Ronto R, Saberi G, Leila Robbers GM, Godrich S, Lawrence M, et al. (2022) Identifying effective interventions to promote consumption of protein-rich foods from lower ecological footprint sources: A systematic literature review. PLOS Global Public Health 2(3): e0000209. https://doi.org/10.1371/journal.pgph.0000209
Open access link to article:
Public health nutrition, sustainability
To identify effective interventions to promote intake of protein-rich foods from lower ecological footprint.
Bottom line for nutrition practice:
There is a clear gap in the current evidence base for interventions that promote plant-based diet in the general population.
Addressing overconsumption of protein-rich foods from high ecological footprint sources can have positive impacts on health such as reduction of non-communicable disease risk and protecting the natural environment. With the increased attention towards development of ecologically sustainable diets, this systematic review aimed to critically review literature on effectiveness of those interventions aiming to promote protein-rich foods from lower ecological footprint sources.
Five electronic databases (Medline, Web of Science, Scopus, Embase and Global Health) were searched for articles published up to January 2021. Quantitative studies were eligible for inclusion if they reported on actual or intended consumption of protein-rich animal-derived and/or plant-based foods; purchase, or selection of meat/plant-based diet in real or virtual environments. We assessed 140 full-text articles for eligibility of which 51 were included in this review.
The results were narratively synthesised. Included studies were categorised into individual level behaviour change interventions (n = 33) which included education, counselling and self-monitoring, and micro-environmental/structural behaviour change interventions (n = 18) which included menu manipulation, choice architecture and multicomponent approaches. Half of individual level interventions (52%) aimed to reduce red/processed meat intake among people with current/past chronic conditions which reduced meat intake in the short term. The majority of micro-environmental studies focused on increasing plant-based diet in dining facilities, leading to positive dietary changes. These findings point to a clear gap in the current evidence base for interventions that promote plant-based diet in the general population.
Details of results:
- One limitation of this review is that most of the included studies have been conducted in high income countries and only a few studies were conducted in low- and middle-income countries (LMIC). This might be due to the fact that plant-based diet concept in high income countries has received increased attention in the last five years and LMICs have not prioritised it as a significant nutrition and environmental issue due to dealing with other diet related issues such as undernutrition and nutrient deficiencies. Research indicates that meat intake in LMIC has been associated with wealth as the rise in income has resulted in significant animal-derived food consumption in these countries .
- Furthermore, most studies used self-reported measures to measure dietary behaviours which may increase biases .
- Also, this review was limited to the literature published in English language and did not included articles published in grey literature, therefore it may be we missed some important research written in other languages. Finally, the majority of individual level behaviour change interventions included people who may be highly motivated to change their dietary behaviour such as cancer survivors, people at risk of developing chronic conditions, limiting the generalizability of the data to general population.
The present review identified effective individual and micro-environmental behaviour change interventions which showed promising results in reducing protein intake from high ecological footprint sources.
- The findings suggest that individual behaviour change interventions such as education, counselling and self-monitoring interventions might be useful strategies to educate people to change their dietary behaviours to more sustainable ones. However, there is a need to test these strategies among the general population longitudinally.
- In addition, our findings showed that altering food environments using nudging and choice architecture approaches can achieve positive dietary changes but there is a need for development and evaluation of interventions in general settings (macro-environments) and explore motivations in sustainable food purchasing behaviours.
Our findings inform future research for development and evaluation of interventions and strategies to encourage greater adoption of sustainable and healthy diets.
Of additional interest:
- See the article reference list
Conflict of interest/ Funding:
None to declare
External relevant links:
Dr Rimante Ronto
Department of Health Sciences, Macquarie University, Australia
Transparency | Diversity | Dynamism | Evidence-based |