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What factors influence sustainable and healthy diet consumption? A review and synthesis of literature within the university setting and beyond (2024)

Elliott, P. S., Devine, L. D., Gibney, E. R., & O’Sullivan, A. M. (2024). What factors influence sustainable and healthy diet consumption? A review and synthesis of literature within the university setting and beyond. Nutrition Research, 103, 1-12. https://doi.org/10.1016/j.nutres.2024.03.004

Highlights
• We identified factors that may influence sustainable and healthy diet consumption.
• Using a novel scoring system, these factors were then ranked by priority.
• The scoring system identified high-priority factors to target in future research.
• Most high-priority factors were at the environmental level (e.g., product price).
• These findings can inform the development of future personalized interventions.

Abstract
Globally, typical dietary patterns are neither healthy nor sustainable. Recognizing the key role of dietary change in reducing noncommunicable disease risk and addressing environmental degradation, it is crucial to understand how to shift individuals toward a sustainable and healthy diet (SHD).

In this literature review, we introduced the concept of SHD and outlined the dietary behaviors necessary to transition toward SHD consumption; we reviewed the literature on factors that may influence sustainable (and unsustainable) dietary behaviors in adults; and we developed a novel scoring system to rank factors by priority for targeting in future research. Given the significant potential to promote an SHD transition on the university campus—where factors that may impact dietary behaviors can be targeted at all levels of influence (i.e., individual, interpersonal, environmental, policy)—we narrowed our focus to this setting throughout.

Aided by our novel scoring system, we identified conscious habitual eating, product price, food availability/accessibility, product convenience, self-regulation skills, knowledge of animal ethics/welfare, food promotion, and eating norms as important modifiable factors that may influence university students’ dietary behaviors. When scored without consideration for the university population, these factors were also ranked as the highest priority, as were modified portion sizes.

Our findings offer insight into factors that may warrant attention in future research aimed at promoting SHDs. In particular, the high-priority factors identified from our synthesis of the literature could help guide the development of more personalized dietary behavioral interventions within the university setting and beyond.

School Meal Programs Around the World: Results from the 2024 Global Survey of School Meal Programs: Survey Highlights (2024)

The Global Survey of School Meal Programs was launched in 2019 to gather information about school meal programs in every country in a standardized manner, and it has been repeated every 2-3 years. The survey spans a broad set of topics of relevance to school meals, bringing them together under one umbrella to spotlight their linkages. The 2024 Global Survey of School Meal Programs received a response from 142 country governments, which represents 73% of the 194 countries that were invited to participate in the survey.

School meal programs have the potential to play an important role in food systems transformation. This follows from the aggregate scale of these programs, which reach at least 408.2 million children worldwide and are found in at least 148 countries. It also follows from the programs’ multisectoral nature, with relevance for social protection, education, health and nutrition, agricultural and economic growth, and environmental sustainability. School meal programs touch on each of the key goals of food systems transformation.

Environment and Climate

Sustainability is increasingly prioritized in school meal programs, with countries implementing a variety of initiatives to both limit their environmental vulnerability and reduce their environmental impact. The Global Survey of School Meal Programs captured various indicators of environmental sustainability in school meal programs.

A large majority (81%) of school meal programs took some steps to limit food waste. This was generally more common in lower-income settings, where food tends to be less plentiful.
A majority (67%) of school meal programs also took some steps to limit package waste. Most commonly, these included the re-use of bags/containers (followed by 57% of programs that took some step to limit package waste) and the recycling of packaging materials.
Approximately 58% of school meal programs relied on wood stoves or charcoal stoves for food preparation, and among these, 78.5% took some steps to reduce the use of firewood/charcoal as fuel. Toward this end, the most common step taken was the use of fuel efficient (energy efficient) stoves.
As part of the food system, school meal programs are both affected by, and a driver of, climate change. Nevertheless, just 38% of programs targeted foods that were considered to be “climate friendly”.
On the other hand, a large majority (79%) of programs took some steps to reduce the distance traveled by food from the site of production to consumption (i.e., the food miles/kilometers). Across regions, this emphasis on local procurement was most common in Sub-Saharan Africa, where 89% of programs aimed to reduce the distance traveled by food.

Drivers of the food system based on food sovereignty domains: an integrative systematic literature review (2024)

Rivera, I., Díaz de León, D., & Pérez-Salazar, M. del R. (2024). Drivers of the food system based on food sovereignty domains: An integrative systematic literature review. Frontiers in Sustainable Food Systems, 8. https://doi.org/10.3389/fsufs.2024.1450321

Abstract

Food sovereignty, as defined by the comprehensive definition offered in the 2007 Nyéléni Forum, encompasses essential action lines for transforming a food system based on food sovereignty principles. Understanding how current food system initiatives align with these principles is essential for identifying the necessary processes of change to drive this transformation. This study aimed to consolidate the contributions of advancements in food sovereignty to the existing literature.

A systematic literature review was conducted to achieve this, analyzing 250 papers published between 2008 and 2023. The focus was on the research methods employed by the authors, food initiatives within the domains of food sovereignty, and the key drivers of a food system rooted in food sovereignty principles.

The findings revealed that approximately 36% of the studies utilized interviews, surveys, and questionnaires for data collection, while 34% concentrated on targeted fieldwork through case studies. Around 19% of the studies involved in-depth interaction with specific groups, and just under 10% employed document analysis methods. The most extensively discussed domain was the use of agroecological management practices for food production, followed by the valuation of traditional knowledge, the promotion of social justice and equity, self-determination through the transformation of economic and political institutions, and the localization of food production and consumption.

The food initiatives outlined overarching goals within each domain of food sovereignty, with three common goals identified across these domains: food security and consumption, environmental stewardship, and crisis preparedness. Furthermore, 29 drivers of a food system based on the domains of food sovereignty were identified, encompassing networks and a holistic approach present in all 5 domains. The study also highlights the implications for supporters of food sovereignty within the context of the identified goals of the food initiatives.

Choice architecture promotes sustainable choices in online food-delivery apps (2024 Oct)

Lohmann PM, Gsottbauer E, Farrington J, Human S, Reisch LA. Choice architecture promotes sustainable choices in online food-delivery apps. PNAS Nexus. 2024 Sep 19;3(10):pgae422. doi: 10.1093/pnasnexus/pgae422. PMID: 39372540; PMCID: PMC11450623. (open access)

Abstract

Greenhouse gas emissions from the food system constitute about one-third of the global total, hence mitigation in this sphere of human activity is a vital goal for research and policy.

This study empirically tests the effectiveness of different interventions to reduce the carbon footprint of food choices made on food-delivery apps, using an incentive-compatible online randomized controlled trial with 4,008 participants. The experiment utilized an interactive web platform that mimics popular online food-delivery platforms (such as Just Eat) and included three treatment conditions: a sign-posted meat tax, a carbon-footprint label, and a choice-architecture intervention that changed the order of the menu so that the lowest carbon-impact restaurants and dishes were presented first.

Results show that only the choice-architecture nudge significantly reduced the average meal carbon footprint—by 0.3 kg/CO₂e per order (12%), driven by a 5.6 percentage point (13%) reduction in high-carbon meal choices. Moreover, we find evidence of significant health and well-being co-benefits. Menu repositioning resulted in the average meal order having greater nutritional value and fewer calories, whilst significantly increasing self-reported satisfaction with the meal choice.

Simple back-of-the-envelope calculations suggest that menu repositioning would be a highly cost-effective policy instrument if implemented at scale, with the return on investment expected to be in the range of £1.28 to £3.85 per metric ton of avoided CO₂ emissions, depending on implementation costs.

The SALSA Questionnaire: creation and validation of a tool to assess people’s self-perceived barriers and facilitators to follow a sustainable and healthy diet (2025 Feb)

Muñoz-Martínez, J., Cañete-Massé, C., Cussó-Parcerisas, I. et al. The SALSA Questionnaire: creation and validation of a tool to assess people’s self-perceived barriers and facilitators to follow a sustainable and healthy diet. Environ Dev Sustain (2025). https://doi.org/10.1007/s10668-024-05954-y (open access)

This work was partially supported by an ICDA SFS Toolkit grant. You can read more under ‘Spain’ on the NDA SFS Grant page.

*From the Article: Table 2 Results from the Exploratory Factor Analysis with sample A (n = 207), including factor loadings, eigenvalues, and percentage of variance*

Abstract:

A transition towards a sustainable and healthy diet (SHD) is crucial for both population and planetary health. However, changing consumer’s behaviour is challenging due to the many factors influencing food choices. Tools that comprehensively assess these factors are paramount, yet none are available in Spain. Hence, we created and validated the SALSA questionnaire to capture self-perceived barriers and facilitators for SHD.

The process involved three phases:
— First, item development combining insights from a scoping review and content validity with experts (n = 9) and the target population (n = 38);
— Second, scale development by pre-testing the questionnaire (n = 4), administering it through an online survey to two samples(Dimensionality-Sample, n = 516; Reliability-Sample, n = 61), and applying exploratory factor analysis for factors extraction and item reduction;
— Third, scale evaluation by testing its dimensionality through confirmatory factor analysis, its reliability through Cronbach’s alpha and McDonald’s omega, and intra-class correlation coefficient, and construct validity through discriminant validity, convergent validity, and correlation analysis.

Results yielded a questionnaire with 27 items grouped into four dimensions: personal factors, sociocultural factors, external factors, and meat and plant-based meat alternatives. The psychometric analysis revealed that the SALSA questionnaire is a reliable instrument to identify behavioural determinants.

School Meals Coalition. (2021 website)

The School Meals Coalition is a prominent and innovative vehicle for multilateral action and addresses multiple Sustainable Development Goal (SDG) outcomes. The School Meals Coalition is a government-led and partner-supported effort that aims at ensuring that by 2030 every child worldwide can receive a healthy meal in school. Led by Brazil, Finland, and France, the Coalition was one of the most impactful and successful initiatives coming out of the UN Food Systems Summit in 2021.

The Coalition is an example of a new generation of multilateralism; It’s about governments and partners agreeing to join forces and work together to improve the quality, sustainability, and scale of national school meals programmes and complementary interventions. It is about breaking silos and pooling resources – best practices, experience, information, and technical support. Through its multisectoral and holistic approach, the Coalition addresses implementation bottlenecks, strengthens evidence for decision-making, provides opportunities for improved coordination and generates the political will and buy-in needed for change through advocacy.

Besides food provision (SDG 2), school meal programs boost agriculture, create jobs, increase school attendance and learning, and enhance health. They function as in-kind cash transfers, promoting social stability, gender equity, and comprehensive social protection efforts. Additionally, school meals programmes can integrate complementary interventions, including WASH (Water, Sanitation, and Hygiene), nutrition education, and other routine school health and nutrition services.

School meals represent a powerful, multisectoral tool, which can contribute to achieving multiple Sustainable Development Goals, including poverty (SDG1), hunger (SDG2), health (SDG3), education (SDG4), gender equality (SDG5), economic growth (SDG8), reduced inequalities (SDG10), Responsible consumption and production (SDG12), climate action (SDG13) and strengthened partnerships (SDG17).

To achieve this member states have set three objectives:

Restore all national school meal programmes lost to the pandemic by 2023
Reach the 73 million most vulnerable children who were not reached even prior to the pandemic by 2030
Improve the quality and efficiency of school health and nutrition programmes globally by 2030

2025 January

Planet-friendly school meals: opportunities to improve children’s health and leverage change in food systems (2024)

Pastorino, S., et al. (2024, November 18). Planet-friendly school meals: Opportunities to improve children’s health and leverage change in food systems. The Lancet Planetary Health. https://doi.org/10.1016/S2542-5196(24)00302-4

Planet-friendly school meals, defined as programmes delivering equitable and healthy foods for children, produced in ways that do not pollute or overexploit natural resources and protect biodiversity, are a platform to tackle many food system challenges.

Multiple stakeholder collaborations are required to move towards planet-friendly school meals. This entails changes directed at two sets of policies as outlined in the Planet-friendly school meals conceptual framework (figure): those making immediate changes to school meal programmes; and those developing demand-driven planet-friendly procurement policies that promote ecological farming and develop sustainable regional food systems.

School meals, mostly state-funded, reach 418 million children every day worldwide offering an opportunity to improve diet quality, and ultimately nutrition and health, and act as a catalyst for food systems transformation contributing to meeting global climate, food, and biodiversity goals.

2025 January

Good Practices in School Gardens and School Meals: Africa, Asia and Latin America and the Caribbean (2024)

As part of food and nutrition education actions and a component of Sustainable Schools, the Programme encourages school garden initiatives, considering their potential to transform food habits of current and future generations, training students to be aware of the impacts of food production on the environment and on agri-food systems. In addition, with the greater impact of climate change, this educational tool becomes even more relevant as it can offer concrete contributions to the mitigation of climate effects.

Since 2009, the Brazil-FAO International Cooperation Programme for School Meals, an alliance between the National Fund for Education Development (FNDE), the Brazilian Cooperation Agency (ABC) and the United Nations Food and Agriculture Organisation (FAO), has been developing activities to strengthen and institutionalise school meal programmes in Latin America and the Caribbean (LAC).

About 2 billion people in the world are overweight or obese due to a poor diet and sedentary lifestyle. Around 133.4 million Latin Americans and Caribbeans do not have access to a healthy diet. In addition, this region has the highest healthy food costs (LAC Food and Nutrition Security Overview, 2023).

Given this scenario, the cooperation has promoted actions aimed at offering healthy and adequate menus, public procurement from smallholder farming, improvement of school infrastructure and food and nutrition education actions such as school gardens, exchanges of experiences, training and technical visits between 26 LAC countries, within the framework of the Sustainable School Feeding Network (RAES).

2025 January

Global Roots (website)

Global Roots promotes regenerative, equitable, and nutritious plant-based food systems by modeling agricultural conservation projects, partnering with organizations around the world to implement whole systems change, and providing on-the-ground education programs. They are based in the USA* and the Dominican Republic** in partnership with the T. Colin Campbell Center for Nutrition Studies and are exploring other expansion areas. By recognizing the overlap between nutrition for personal and planetary health, we can drastically improve global health standards while simultaneously reducing agricultural land use requirements paving the way for increased conservation.

Objectives:

Expand the practice of agriculture as a form of conservation, life-enhancement, and regeneration to areas around the world.
Provide education opportunities on how to transition consolidated, top-down food systems to community-owned land trusts and regenerative land practices.
Demonstrate through model programs how transitioning inefficiently used farmland from speculative markets to locally-owned land initiatives increases healthy food options, employment opportunities, and resilient communities of health.
Increase peer-to-peer networking and coalition building through the Whole-Communities platform.
Provide technical support to promote regenerative, equitable, and nutritious plant-based food systems.

* The Brightside Farm and Nursery in the USA is the home of Global Roots. The farm is located outside of Chapel Hill, North Carolina in growing zone 8a and covers an area of 2.5 acres hosting the nursery, mixed vegetable production, and orchard. Operations of the farm and nursery are governed by the Global Roots staff and board of directors.

** The RAICES Institute education center is located in the Dominican Republic in the province of Las Hermanas Mirabal, north of Salcedo in the village of La Cumbre. The center is owned and operated by RAICES Global with program support from Global Roots and the T. Colin Campbell center for Nutrition Studies. The center hosts education programs and aims to establish plant-based communal food hubs.

2025 January

Options for reforming agricultural subsidies from health, climate, and economic perspectives (2022)

Springmann, M., Freund, F. Options for reforming agricultural subsidies from health, climate, and economic perspectives. Nat Commun 13, 82 (2022). https://doi.org/10.1038/s41467-021-27645-2

Agricultural subsidies are an important factor for influencing food production and therefore part of a food system that is seen as neither healthy nor sustainable. Here we analyse options for reforming agricultural subsidies in line with health and climate-change objectives on one side, and economic objectives on the other.

Using an integrated modelling framework including economic, environmental, and health assessments, we find that on a global scale several reform options could lead to reductions in greenhouse gas emissions and improvements in population health without reductions in economic welfare. Those include a repurposing of up to half of agricultural subsidies to support the production of foods with beneficial health and environmental characteristics, including fruits, vegetables, and other horticultural products, and combining such repurposing with a more equal distribution of subsidy payments globally.

The findings suggest that reforming agricultural subsidy schemes based on health and climate-change objectives can be economically feasible and contribute to transitions towards healthy and sustainable food systems.

2025 January