (BMI) in the post-COVID-19 period.

The questionnaire used in this study comprised three main segments: sociodemographic information, a semiquantitative food frequency questionnaire and the International Physical Activity Questionnaire.

Results indicated that males exhibited significantly higher (p < 0.05) mean intakes of total dietary energy and macronutrients compared to females. Compared to the Malaysian Recommended Nutrient Intakes 2017, 76.4% of males and 68.8% of females had a sufficient daily energy intake. The majority of males (52.7%) and females (46.4%) were moderately physically active. Regression analysis revealed that male university students with lower fiber intake (ß = −0.309, p = 0.002) were significantly associated with higher BMI reading after confounding adjustment. However, a similar trend was not observed in female university students.

Understanding the gender differences in dietary intake and physical activity can provide insights into the development of effective gender-specific health promotion strategies and the formulation of policies aimed at promoting healthier lifestyles among university students in the post-COVID-19 pandemic era.

This study provides insights into the gender differences in the dietary and physical activity habits of university students, as well as the factors influencing their BMI in the post-COVID-19 pandemic era.

High levels of child obesity alongside rising stunting and the absence of a coherent food policy have deemed UK’s food system to be broken. The National Food Strategy (NFS) was debated intensely in media, with discussions on how and who should fix the food system.

Using a mixed methods approach, the authors conduct framing analysis on traditional media and sentiment analysis of twitter reactions to the NFS to identify frames used to shape food system policy interventions.

The study finds evidence that the media coverage of the NFS often utilised the tropes of “culture wars” shaping the debate of who is responsible to fix the food system – the government, the public or the industry. NFS recommendations were portrayed as issues of free choice to shift the debate away from government action correcting for market failure. In contrast, the industry was showcased as equipped to intervene on its own accord. Dietary recommendations made by the NFS were depicted as hurting the poor, painting a picture of helplessness and loss of control, while their voices were omitted and not represented in traditional media.

British media’s alignment with free market economic thinking has implications for food systems reform, as it deters the government from acting and relies on the invisible hand of the market to fix the system. Media firms should move beyond tropes of culture wars to discuss interventions that reform the structural causes of the UK’s broken food systems.

As traditional media coverage struggles to capture the diversity of public perception; the authors supplement framing analysis with sentiment analysis of Twitter data. To the best of our knowledge, no such media (and social media) analysis of the NFS has been conducted. The paper is also original as it extends our understanding of how media alignment with free market economic thinking has implications for food systems reform, as it deters the government from acting and relies on the invisible hand of the market to fix the system.

Polycystic ovary syndrome (PCOS) is a prevalent and multifaceted metabolic and endocrine disorder that affects a significant number of women in their reproductive years. The purpose of this study is to investigate the relationship between the lifeline diet score (LLDS) and PCOS.

In this study, the authors enrolled 105 women who had recently been diagnosed with PCOS. 105 women without PCOS, matched for age and body mass index (BMI), were selected as the control group. The mean age of the participants was 34.80 ± 5.37 years old. Standardized procedures were used to measure anthropometric indicators and assess the body composition of each participant. To determine the dietary patterns, a validated and reliable 147-item food frequency questionnaire (FFQ) was administered. Based on the responses to the FFQ, the LLDS was calculated using 12 specific components. Multiple and univariate logistic regression analyses were performed to estimate the associations between LLDS and PCOS, considering various factors.

In the control group, the mean LLDS was 45.61 ± 9.67; while in the case group, the mean LLDS was 25.10 ± 7.49, respectively (P = 0.001). After adjusting for socioeconomic status (SES), age, protein, fat, physical activity and BMI, the probability of developing PCOS is 69% lower in the third tertiles of LLDS than in the first tertiles (OR = 0.31, CI 95% = 0.15–0.62), (P < 0.001).

The study finds that a higher LLDS correlates with reduced PCOS risk, echoing dietary advice to boost fruits, dairy, vegetables, legumes, poultry and grains while limiting pasta, rice, bread, eggs, red meat, sweets, sugar and hydrogenated fats.

This study aims to examine the dietary compliance of children and adolescents with celiac disease (CD) and their diet quality (DQ) and dietary acid load (DAL) and to determine the relationship of these dietary parameters with health-related quality of life (HRQoL).

Ninety-one children and adolescents with CD and 144 healthy peers were included in this cross-sectional study. Anthropometric measurements were conducted by researchers. DQ and DAL were calculated from participants’ 24-h dietary recall records. HRQoL was assessed using the Pediatric Quality of Life Inventory, and compliance with a gluten-free diet (GFD) was obtained using the GFD score. Data was collected through a face-to-face questionnaire.

Of celiac patients, 53.1% were strictly compatible with the GFD, and 35.8% were non-compliant with the diet. The DQ scores of participants with CD were higher than their healthy peers, and the DAL scores were lower (p < 0.01). Finally, no relationship was found between the DQ and DAL with HRQoL scores in celiac patients (p > 0.05). However, better dietary compliance with the GFD was associated with improved HRQoL (p < 0.05).

While DQ and DAL had no association with HRQoL, better dietary compliance improved the HRQoL of celiac patients. This may help develop solutions to the problems experienced by celiac patients, thereby improving the management of CD.

To the best of the authors’ knowledge, this study is the first to investigate the association of DQ and DAL with HRQoL in children with CD.

This was an explorative study, the purpose of which was to understand how Chinese flexitarians were motivated to reduce their animal-based food consumption and specifically to explore why and what was behind these changes. Further, this study provides insights into how a transition towards a more plant-based diet might occur.

This study conducted 30 in-depth online interviews with Chinese flexitarians from two major Chinese cities. Interview transcripts were analysed through the lens of the Food Choice Process Model.

Participants adopted flexitarian diets due to health (n = 22), sustainability (n = 5) or ethical (n = 3) concerns. Many participants stated that they still enjoyed animal-sourced foods, were uncomfortable talking about their dietary transition and needed more social support. Consequently, most participants were unlikely to progress to vegetarian or vegan diets. While there are some commonalities between these findings and the results of similar studies with Western consumers, the many culturally and context-specific results revealed herein make an important contribution to the sustainability literature.

This is the first study exploring Chinese consumers’ flexitarianism experiences. These findings can be used by the food industry and interested business actors to improve communication and promotional strategies that encourage consumers to make healthier and more sustainable food choices.