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Article

The Correlation between Knowledge of Food Sustainability, Sustainable Eating Attitudes, and Adherence to the Mediterranean Diet among Blue- and White-Collar Employees

by
Sümeyra Şahin Bayram
1,* and
Gül Kızıltan
2
1
Nutrition and Dietetics Department, Faculty of Health Sciences, Selçuk University, 42130 Konya, Turkey
2
Nutrition and Dietetics Department, Faculty of Health Sciences, Başkent University, 06790 Ankara, Turkey
*
Author to whom correspondence should be addressed.
Sustainability 2024, 16(19), 8644; https://doi.org/10.3390/su16198644 (registering DOI)
Submission received: 10 September 2024 / Revised: 4 October 2024 / Accepted: 4 October 2024 / Published: 6 October 2024
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Abstract

:
To enhance and advance both human and planetary health, it is imperative to transition towards more sustainable nutrition approaches. This study aimed to assess the correlation between the levels of sustainability and sustainable nutrition knowledge, attitudes towards sustainable nutrition, and adherence to the Mediterranean diet (MD) among blue- and white-collar employees. This study included 210 adults, half of whom were white-collar employees, with the other half being blue-collar employees. Sociodemographic data were collected, and anthropometric measurements were performed. The Questionnaire on Food Sustainability Knowledge and Attitudes to Sustainable Eating and the Mediterranean Diet Adherence Scale (MEDAS) were also included in the applied survey. Dietary intake was assessed using 24 h dietary records. The mean age was 41.9 ± 10.87 years. Of the participants, 56.2% were classified as being overweight or obese. The level of knowledge on the concept of “food sustainability” among all participants was 30.5%. The mean MEDAS score of all the participants was 5.4 ± 1.90, and 74.8% of all the participants did not follow the MD. Positive correlations were found between the MEDAS score and the Sustainable Diet Definition score (r = 0.174) (p ˂ 0.05) and Sustainable Eating Attitude score (r = 0.312) (p ˂ 0.001). Negative correlations were found between the MEDAS score and body weight (r = −0.320; p ˂ 0.001), BMI (r = −0.249; p ˂ 0.001), waist circumference (r = −0.278; p ˂ 0.001), and PBF (r = −0.177; p ˂ 0.05). We found that, as the level of sustainable nutrition knowledge increased, sustainable nutrition behaviors improved, and as adherence to the MD increased, the incidence of obesity decreased.

1. Introduction

The United Nations (UN) World Population Prospects 2024 anticipates that the global population will continue to expand over the next fifty to sixty years, reaching a peak level of approximately 10.3 billion individuals in the mid-2080s, a significant increase from the 8.2 billion recorded in 2024 [1]. Each year, the world experiences increased malnutrition, which is worsened by the rapid growth in population, leading to higher nutritional requirements. With worldwide climate change, environmental shifts, and decreasing resources, humanity is confronted with a significant obstacle in ensuring a sustainable, safe, healthy, economical, and exceptional food supply for its expanding population while minimizing land usage and reducing inputs [2].
The steady rise in the global population and subsequent growth in food consumption highlight the crucial and essential aspect of food security for the world. Food security extends beyond just staying alive; it is a fundamental birthright of every human being. It has significant consequences for global stability, economic influence, safety, and sustainability [3]. Sustainability is a widespread term in modern-day discussion, often associated with topics such as sustainable economy, resource management, development, ecology, global affairs, and nutrition. Sustainability is typically defined as the capacity of a system to be preserved over the long term while fulfilling present needs without compromising the requirements of future generations [4]. In 1986, Gussow and Clancy [5] first introduced an idea of sustainable nutrition, contending that sustainability is crucial for a healthy diet. The concept of sustainable nutrition was formulated through a holistic approach that considers multiple aspects, including human health, environmental, economic, and sociocultural factors [6]. Sustainable nutrition is a dietary model that guarantees the provision of food and nutrients to all individuals in a sufficient and safe manner, while also safeguarding the environment, biodiversity, and local resources [7].
The interaction between globalization, population growth, food resource depletion, climate change crises, and environmental issues significantly impacts food production systems. Consequently, there is an expanding need for sustainable food that has minimal adverse effects on the environment. In addition, the increasing demand for food presents a substantial risk to soil, water, and energy resources, thereby posing a risk to food security [8]. Enhancing the nutritional value while minimizing the environmental footprint and attaining sustainable development outcomes is a crucial global priority. The worldwide shift towards the “Western diet”, which is defined by a high consumption of refined carbohydrates, added sugar, sodium, and animal-based meals and a low intake of fruits, vegetables, and whole grains, has posed concurrent difficulties for both public health and environmental sustainability [9].
Food choices and eating habits are influenced by a multitude of components, such as individual, environmental, social, biological, psychological, sociocultural, and economical influences. Higher income levels in most industrialized countries are commonly linked to enhanced nutrition and improved health indices. Urbanization, together with higher income levels and more purchasing power, results in a change in food preferences towards animal-based foods. This change requires greater utilization of energy, water, and land resources [10]. However, whereas trade liberalization has resulted in the norms and safety of food quality being enhanced, it has also expanded the accessibility of inexpensive, highly processed, and hazardous food products. Individuals with lower levels of education and poverty tend to have a greater preference for energy-dense and affordable food choices [11]. It is necessary to examine the levels of awareness and interest among the general population regarding food sustainability and the extent to which individuals of different age groups are knowledgeable about sustainable nutrition and its environmental impact. Additionally, it is important to understand how the attitudes and behaviors of the general population contribute to food sustainability and efforts to mitigate climate change. Reversing present worldwide dietary patterns with plant-based dietary patterns as opposed to the Western diet, which contains significant amounts of animal products, shall result in more durable and effective protection against chronic diseases [12].
Corporate sustainability has become a fundamental aspect of the worldwide business environment [13]. Businesses embrace the notion of corporate sustainability to mitigate the harm they inflict on the environment while simultaneously bolstering their own financial frameworks [14]. This framework also views employees’ knowledge, attitudes, and behaviors regarding sustainability and sustainable nutrition as components of corporate sustainability.
To enhance and advance both human and planetary health, it is imperative to transition towards more sustainable nutrition approaches. Evaluating the extent of sustainable nutrition knowledge, attitudes, and behaviors in society is essential for creating national plans and policies in this domain. The existing body of knowledge indicates the necessity of implementing sustainable nutrition education with the aims of educating individuals about the environmental impact of their daily food choices, promoting the adoption of sustainable eating habits, and increasing awareness about reducing the negative environmental effects associated with current eating patterns and the risk of chronic diseases [15]. However, there is a lack of research examining sustainable nutrition knowledge, attitudes, and behaviors in Turkey. The purpose of this study was to assess the correlation between the levels of sustainability and sustainable nutrition knowledge, attitudes towards sustainable nutrition, and adherence to the Mediterranean diet (MD) among blue- and white-collar participants employed in a corporate company in Konya, Turkey.

2. Materials and Methods

2.1. Sample and Study Design

This descriptive cross-sectional study was conducted with a sample from June 2023 to August 2023. It involved face-to-face interviews with blue-collar and white-collar employees. Blue-collar employees are those who use physical and manual strength, while white-collar employees depend on mental strength [16]. The participants were aged 20 and above and voluntarily agreed to take part in the study. They were employed by subsidiaries of a private company headquartered in Konya, Turkey (N = 407). This study’s sample size was determined using a power analysis through the R statistical programming language “www.r-project.org (accessed on 25 May 2023)”. To determine whether there was a statistically significant difference between the knowledge and attitude means of blue-collar and white-collar employees regarding sustainable nutrition and their MEDAS scores, the sample consisted of 210 employees divided into blue-collar (n = 105) and white-collar (n = 105) groups for a two-way independent sample t-test at a significance level of 5.0%, a statistical power of 95.0%, and a medium effect size of 0.5. (Cohen’s d = 0.5, alpha (α) = 0.05, power (1 − β) = 0.95).

2.2. Ethical Approval

Ethical approval for this study was provided by the Baskent University Non-Interventional Clinical Research Ethics Committee (date: 30 March 2022, no. 22/62), and the principles of the Declaration of Helsinki were considered. Prior to the beginning of the research, the participants were required to sign an informed consent form confirming their voluntary participation in this study. Individuals who declined to participate; individuals with any psychological disorders, including eating disorders; individuals with special requirements (such as being pregnant or breastfeeding); and individuals with physical handicaps were excluded.

2.3. Data Collection Tools

The participants were given a survey that included questions on sociodemographic aspects, nutritional habits, lifestyle habits, anthropometric measurements, and physical activity status and a 24 h dietary recall form. The Questionnaire on Food Sustainability Knowledge and Attitudes to Sustainable Eating [17] and the Mediterranean Diet Adherence Scale (MEDAS) [18] were also included in the applied survey.

2.3.1. General Information Form

A 20-item questionnaire prepared by the researchers was used to determine the general characteristics of the individuals. The questionnaire gathered data on the individuals’ demographic variables (age, gender, etc.), overall health details (diagnosed illnesses, dietary habits, etc.), nutritional patterns (meal frequency, skipping meals, etc.), physical activity levels (type, frequency, etc.), lifestyle behaviors (smoking, alcohol consumption, etc.), and anthropometric measurements (height, body weight, waist circumference, hip circumference, percentage of body fat, etc.).

2.3.2. Anthropometric Measurements

As part of the anthropometric measurements, the individuals’ body weights, heights, and waist and hip circumferences were measured by the researchers, and their body mass index (BMI) was calculated using the body weight and height measurements. The World Health Organization (WHO) classification was used to evaluate the participants’ BMI [19]. The waist/hip ratios were calculated from the participants’ waist and hip circumferences, and the evaluation was based on the WHO’s risk classification for chronic diseases [20]. The participants’ body compositions were measured by the researchers with the handheld Xiaomi Mi Smart Body Composition Scale 2. The percentage of body fat (PBF) values of both the male and female participants were assessed using the WHO’s classification [21].

2.3.3. The 24 h Dietary Recall Form

Using a 24 h dietary recall form, we obtained comprehensive data regarding all the foods and beverages consumed by the individuals within the past 24 h. Subsequently, we examined the amount of energy, macronutrients, and micronutrients consumed through the daily diet using the “Computer Assisted Nutrition Programme, Nutrition Information Systems Package Program (BeBiS)” developed for Turkey.

2.3.4. The Questionnaire on Food Sustainability Knowledge and Attitudes to Sustainable Eating

The Questionnaire on Food Sustainability Knowledge and Attitudes to Sustainable Eating, first developed by Garcia-Gonzalez et al. (2021) [17] and then adapted into Turkish by Şahin Bayram and Kızıltan (2024) [22], consists of 33 items. Among the 33 items, 31 evaluate the participants’ awareness of sustainable nutrition by measuring their knowledge of concepts such as food sustainability, ecological footprint, carbon footprint, biodiversity, greenhouse gas emissions, food production systems, and nutritional factors that impact sustainable nutrition. In addition, they evaluate the impact or detriment of various food categories on global sustainability, the preservation of water resources worldwide, the influence of different foods on water consumption in food production, and the potential interchangeability of the terms sustainable nutrition and healthy nutrition. The remaining two items assess attitudes towards sustainable nutrition by evaluating consumers’ emphasis on the sustainable manufacturing of the items they consume and their opinions on the willingness to pay a higher price for sustainably produced food and beverages.
Eight items are related to knowledge about sustainability and sustainable nutrition, and the awareness of concepts related to sustainability was evaluated with the expressions “yes”, “no”, and “I heard but I don’t know what it means”. Whether the terms sustainable nutrition and healthy nutrition were synonymous was assessed with the expressions “yes”, “no”, “similar concepts but not the same”, and “I don’t know”. The 12 items related to the level of knowledge regarding its contribution to defining a sustainable diet were scored on a Likert scale, and the participants were asked to mark each item as “not important at all”, “of little importance”, “moderately important”, “important”, “very important”, and “I don’t know”. Seven items were related to knowledge about planetary health and sustainability. We evaluated the contribution of foods to planetary sustainability using the expressions “positive impact”, “negative impact”, and “I don’t know”. The three items related to the importance of water use in food production were scored on a Likert scale, and the participants were asked to mark each item as “do not agree”, “agree a little”, “mostly agree”, “agree”, “completely agree”, and “I don’t know”. The two items related to sustainable eating attitudes and the importance of sustainable production of consumed products were assessed on a Likert scale with the expressions “not important at all”, “of little importance”, “moderately important”, “important”, “very important”, and “I don’t know”. The willingness to spend more money for sustainably produced products was assessed on a Likert scale with the expressions “not at all”, “unwilling”, “moderately willing”, “quite willing”, “willing”, and “I don’t know”.

2.3.5. The Mediterranean Diet Adherence Scale (MEDAS)

This 14-item scale, whose Turkish validity and reliability assessment was carried out by Özkan Pehlivanoğlu et al. (2020) [23], was developed by Martinez-González et al. (2012) [18]. Each item awards a score of 0 or 1 based on whether the individual’s consumption is above or below the specified amounts. In this case, the scale can produce a maximum score of 14 and a minimum score of 0. A score of seven or higher indicates a moderate level of adherence to the MD, while a score of nine or above indicates a high level of adherence.

2.4. Statistical Analysis

The Statistical Package for the Social Sciences (SPSS) 26.0 software was used for a statistical analysis of the data. Descriptive statistics were presented as frequencies, percentages, means (X), and standard deviations (SD). The Kolmogorov–Smirnov test was used when normality was tested. The frequency and percentage values were used to evaluate the categorical variables. Pearson’s chi-square (x2) test was used to evaluate the categorical variables in independent groups, and Fisher’s exact test was used when the expected value per group was five or less. In the evaluation of continuous variables that met the parametric test conditions, the t-test was used in two independent groups, and a One-Way Analysis of Variance (ANOVA) was used in more than two independent groups. The correlations between variables were assessed using Pearson’s coefficient of correlation if the variables had a normal distribution, and the Spearman correlation coefficient was used if the variables did not have a normal distribution. In all analyses, p < 0.05 denoted a statistically significant difference.

3. Results

3.1. General Characteristics of Participants

The participants’ general characteristics are presented in Table 1. The study population included 210 participants, of which 105 (50.0%) were white-collar and 105 (50.0%) were blue-collar employees. The mean age was 41.9 ± 10.87 years. The mean ages of the white-collar (43.9 ± 9.63) and blue-collar (39.8 ± 11.69) employees were not statistically different (p > 0.05). The percentages of male workers in both white-collar and blue-collar employment were 72.4% and 69.5%, respectively. There was no significant difference in gender distribution between groups (p > 0.05). In total, 9.5% of the white-collar employees had a high school diploma, 57.2% had a university degree, and 33.3% had postgraduate education; 10.5% of blue-collar employees graduated elementary school, 73.3% graduated from high school, and 16.2% had a university degree. White-collar employees had a significantly higher education level than blue-collar employees (p < 0.05). Blue-collar employees significantly smoked more than white-collar employees (71.4% and 38.1%, respectively; p < 0.05), but there was no significant difference in alcohol consumption (p > 0.05). The mean BMI was 26.0 ± 4.30 kg/m2, and there was no significant difference between groups (26.3 ± 3.20 and 26.0 ± 4.30, respectively) (p > 0.05). According to the BMI categories, underweight (1.9% and 1.0%, respectively), normal (38.1% and 46.7%, respectively), overweight (47.6% and 40.9%, respectively), and obese (12.4% and 11.4%, respectively) did not show statistically difference between groups (p > 0.05). No significant difference was seen between the groups for waist/hip ratio and PBF categorization (p > 0.05).

3.2. Sustainability and Food Sustainability Knowledge Results

The participants were asked about the meanings (“yes/no/have heard the term but does not know what it means”) of different terms related to food sustainability. As shown in Figure 1, we discovered that the individuals showed the highest level of knowledge for terms such as “local food”, “environmental impact”, and “biodiversity”. However, their knowledge of “green water/blue water” was very weak. Half of the terms were identified by more than 50.0% of the white-collar employees. The concepts most recognized by white-collar employees were “local food” and “environmental impact”, whilst the less familiar terms were “ecological footprint” and “green water/blue water”. Only the concept of “local food” was identified by more than 50.0% of the blue-collar employees. In general, more white-collar than blue-collar employees recognized the terms (p < 0.05) (Figure 1).
The participants were also asked to rate the importance of a list of attributes which can be used to define a sustainable diet, on a scale 1 to 5, with 1 being “not important at all” and 5 being “very important”. Table 2 shows the results regarding the importance given to the different attributes that define a sustainable diet by employee groups. The blue-collar employees gave lower scores to each item than the white-collar employees, except for “a sustainable diet is affordable” (p < 0.05). The white-collar and blue-collar employees did not significantly differ in their scores for the “easy-to-follow” and “locally produced” attributes that define a sustainable diet (p > 0.05). The most important attribute of a sustainable diet according to all participants was the “diet is affordable”, while the least important attribute was a “low environmental impact”.
When linking sustainability to health, 31.0% of the participants believed that the terms sustainable diet and healthy diet are synonymous, while 31.0% believed that sustainable diet and healthy diet are similar concepts but not the same. Although more white-collar employees than blue-collar employees believed that the terms sustainable nutrition and healthy nutrition are synonymous, this difference was not statistically significant (p > 0.05).
Figure 2 shows the participants’ perceptions of the impact of different food groups on sustainability (“positive impact/negative impact/I don’t know”). The majority of participants (84.3%) stated that vegetables contribute positively to food sustainability. Likewise, more than 50.0% of the participants thought that meat and derivates contribute positively to food sustainability, whereas 69.5% attributed a positive effect to fish and derivates, 68.6% to milk and dairy products, and 67.6% to eggs. In contrast, the participants attributed the primary negative effect on sustainability to processed food (90.0%) and processed beverages (95.2%).
The participants were asked to what extent they agreed with statements regarding water and its use in food production on a scale 1 to 5, with 1 being “do not agree” and 5 being “completely agree”. Regarding perceptions of the importance of water and its use in food production, the results show that more blue-collar employees (2.5 ± 1.62) than white-collar employees (1.6 ± 1.85) thought that more water was needed to produce vegetables than animal food products (p < 0.05). On the other hand, more white-collar employees’ (2.2 ± 1.54) than blue-collar employees (1.4 ± 1.71) thought that more water was needed to produce animal food products than vegetables (p < 0.05). Moreover, white-collar employees (3.6 ± 1.38) had a statistically significantly higher rate of agreement with the statement “Enough water for the planet is granted by the natural cycle of water” than blue-collar employees (1.8 ± 1.80) (p < 0.05) (Table 3).

3.3. Sustainable Eating Attitudes Results

The participants were asked to assess the significance of acquiring sustainable food on a scale ranging from 1 to 5, with 1 being “not important at all” and 5 being “very important”. The mean score was 2.9 ± 1.70, with the white-collar employees (4.0 ± 1.07) giving a statistically significantly higher score than the blue-collar employees (1.9 ± 1.57) (p < 0.05). Regarding the participants’ willingness to pay more for sustainable food on a similar scale ranging from 1 to 5, with 1 being “not willing at all” and 5 being “absolutely willing”, the mean score was 2.2 ± 1.38, with the white-collar employees (2.9 ± 1.20) giving a statistically significantly higher score than the blue-collar employees (1.5 ± 1.23) (p < 0.05) (Table 4).

3.4. Mediterranean Diet Adherence Results

Table 5 shows the mean MEDAS scores based on employee groups. The mean MEDAS score of all participants was 5.4 ± 1.90. The mean score of the white-collar employees (6.3 ± 1.99) was significantly higher than that of the blue-collar employees (4.4 ± 1.15); the mean score of white-collar men (6.2 ± 2.06) was significantly higher than that of blue-collar men (4.2 ± 1.15); and the mean score of white-collar women (6.8 ± 1.78) was significantly higher than that of blue-collar women (4.8 ± 1.06) (p < 0.05). We found that 74.8% of all individuals did not follow the MD, 18.1% had moderate adherence, and 7.1% had high adherence to the MD. We found that white-collar employees were statistically more likely to moderately adhere to the MD than blue-collar employees, and no blue-collar employees demonstrated high adherence (p < 0.05).

3.5. The Association between the Mediterranean Diet Adherence, Sustainability Knowledge, Sustainable Eating Attitude, Age, Anthropometric Measurements, and Nutrient Intake Results

Table 6 shows the correlation of the Water Use Importance score, Sustainable Diet Definition score, Sustainable Eating Attitude score, and MEDAS with age and anthropometric measurements. While positive correlations were found between the MEDAS score and the Sustainable Diet Definition score (r = 0.174) (p ˂ 0.05) and Sustainable Eating Attitude score (r = 0.312) (p ˂ 0.001), no correlation was found with the Water Use Importance score. Negative correlations were found between the MEDAS score and body weight (r = −0.320; p ˂ 0.001), BMI (r = −0.249; p ˂ 0.001), waist circumference (r = −0.278; p ˂ 0.001), and PBF (r = −0.177; p ˂ 0.05). There was no relationship between the MEDAS score and age nor waist/hip ratio. There was a negative relationship between the Sustainable Eating Attitude score and body weight (r = −0.255; p ˂ 0.001), BMI (r = −0.161; p ˂ 0.05), waist circumference (r = −0.241; p ˂ 0.001), and PBF (r = −0.150; p ˂ 0.05). There was no relationship between the Sustainable Eating Attitude score and age nor waist/hip ratio.
Table 7 shows the correlation of BMI, PBF, waist circumference, and MEDAS score with some nutrient intake. There was a positive association between the MEDAS score and the intake of plant-based protein (r = 0.179; p ˂ 0.05), monounsaturated fatty acid (MUFA) (r = 0.383; p ˂ 0.001), and omega-3 polyunsaturated fatty acid (PUFA) (r = 0.283; p ˂ 0.001). Conversely, there was a negative correlation between the MEDAS score and the intake of saturated fatty acid (SFA) (r = −0.256; p ˂ 0.001) and the ratio of omega-6 to omega-3 fatty acids (r = −0.301; p ˂ 0.001). There was no association between the MEDAS score and the intake of PUFA and dietary fiber. There were negative correlations between the BMI and plant-based protein (r = −0.164; p ˂ 0.05), MUFA (r = −0.189; p ˂ 0.05), and omega-3 PUFA (r = −0.219; p ˂ 0.05). Conversely, there was a positive correlation between BMI and the omega-6/omega-3 intake ratio (r = 0.196; p ˂ 0.001). There was no observed link between BMI and the intake of SFA, PUFA, and dietary fiber. The PBF showed a significant negative correlation with MUFA intake (r = −0.268; p ˂ 0.001). There was no correlation between the waist circumference and plant-based protein, SFA, MUFA, PUFA, omega-3 PUFA, omega-6/omega-3 ratio, and dietary fiber.

4. Discussions

4.1. Sustainability and Food Sustainability Knowledge

After analyzing the knowledge level regarding sustainability and food sustainability among both white- and blue-collar employees, we found that all participants exhibited the highest levels of knowledge on topics such as “local food”, “environmental impact”, and “biodiversity”. Nevertheless, their knowledge of “green water/blue water” was extremely inadequate. The term “blue water” refers to surface and groundwater, whereas “green water” denotes rainwater retained in the soil as soil moisture. Green water constitutes the majority part of water used throughout agricultural production processes [24]. The participants, like those in the original study conducted in Spain, demonstrated the highest level of knowledge of the terms of “environmental impact” and “local food”, while they exhibited the lowest level of knowledge with the term “green water/blue water” [17]. Presently, “ecological footprint”, “carbon footprint”, and “water footprint” are the most used concepts in the media, particularly in social media, to raise awareness about sustainability. Nevertheless, the lack of detailed emphasis on the water footprint component is concerning. Promoting the use of local foods to reduce the environmental impact and carbon footprint and emphasizing the need to protect biodiversity to ensure sustainability could potentially enhance the societal awareness of these concepts. In addition, for eight concepts related to sustainability and food sustainability, the knowledge level of white-collar employees was expected to be statistically significantly higher than that of blue-collar employees (p < 0.05), and this situation can be associated with the high education and sociocultural levels of white-collar employees.
The level of knowledge on the concept of “food sustainability” among both white-collar and blue-collar employees was 30.5%. In contrast to our study, the original Spanish study declared that over 50.0% of the participants comprehended the term “food sustainability” [17]. A study in Turkey found that 24.3% of participants were knowledgeable about the concept of “sustainable nutrition” [25], whereas another study found that 21.1% of participants had only heard of it [26]. These findings are believed to be correlated with the delayed introduction and awareness of the subject of sustainability in our country in comparison to European countries.
In 2010, the Food and Agriculture Organization (FAO) established a definition for sustainable diets. These diets are characterized by their low impact on the environment while also promoting food and nutrition security and supporting the health and well-being of current and future generations. It is also said that sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair, affordable, nutritionally adequate, safe, and healthy while optimizing natural and human resources [27]. The participants were asked to rate the importance of a list of attributes which can be used to define a sustainable diet. The blue-collar employees gave lower scores than the white-collar employees to items associated with environment health. The increased level of education and associated knowledge about environment health issues among white-collar employees might explain this occurrence. The most important attribute of a sustainable diet for all participants was the “diet is affordable”, while the least important attribute was a “low environmental impact”. All participants determined the availability of access and suitability as the most significant criteria in defining sustainable nutrition, which highlights the essential role of the social aspect of sustainable nutrition in Turkish society.
When all participants were asked about the impact of different food groups on sustainability, over 80% said that “vegetables” contribute positively to planetary health in terms of sustainability. Conversely, over 90% of participants indicated that “processed foods” and “sodas and processed drinks” had negative impacts. More than half of the participants expressed that “meat and derivates”, “fish and derivates”, “milk and dairy”, and “eggs” had beneficial effects on planetary health. Consistent with this study, 85% of the participants in the original study conducted in Spain said that “vegetables” contribute positively to the health of the planet, while 87% reported that “processed foods” and 82% declared that “soda and processed drinks” had negative effects. Additionally, over 50% of the participants expressed that “meat and derivatives”, “fish and derivatives”, “milk and dairy”, and “eggs” had beneficial effects on planetary health [17]. According to this study’s results, it is generally accepted in society that vegetables and fruits are the primary food groups for a sustainable diet, whereas processed foods and drinks have a damaging impact on sustainability. Nevertheless, there is a lack of information regarding the impacts of animal-based foods on sustainability. Plant-based foods have significantly less negative environmental impact than animal-based foods. Even plant-based foods, vegetables, and grains with the highest environmental impacts cause less environmental damage than meat and dairy products with the lowest impact [28]. Life cycle assessment studies have shown that pork, chicken, and seafood produce less greenhouse gas emissions than beef; however, even the lowest-impact animal-based products exceed the average greenhouse gas emissions of substitute plant proteins [29]. For developed countries, reducing red meat consumption is crucial to achieving emission targets, and shifting to animal-free diets has the potential to reduce global greenhouse gas emissions by 49% [30]. In addition, although seafood is considered a low-environmental-impact source of animal protein, 60% of the world’s fish stocks have been completely captured, and more than 30% are currently overfished, overtaxing marine systems [31]. Sustainable resource management is critical to ensuring the long-term viability of biodiversity and ecosystems on which societies depend. The accurate measurement of the supply of and demand for natural resources is the key to their effective management [32].
According to the results regarding the importance of water use in food production, the white-collar employees stated that more water is needed to grow animal-based foods than blue-collar employees, while the blue-collar employees stated the opposite. This situation can again be explained by the fact that white-collar employees have a higher level of education than blue-collar employees and therefore have more knowledge about planetary health and sustainability. Global agriculture accounts for 70% of the freshwater extracted for human use. Moreover, when we consider that approximately half of all grains grown worldwide are used as animal feed, the increasing demand for meat and dairy products has direct effects on land and water use [28]. A study found that the water footprint of 1 kg of beef is sixty-one times higher than the water footprint of the same amount of vegetables and eleven times higher than the water footprint of pasta [33]. Another study found that 3.8 m2 of land, 2.5 m3 of water, 39 g of fertilizer, and 2.2 g of pesticides are required to produce 1 kg of beans and that 52 m2 of land, 20.2 m3 of water, 360 g of fertilizer, and 17.2 g of pesticides are required to produce the same amount of beef [34]. The UN’s 2011 World Economic and Social Survey concluded that intensive livestock production is the largest source of sector-specific water pollution [35]. In addition, the fact that the mean scores in our study comparing the amount of water required to produce plant-based and animal-based foods are very close to each other shows that this information has not fully reached the general public.

4.2. Sustainable Eating Attitudes

Upon analyzing the results regarding sustainable eating attitudes, we discovered that white-collar employees prefer everything they consume to be sustainably produced. Furthermore, they were more likely to spend extra money on sustainably produced food and beverage items compared to blue-collar employees. This outcome was expected as financial restrictions are the most significant barrier to consuming sustainable and healthy food. The Turkey Nutrition and Health Survey (TNHS) 2017 findings indicate that 23.4% of the participants showed concern about insufficient food availability resulting from financial and resource limitations [36]. A systematic review and meta-analysis revealed that the price of healthy foods and dietary patterns is greater compared to that of less healthy options. This highlights the importance of addressing economic barriers such as income inequality to encourage healthy and sustainable eating habits [37].

4.3. The Mediterranean Diet Adherence

The MD is a dietary pattern that involves consuming a significant amount of vegetables, fruits, whole-grain bread, whole-grain rice, pulses, and nuts. It also includes moderate amounts of fish and dairy products, particularly cheese and yogurt. However, it restricts the consumption of red meat and emphasizes the use of virgin olive oil as the main source of fat [38,39]. The MD involves not only a variety of foods but also a cultural model that encompasses the selection, production, processing, and distribution of these foods. The Mediterranean diet is not only shown as a cultural concept but also as a healthy and environmentally friendly model [40]. A study investigating the effects of different diet models on the environment found that while a vegan diet has a high health score and is sustainable, an environmentally friendly diet that reduces the consumption of animal-based foods, such as MD, is a more acceptable option for society as a whole [41]. Another study in Spain showed that switching to a MD would reduce the environmental impact (−72%), land use (−58%), and energy (−52%) and water (−33%) consumption [42]. It was also reported that the reduced consumption of processed foods in the MD reduces plastic consumption and the emissions associated with processing, packaging, and transporting these products. It was stated that a more climate-friendly approach can easily be adopted by focusing on consuming seasonal, locally sourced, and sustainably harvested and processed ingredients to further reduce emissions while following the MD [43]. Overall, the MD is described as a potential sustainable diet model [44].
When we evaluated the participants’ adherence to the MD, the mean score was 5.4 ± 1.90, and the mean score of white-collar employees was statistically significantly higher than that of blue-collar employees. Based on the MEDAS classification, all individuals exhibited non-adherence to the MD at a frequency of 74.8%, moderate adherence at 18.1%, and high adherence at 7.1%. Notably, white-collar employees were the only ones who highly followed the MD, with only four blue-collar employees showing moderate adherence. Other studies on MD adherence conducted in our country revealed a low rate of participants with high adherence, whereas our study revealed a high rate of moderate adherence [45,46]. It is thought that the main reason for this difference is that half of this study’s sample consisted of blue-collar employees with low socioeconomic, cultural, and educational levels. Another study conducted in our country assessed highly educated individuals’ adherence to the MD. Moderate adherence to the MD among individuals was similar to that of white-collar employees in our study [47].

4.4. The Association between the Mediterranean Diet Adherence, Sustainability Knowledge, Sustainable Eating Attitude, Age, Anthropometric Measurements, and Nutrient Intake

The participants’ MEDAS scores were low in this study; however, the positive relationship between the MEDAS score and the Sustainable Diet Definition score and Sustainable Eating Attitude score emerged as one of this study’s important outcomes. In accordance with our study, some studies in our country found correlations between the level of adherence to the MD and an increase in awareness of the ecological footprint, which is a component of sustainability [48,49]. On the other hand, no significant correlation was found between Water Use Importance score and MEDAS score, age, and anthropometric measurements. Animal-based products have a significantly larger water footprint than plant products with equivalent nutritional and energy value; therefore, substituting animal products with nutritionally equivalent plant-based products can reduce the water footprint [50]. One study reported that replacing animal-based diets with nutritionally equivalent plant-based diets will reduce the water footprint by 36% in developed countries and 15% in developing countries [51]. Nevertheless, this information was not released to the general population, since our findings indicated that all participants showed comparable assessments of the water requirements for producing plant-based versus animal-based foods (2.1 ± 1.79 and 1.8 ± 1.67, respectively). Therefore, it is thought that there is no significant correlation between the Water Use Importance score and other variables. In addition, body weight, BMI, waist circumference, and PBF were associated with low MEDAS and Sustainable Eating Attitude scores.
Overweight and obesity are significant global public health problems. In recent decades, there has been a significant increase in the worldwide occurrence of overweight and obesity, and this trend will likely continue [52]. The World Health Organization (WHO) states that Turkey has the highest obesity percentage among adults in Europe, standing at 32.1%, while the rest of Europe has a rate of 23.3% [53]. Within this study, 56.2% of the participants notably showed an attribute that classified them as being overweight or obese. Observational studies have shown that adopting sustainable healthy eating patterns is linked to a reduced risk of overweight and/or obesity [48,54,55]. Consequently, more studies are required to investigate the impact of obesity on the long-term sustainability of the environment and the effects of sustainable diets on the prevalence of obesity. The MD is a dietary pattern that involves consuming a considerable amount of dietary fiber [56]. In our study, no relationship was found between dietary fiber and MEDAS score, showing the generally low adherence of our population to the MD.
Another significant outcome of this study is the positive relationship between MEDAS score and plant-based protein, MUFA, and omega-3 PUFA intake and a negative relationship between MEDAS score, SFA, and omega-6/omega-3 ratio. Olive oil is the most characteristic attribute of the MD. Hence, while this result was expected, the relatively low frequency of high adherence to the MD in the sample (7.1%) could be attributed to the higher cost of olive oil compared to alternative vegetable oils.
The dietary intake of omega-3 and omega-6 fatty acids is considered crucial in the prevention and development of chronic disorders. Omega-3 polyunsaturated fatty acids are known to have beneficial effects on health through their anti-inflammatory, antioxidant, and antilipidemic actions [57]. The recommended ratio of omega-6/omega-3 fatty acids for optimal health benefits is in the range of 1:1–2:1. Nevertheless, due to industrialization, the typical Western diet may have substantially elevated this ratio, reaching up to 20:1 [58]. The MD emphasizes the consumption of locally sourced and seasonal seafood, making it a healthy choice with a minimal environmental impact [59]. Therefore, it is expected that a high adherence to the MD has a positive correlation with omega-3 intake and a negative correlation with the omega-6/omega-3 ratio. Nevertheless, the literature does not provide a definitive understanding of the influence of seafood on a sustainable diet. Despite the high health benefits of seafood consumption and its lower impact on greenhouse gas emissions compared to other animal-based proteins, it is important to consider that marine systems are under stress due to the complete capture of 60% of the world’s fish stocks and overfishing of more than 30% [31].
Multiple mechanisms could explain the beneficial effect of omega-3 fatty acids. Overall, their capacity to decrease fat synthesis in adipose tissue and their potential for reducing low-grade inflammation through their anti-inflammatory characteristics may prove effective in weight management [57]. One of the most important dietary factors in preventing obesity is a stable omega-6/omega-3 ratio, and a lower omega-6/omega-3 ratio should be adhered to for the management of obesity. While a high omega-6 fatty acid intake and a high omega-6/omega-3 ratio are associated with weight gain in both animal and human studies, it is reported that a high omega-6 fatty acid intake reduces the risk of weight gain [57,58,60]. Hence, the negative correlation of BMI with omega-3 intake and the positive correlation with the omega-6/omega-3 ratio were expected and are significant outcomes of this study. The impact of MUFAs on inflammation is not well documented; however, an increasing amount of research is establishing an association between MUFAs and anti-inflammatory diseases [61]. Obesity is a significant component of the metabolic syndrome and is frequently associated with chronic inflammation [62]. This study revealed a negative correlation between MUFA intake and BMI, suggesting that MUFAs may play a significant role in managing obesity.
Finally, one of the most important results of this study is the negative correlation between plant-based protein consumption and BMI, an important component of both environmental and human health. Plant-based diets include any dietary patterns that promote consuming plenty of plant-based foods while restricting or reducing the consumption of animal-based products. Plant-based diets, such as vegetarianism and veganism, are typically characterized by the types of food they eliminate rather than include [26]. Multiple studies examining various dietary patterns consistently found that diets that limit meat consumption, including plant-based and vegan diets, are linked to improved health outcomes; decreased greenhouse gas emissions; and reduced use of land, energy, and water [63,64,65]. Vegans who adhere to a well-balanced diet that achieves their bodies’ essential nutritional requirements have a reduced likelihood of developing obesity, hypertension, cardiovascular disease, diabetes, arthritis, cancer (particularly colon and prostate cancers), and fatal ischemic heart disease. This is due to the presence of protective compounds in fruits, vegetables, legumes, seaweed, oilseeds, whole grains, vegetable oils, and other plant-based foods [66]. Nevertheless, vegans are at risk of lacking omega-3 fatty acids; iron; calcium; vitamins B12, B2, and B3; zinc; vitamin D; and iodine due to their diets being based on plant protein. These deficiencies can potentially harm the maintenance of an adequate immune system [67]. As a result, it is extremely important that nutrition messages focus on consuming animal-based foods in moderation rather than strictly eliminating them from the diet to improve environmental and human health. To develop national plans and policies on sustainable nutrition, it is crucial to determine the public’s level of knowledge about sustainable nutrition and to evaluate their behaviors. This study shows that the public has a lack of knowledge about sustainability and sustainable nutrition and that their compliance with the Mediterranean diet is quite low.

Strengths and Limitations

One of this study’s strengths is its examination of the public’s level of knowledge and awareness on the subject with the aim of enhancing planetary and public health, a globally significant issue. This study was the first in Turkey to employ the validated and reliable Questionnaire on Food Sustainability Knowledge and Attitudes to Sustainable Eating. We evaluated not only sustainability knowledge and attitude levels but also compliance with the Mediterranean diet, one of the sustainable nutrition models. Additionally, we collected 24 h retrospective dietary records from the participants to enhance the validity of data on their consumption of sustainable nutrition components. We selected both white-collar and blue-collar employees for our sample, considering that the level of knowledge is proportional to the level of education. However, this study has a limitation: due to its voluntary nature, obtaining 24 h dietary records and body composition measurements from the participants was difficult. This prevented the sample size from increasing. We anticipate that the results of studies conducted on this subject with larger samples will incorporate the nutritional aspect into corporate sustainability policies.

5. Conclusions

According to reports, replacing current global nutritional models with more sustainable ones, like the Mediterranean diet, will improve and develop both human and planetary health. One of the most important obstacles to the public’s transition to sustainable nutritional models is undoubtedly the lack of knowledge about sustainability and sustainable nutrition. Additionally, this study shows that it would be beneficial to measure the public’s level of knowledge about sustainability and sustainable nutrition with larger-scale research to identify sustainable nutritional education needs to minimize the damage to the environment, ecology, and the world and to protect human health; this will help us develop strategies for this purpose.
We recommend that future research use longitudinal studies to evaluate sustainability knowledge and adherence to sustainable dietary habits. Longitudinal research will clarify the causality of the interactions among these factors. We also suggest that future research should examine the influence of corporate policies, environmental factors, and access to sustainable food on the adherence to sustainable dietary patterns.

Author Contributions

Conceptualization, S.Ş.B. and G.K.; Methodology, S.Ş.B. and G.K.; Validation, S.Ş.B.; Formal Analysis, S.Ş.B.; Writing—Original Draft preparation, S.Ş.B.; Writing—Review and Editing S.Ş.B. and G.K.; Supervision, G.K. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

This study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Başkent University Non-Interventional Clinical Research Ethics Committee (22/62, dated 30 March 2022).

Informed Consent Statement

Informed consent was obtained from all subjects involved in this study.

Data Availability Statement

The dataset is available upon request from the authors due to privacy restrictions.

Conflicts of Interest

The authors declare no conflicts of interest.

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Figure 1. The percentages of participants that stated knowing the meanings of different terms related to food sustainability based on employee groups. Sample size: 105 white-collar and 105 blue-collar employees.
Figure 1. The percentages of participants that stated knowing the meanings of different terms related to food sustainability based on employee groups. Sample size: 105 white-collar and 105 blue-collar employees.
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Figure 2. The perceived impacts of the different food groups on sustainability based on employee groups. Sample size: 105 white-collar and 105 blue-collar employees.
Figure 2. The perceived impacts of the different food groups on sustainability based on employee groups. Sample size: 105 white-collar and 105 blue-collar employees.
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Table 1. General characteristics of all participants (n: 210).
Table 1. General characteristics of all participants (n: 210).
WC (n: 105)BC (n: 105)All (n: 210)
Variables X ± SD or n (%)X ± SD or n (%)X ± SD or n (%)p
Age (years)43.9 ± 9.6339.8 ± 11.6941.9 ± 10.870.058
Gender
Male76 (72.4%)73 (69.5%)149 (70.9%)0.292
Female29 (27.6%)32 (30.5%)61 (29.1%)
Education level
Elementary school-11 (10.5%) *11 (5.2%)0.000 *
High school10 (9.5%)77 (73.3%) *87 (41.4%)
University60 (57.2%)17 (16.2%) *77 (36.7%)
Postgraduate35 (33.3%) *-35 (16.7%)
Smoker
Yes40 (38.1%)75 (71.4%)115 (54.8%)0.006 *
No65 (61.9%)30 (28.6%)95 (45.2%)
Consume alcohol
Yes3 (2.9%)8 (7.6%)11 (5.2%)0.418
No102 (97.1%)97 (92.4%)199 (94.8%)
BMI (kg/m2)26.3 ± 3.2025.8 ± 5.4926.0 ± 4.300.216
Underweight2 (1.9%)1 (1.0%)3 (1.4%)0.586
Normal40 (38.1%)49 (46.7%)89 (42.4%)
Overweight50 (47.6%)43 (40.9%)93 (44.3%)
Obese13 (12.4%)12 (11.4%)25 (11.9%)
Waist/hip ratio
Normal48 (45.7%)53 (50.5%)101 (48.1%)0.613
High57 (54.3%)52 (49.5%)109 (51.9%)
PBF (%)
Normal59 (56.2%)48 (45.7%)107 (50.9%)0.742
High46 (43.8%)57 (54.3%)103 (49.1%)
* p < 0.05; BMI: body mass index, PBF: percentage of body fat, WC: white collar, BC: blue collar. The PBF value is classified as high when it is >25.0% in males and >35.0% in females.
Table 2. The perceived attributes that define a sustainable diet, rated on a scale of 1–5 (1 = not important at all; 5 = very important) by employee groups (* p < 0.05; p1: the difference between the mean scores of male white- and blue-collar participants, p2: the difference between the mean scores of female white- and blue-collar participants, p3: the difference between the mean scores of all white- and blue-collar participants, WC: white collar, BC: blue collar).
Table 2. The perceived attributes that define a sustainable diet, rated on a scale of 1–5 (1 = not important at all; 5 = very important) by employee groups (* p < 0.05; p1: the difference between the mean scores of male white- and blue-collar participants, p2: the difference between the mean scores of female white- and blue-collar participants, p3: the difference between the mean scores of all white- and blue-collar participants, WC: white collar, BC: blue collar).
MaleFemaleAll
WC (n: 76)BC (n: 73)Male (n: 149) WC (n: 29)BC (n: 32)Female (n: 61) WC (n: 105)BC (n: 105)All (n: 210)
Attributes X ¯  ± SD X ¯  ± SD X ¯  ± SDp1 X ¯  ± SD X ¯  ± SD X ¯  ± SDp2 X ¯  ± SD X ¯  ± SD X ¯  ± SDp3
Low environmental impact3.4 ± 1.371.4 ± 1.622.4 ± 1.800.000 *3.4 ± 1.501.2 ± 1.672.2 ± 1.940.000 *3.4 ± 1.401.3 ± 1.632.3 ± 1.840.000 *
Respect towards biodiversity3.6 ± 1.361.3 ± 1.632.5 ± 1.870.000 *3.6 ± 1.541.1 ± 1.652.3 ± 2.040.000 *3.6 ± 1.401.3 ± 1.632.4 ± 1.920.000 *
No additives4.2 ± 1.002.5 ± 1.073.4 ± 1.340.000 *4.2 ± 1.093.3 ± 1.313.7 ± 1.280.005 *4.2 ± 1.022.8 ± 1.193.5 ± 1.330.000 *
Low processing4.0 ± 1.122.6 ± 0.993.3 ± 1.280.000 *4.1 ± 1.133.4 ± 1.343.7 ± 1.280.034 *4.0 ± 1.122.8 ± 1.163.4 ± 1.290.000 *
Few ingredients3.7 ± 1.142.4 ± 1.113.1 ± 1.320.000 *3.8 ± 1.213.3 ± 1.353.5 ± 1.300.1533.7 ± 1.162.6 ± 1.263.2 ± 1.330.000 *
Organic growth/ecologic products3.7 ± 1.402.1 ± 1.182.9 ± 1.530.000 *3.9 ± 1.373.0 ± 1.673.4 ± 1.590.026 *3.8 ± 1.382.4 ± 1.403.1 ± 1.560.000 *
Plenty of fresh products4.1 ± 1.073.3 ± 1.223.7 ± 1.210.000 *4.5 ± 1.093.9 ± 1.304.2 ± 1.240.041 *4.2 ± 1.093.5 ± 1.273.9 ± 1.240.000 *
Rich in vegetables3.8 ± 1.312.3 ± 1.123.1 ± 1.410.000 *4.2 ± 1.103.2 ± 1.343.7 ± 1.320.003 *3.9 ± 1.272.6 ± 1.263.3 ± 1.410.000 *
Typical from own culture3.3 ± 1.352.8 ± 1.153.0 ± 1.270.029 *3.4 ± 1.123.2 ± 1.273.3 ± 1.200.4073.3 ± 1.292.9 ± 1.193.1 ± 1.250.024 *
Locally produced3.7 ± 1.434.0 ± 1.633.9 ± 1.530.1903.6 ± 1.453.8 ± 1.473.7 ± 1.450.6103.7 ± 1.434.0 ± 1.583.8 ± 1.510.171
Affordable4.2 ± 0.854.7 ± 0.934.5 ± 0.930.000 *4.2 ± 1.174.6 ± 0.974.4 ± 1.090.1054.2 ± 0.944.7 ± 0.944.4 ± 0.970.000 *
Easy to follow4.3 ± 0.674.1 ± 0.914.2 ± 0.800.1144.4 ± 0.744.3 ± 0.964.4 ± 0.860.4524.3 ± 0.694.1 ± 0.924.2 ± 0.820.092
Table 3. The perceived importance of water use in food production, rated on a scale of 1–5 (1 = totally disagree; 5 = totally agree) by employee groups.
Table 3. The perceived importance of water use in food production, rated on a scale of 1–5 (1 = totally disagree; 5 = totally agree) by employee groups.
Importance of Water Use in Food ProductionWCBCAll
X ¯  ± SD X ¯  ± SD X ¯  ± SDp
1. Enough water for the planet is granted by the natural cycle of water.3.6 ± 1.381.8 ± 1.672.7 ± 1.820.000 *
2. The foods requiring a greater expenditure of water are of animal origin.2.2 ± 1.541.4 ± 1.711.8 ± 1.670.000 *
3. The foods requiring a greater expenditure of water are of vegetable origin.1.6 ± 1.852.5 ± 1.622.1 ± 1.790.000 *
* p < 0.05; WC: white collar, BC: blue collar.
Table 4. Importance of and willingness to pay for a sustainable diet based on data from employee groups.
Table 4. Importance of and willingness to pay for a sustainable diet based on data from employee groups.
Gender
Male Female All
Group X ¯  ± SDp1 X ¯  ± SDp2 X ¯  ± SDp3
How important is it for you that the products you consume are produced in a sustainable way?WC3.9 ± 1.090.000 *4.2 ± 1.000.000 *4.0 ± 1.070.000 *
BC2.0 ± 1.541.7 ± 1.671.9 ± 1.57
All2.9 ± 1.64 2.9 ± 1.84 2.9 ± 1.70
To what extent are you willing to pay more money for food and drink products that are produced in a sustainable way?WC2.9 ± 1.190.000 *2.9 ± 1.250.000 *2.9 ± 1.200.000 *
BC 1.6 ± 1.201.4 ± 1.321.5 ± 1.23
All2.2 ± 1.35 2.1 ± 1.46 2.2 ± 1.38
* p < 0.05; p1: the difference between the mean scores of male white- and blue-collar participants, p2: the difference between the mean scores of female white- and blue-collar participants, p3: the difference between the mean scores of all white- and blue-collar participants, WC: white collar, BC: blue collar.
Table 5. Mean MEDAS scores and classifications of all participants based on employee groups.
Table 5. Mean MEDAS scores and classifications of all participants based on employee groups.
Groups
WCBCAll
Gender X ¯  ± SD or n (%) X ¯  ± SD or n (%) X ¯ p1p2p3
MEDASMale 6.2 ± 2.064.2 ± 1.155.2 ± 1.280.000 *
Female6.8 ± 1.784.8 ± 1.065.7 ± 1.62 0.000 *
All6.3 ± 1.994.4 ± 1.155.4 ± 1.90 0.000 *
MEDAS Classification
No adherenceMale 43 (56.5)71 (97.3)114 (76.5)
Moderate adherence23 (30.3)2 (2.7)25 (16.8)0.000 *
High adherence10 (13.2)-10 (6.7)
No adherenceFemale13 (44.8)30 (93.8)43 (70.5)
Moderate adherence11 (37.9)2 (6.2)13 (21.3) 0.000 *
High adherence5 (17.3)-5 (8.2)
No adherenceAll56 (53.3)101 (96.2)157 (74.8)
Moderate adherence34 (32.4)4 (3.8)38 (18.1) 0.000 *
High adherence15 (12.3)-15 (7.1)
* p < 0.05; p1: the difference between the mean scores/frequency of male white- and blue-collar participants, p2: the difference between the mean scores/frequency of female white- and blue-collar participants, p3: the difference between the mean scores/frequency of all white- and blue-collar participants, WC: white collar, BC: blue collar.
Table 6. The correlation between age, anthropometric measurements, sustainability and food sustainability knowledge, sustainable eating attitudes, and the Mediterranean diet adherence.
Table 6. The correlation between age, anthropometric measurements, sustainability and food sustainability knowledge, sustainable eating attitudes, and the Mediterranean diet adherence.
Water Use Importance ScoreSustainable Diet Definition ScoreSustainable Eating Attitude ScoreMEDAS Score
MEDAS Scorer0.1040.174 *0.312 **1
p0.1420.0140.000
Ager0.0390.0780.0470.007
p0.5870.2740.5040.927
Body Weightr−0.0480.037−0.255 **−0.320 **
p0.6340.6080.0000.000
BMIr0.0540.013−0.161 *−0.249 **
p0.4520.8510.0230.000
Waist Circumferencer0.0680.088−0.241 **−0.278 **
p0.3410.2160.0000.000
Waist/Hip Ratior−0.105−0.013−0.143−0.007
p0.1390.9010.5430.920
PBFr0.0080.001−0.150 *−0.177 *
p0.9120.9860.0340.012
* p < 0.05 and ** p < 0.001; BMI: body mass index, MEDAS: the Mediterranean Diet Adherence Scale, PBF: percentage of body fat.
Table 7. The correlation between some nutrient intake, anthropometric measurements, and Mediterranean diet adherence.
Table 7. The correlation between some nutrient intake, anthropometric measurements, and Mediterranean diet adherence.
Waist CircumferencePBFBMIMEDAS Score
Plant-Based Proteinr0.0530.001−0.164 *0.179 *
p0.4530.9860.0210.011
SFAr0.0920.1340.152−0.256 **
p0.1950.0590.0520.000
MUFAr0.126−0.268 **−0.189 *0.383 **
p0.4880.0000.0170.000
PUFAr0.2170.0150.0700.002
p0.3960.6050.3240.977
Omega-3 PUFAr0.0020.075−0.219 *0.283 **
p0.9800.2920.0120.000
Omega-6/Omega-3 Ratior0.0160.1990.196 **−0.301 **
p0.3110.0580.0000.000
Dietary Fiberr0.0370.0610.1300.069
p0.6000.3880.0660.328
* p < 0.05 and ** p < 0.001; BMI: body mass index, MEDAS: the Mediterranean Diet Adherence Scale, MUFA: monounsaturated fatty acid, PBF: percentage of body fat, PUFA: polyunsaturated fatty acid, SFA: saturated acid.
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Şahin Bayram, S.; Kızıltan, G. The Correlation between Knowledge of Food Sustainability, Sustainable Eating Attitudes, and Adherence to the Mediterranean Diet among Blue- and White-Collar Employees. Sustainability 2024, 16, 8644. https://doi.org/10.3390/su16198644

AMA Style

Şahin Bayram S, Kızıltan G. The Correlation between Knowledge of Food Sustainability, Sustainable Eating Attitudes, and Adherence to the Mediterranean Diet among Blue- and White-Collar Employees. Sustainability. 2024; 16(19):8644. https://doi.org/10.3390/su16198644

Chicago/Turabian Style

Şahin Bayram, Sümeyra, and Gül Kızıltan. 2024. "The Correlation between Knowledge of Food Sustainability, Sustainable Eating Attitudes, and Adherence to the Mediterranean Diet among Blue- and White-Collar Employees" Sustainability 16, no. 19: 8644. https://doi.org/10.3390/su16198644

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