Search Results (80)

Transitioning to sustainable, plant-forward diets, such as the Planetary Health Diet is a global priority; however, the palatability gap remains a formidable barrier, as consumers often perceive low-sodium, plant-centric diets as sensory-deficient. While aromatic herbs could bridge this gap, the current literature rarely integrates their sensory, ecological, phytochemical, and cultural dimensions. This narrative review explores how Mediterranean aromatic plants indigenous to the Maltese Islands function as sensory and molecular catalysts to bridge this gap. Through a thematic synthesis (2005–2026) integrating ethnobotanical evidence with molecular nutrition and sensory science, the Maltese archipelago is examined as a small-island ecological model. Chronic abiotic stressors, including high salinity and intense solar exposure, induce phytochemical priming, significantly enhancing secondary metabolites like polyphenols and terpenoids. These compounds establish a folk–medicine bridge, where traditional culinary practices align with modern biochemical validation. These bioactives demonstrate a capacity to modulate the NF-κB inflammatory axis, mitigate systemic inflammaging, and support the gut–microbiome–brain axis. Furthermore, these aromatics serve as translational tools for EAT-Lancet 2025 targets by facilitating cross-modal sensory compensation for sodium reduction and improving nutrient bioaccessibility via the culinary entourage effect. The TASTE-MED framework positions culinary nutrition as a vital translational bridge, asserting that flavour is a prerequisite for dietary sustainability and aligning individual molecular resilience with broader planetary health goals. Full article

Background/Objectives: Animal-source protein consumption in Saudi Arabia has increased substantially over the last two decades, raising concerns regarding its environmental impact in a country with among the highest per capita carbon emissions globally. Despite growing interest in sustainable diets, empirical evidence on dietary carbon footprint (CF) in Gulf Cooperation Council countries remains limited. This study aimed to quantify the CF associated with the consumption of animal- and plant-based protein foods among Saudi adults and to identify sociodemographic and lifestyle predictors of dietary CF, with attention to sex differences. Methods: A cross-sectional study was conducted among 1624 Saudi adults (47.1% males; 52.9% females). A newly developed, expert-reviewed, and pilot-tested food frequency questionnaire covering 21 protein-containing food items (13 animal-based; 8 plant-based) was used to estimate daily intake. CF values were calculated using Life Cycle Assessment-derived greenhouse gas emission factors (kgCO₂e/kg food) obtained from peer-reviewed sources. Sex-stratified multiple linear regression models and a pooled sex × animal-source protein food interaction model was used to identify independent predictors of daily CF. Results: Animal-source protein foods contributed 45,641.8 kgCO₂e/week to cumulative CF—a 64-fold excess over plant-based sources (708.33 kgCO₂e/week). Mean individual protein-food CF was 4.07 kgCO₂e/day, of which 98.5% derived from animal sources. Lamb and beef carried the highest emission intensities; nuts the lowest. Animal-source intake was the strongest independent predictor of CF in both sexes, with a significantly stronger association in males than females. High consumers substantially exceeded EAT–Lancet red meat targets across all consumption strata. Conclusions: Red meat dominates protein-food-related GHG emissions among Saudi adults. Even a partial dietary shift toward plant-based proteins, embedded within a coordinated food-system transformation framework, could substantially reduce per capita emissions in alignment with Saudi Vision 2030 and One Health targets. Full article

Background/Objectives: Digestive cancers are among the leading causes of death worldwide. Although their etiology is not fully understood, diet is an important modifiable risk factor. This scoping review aimed to explore the existing evidence on the association between adherence to various plant-based dietary (PBD) patterns and the risk of major digestive cancers. Methods: The scoping review followed the Arksey and O’Malley framework and Joanna Briggs Institute recommendations, and results were reported according to PRISMA-ScR guidelines. A systematic search was performed in PubMed/MEDLINE, Scopus, EMBASE, and Web of Science between January 2020 and May 2025. Original observational studies and clinical trials in English or Spanish examining the association between PBD patterns and digestive cancers were included. Results: A total of 24 studies were identified, including 16 prospective cohort studies and 8 hospital-based case–control studies, conducted mainly in Europe (n = 10), North America (n = 8), and Asia (n = 6). Most studies used food frequency questionnaires and predefined PBD indices, particularly the plant-based diet index (PDI), healthful (hPDI), and unhealthful (uPDI) (n = 13), while others assessed pro-vegetarian (n = 2) or EAT-Lancet dietary patterns (n = 3). Most studies reported protective associations with all digestive cancer localizations examined, particularly in relation to healthful PBD patterns: colorectal (13/15), pancreatic (6/7), liver (4/4), esophageal (4/5), stomach (3/4) and oropharyngeal (2/2) cancers. On the contrary, unhealthful PBD patterns were linked to a higher risk. Conclusions: Overall, the findings of this review highlight that the quality of PBD patterns is crucial for digestive cancer risk. PBD patterns emphasizing whole and minimally processed plant foods were protective, while those characterized by refined or ultra-processed plant products were deleterious. A future standardization of PBD indices would help to improve comparability among studies. Full article

Background/Objectives: High-quality diets are increasingly recognized as a promising strategy for alleviating mental health problems. This study aimed to evaluate the association between adherence to the EAT-Lancet diet (ELD) and depression and anxiety using a systematic review and meta-analysis of observational studies. Methods: A comprehensive literature search of PubMed, Web of Science, and Embase was conducted. Two independent reviewers screened titles, abstracts, and full texts and extracted data, with any discrepancies resolved by consensus. Results: Ultimately, eight unique studies (10 comparisons) met the predefined inclusion criteria. Adjusted effect estimates (odds ratios (ORs) or hazard ratios (HRs)) and corresponding 95% confidence (95%CI) intervals were extracted and pooled using random-effects meta-analysis. Between-study heterogeneity was quantified with the I² statistic. Compared with the lowest ELD adherence, the highest adherence was associated with a lower risk of depression (OR = 0.78, 95% CI 0.73–0.85; I² = 85.0%); a similar inverse association was observed for anxiety (OR = 0.83, 95% CI 0.79–0.86; I² = 0%) and the co-occurrence of depression and anxiety (HR = 0.76, 95% CI 0.68–0.85; I² = 0%). Conclusions: Our findings indicate that, compared with low adherence, high adherence to the ELD is associated with beneficial effects on mental health and may inform dietary recommendations for the early prevention and intervention of depression, anxiety, and their co-occurrence. Full article

The prevalence of diet-related noncommunicable diseases (NCDs; e.g., obesity, type 2 diabetes, cardiovascular disease, and certain cancers) is increasing globally, while food systems are also driving climate change and biodiversity loss. Transitioning to predominantly plant-based (“plant-forward”) dietary patterns can improve health and lower environmental impacts. We present the Slovenian Nutrition Guidelines 2025 (SNG2025)—their methodology, development, and core recommendations. Developed as adult food-based dietary guidelines, the SNG2025 are evidence-informed, drawing on the scientific literature, national nutritional data, and expert consensus. We set quantitative daily intake targets by integrating evidence on primary NCD outcomes with environmental metrics (greenhouse gas emissions, land use, and water use), which led to upper limits for animal-based foods. The recommended plant-forward dietary pattern, aligned with the EAT–Lancet planetary health diet, emphasises vegetables, fruits, legumes, whole grains, nuts, seeds, and unsaturated oils; allows low-to-moderate amounts of seafood, poultry, dairy, and eggs; and keeps red and processed meat, free sugars, refined grains, saturated fat, salt, ultra-processed foods (UPFs), and alcohol to a minimum. For the first time, we operationalise health, environmental sustainability, and equity (cultural diversity and accessibility) through a three-tier, plant-forward food plate model (Mediterranean, vegetarian [lacto-ovo], and whole food, plant-based [vegan]). The SNG2025 aim to reduce the risk of NCDs, lower the dietary environmental footprint, and improve fair access to healthy food. They signal a shift from disease management to a prevention-oriented, systems approach that aligns health and ecological goals. With robust implementation, supportive policies, and multisector collaboration, the SNG2025 can strengthen population health, foster more resilient food systems, and advance equity and long-term sustainability. Full article

Background: The Slovenian Nutrition Guidelines 2025 (SNG2025) provide a quantified, plant-forward framework aligned with the EAT–Lancet diet, whereas previous Slovenian FBDGs were qualitative. Objectives: (i) To compare SNG2025 with the EAT–Lancet diet and previous Slovenian FBDGs and (ii) to assess the alignment of food intake among Slovenian adults with the SNG2025. Methods: The SNG2025 food group targets were mapped to the EAT–Lancet diet and previous Slovenian FBDGs and evaluated against a nationally representative intake (Si. Menu 2017/18; 18–64 years; sex-specific). Sodium intake was corroborated by 24-h urinary sodium levels (2022). Results: The SNG2025 introduces numeric targets across more than 16 food groups, with national adaptations (e.g., potatoes, oils and fats from foods, and dairy being optional via milk-calcium equivalents and beverage specifications). The alignment reveals very low consumption of legumes; limited consumption of vegetables, whole grains, and nuts/seeds (and fruit in men); and excess consumption of total and red/processed meat, ultra-processed foods (UPFs), free sugars/sugar-sweetened beverages, sodium, and alcohol. Biomarkers indicate a mean salt intake approximately two times the <5 g/day limit. Trans fatty acid (TFA) levels ≥ 0.5% persist in a substantial percentage of adults, predominantly from ruminant-derived TFAs. Sex-specific patterns are more adverse for men (e.g., meat, SSBs, alcohol, and sodium), whereas women have a higher intake of sweet UPFs. Conclusions: Slovenian diets are misaligned with the SNG2025. Priorities include increasing the intake of legumes, whole grains, vegetables, and nuts/seeds, while shifting protein sources away from red and processed meat. Additional priorities include reducing the intake of alcohol, sodium, free sugars, and UPFs through reformulation, procurement, and pricing/marketing measures, alongside routine biomarker and UPF surveillance. The SNG2025 enable monitoring and targeted implementation. Considering the limitations of the Si. Menu 2017/18 dataset, which includes food-group aggregation and limited information on food preparation, the results should be interpreted with caution with respect to the magnitude of deviations from SNG2025 targets, while the overall direction of misalignment remains robust. Full article

Background/Objectives: Adherence to the EAT-Lancet Planetary Health Diet (PHD) may promote human health and environmental sustainability, yet evidence regarding adherence and nutritional adequacy in Australia is limited. Globally, no research to date has used the recently updated 2025 PHD guidelines. We benchmarked the compatibility of Australian adults’ dietary patterns with the 2025 PHD and examined its associations with nutritional adequacy and sociodemographic factors. Methods: This was a cross-sectional analysis of dietary data from 5655 adults who participated in the National Nutrition and Physical Activity Survey. Usual intakes were estimated from two 24 h recalls using the Multiple Source Method. PHD adherence was measured using the Healthy Reference Diet Score (0–130 points). Nutrient adequacy was assessed using the full probability method for iron and the Australian/New Zealand Estimated Average Requirement Cut-Point Method for all other nutrients. Survey-weighted regression models examined associations with nutritional adequacy and sociodemographic factors. Results: The mean PHD adherence score was 50 (SE 0.3) points. Higher adherence was associated with lower odds of inadequate intakes of several micronutrients, but with higher odds of inadequacy for vitamin B12 (OR: 1.24; 95% CI: 1.06, 1.45) and calcium (OR: 1.09; 95% CI: 1.01, 1.17). PHD adherence was higher among females, older adults, those with higher educational attainment, those born in countries where English is not the main language, two-person households and non-smokers; adherence was non-linearly associated with alcohol and was lower among those with a Body Mass Index ≥ 30 kg/m². Conclusions: PHD adherence in Australia was low. Higher adherence was associated with improved adequacy for several micronutrients. Trade-offs for vitamin B12 and calcium warrant consideration. Equity-conscious strategies will be needed to support the adoption of nutritionally adequate, environmentally sustainable diets. Full article

Background: Sarcopenic obesity (SO) and diabetic sarcopenia (DS) represent overlapping metabolic–musculoskeletal disorders characterized by the coexistence of excessive adiposity, insulin resistance, and progressive muscle wasting. The Planetary Health Diet (PHD), proposed by the EAT–Lancet Commission, emphasizes plant-forward, nutrient-dense, and environmentally sustainable food patterns that may concurrently address metabolic and muscle health. This review aimed to systematically evaluate dietary and bioactive nutritional interventions aligned with the PHD and their effects on muscle mass, strength, metabolism, and underlying mechanisms in SO and DS. Methods: Following PRISMA guidelines, studies published between 2015 and 2025 were identified across PubMed, Scopus, and Google Scholar. Eligible studies included dietary, nutritional, or supplement-based interventions reporting muscle-related outcomes in obesity- or diabetes-associated conditions. Results: Ninety-one eligible studies were categorized into plant-derived, animal/marine-based, microorganism/fermented, synthetic/pharmaceutical, and environmental interventions. Across diverse models, bioactive compounds such as D-pinitol, umbelliferone, resveratrol, GABA, ginseng, whey peptides, probiotics, and omega-3 fatty acids consistently improved muscle mass, strength, and mitochondrial function via AMPK–SIRT1–PGC-1α and Akt–mTOR signaling. These mechanisms promoted mitochondrial biogenesis, suppressed proteolysis (MuRF1, Atrogin-1), and enhanced insulin sensitivity, antioxidant capacity, and gut–muscle communication. Conclusions: PHD-aligned foods combining plant proteins, polyphenols, and fermented products strengthen nutrient sensing, mitochondrial efficiency, and cellular resilience, representing a sustainable nutritional framework for preventing and managing SO and DS. Full article

Taking into account both the health and environmental aspects of food, the EAT-Lancet Commission proposed a healthy reference diet (Planetary Health Diet—PHD). The aim of this narrative review is to summarize the results obtained in epidemiological studies on the association between the PHD and risk factors, non-communicable diseases, and cause-specific mortality. The literature search was conducted in February 2025 and was based on the PubMed electronic database. The results of this review are divided into four parts, which include the results of cohort studies, cross-sectional studies, case–control studies, and meta-analyses. This review, showing what types of studies have been conducted so far, allows for a summary of the current knowledge of the relationship between the PHD and risk factors, non-communicable diseases, and cause-specific mortality. Cohort studies provided most of the results, which confirmed that higher adherence to the PHD has a beneficial effect on human health, especially taking into account the lower risk of diabetes, cardiovascular disease (CVD) and CVD mortality, cancer and cancer mortality, as well as all-cause mortality. However, it is concluded that the association between the PHD and stroke, different types of stroke, hypertension, dyslipidemia, and some specific types of cancer must be confirmed. Specifically, randomized controlled trials should be conducted, as, to our knowledge, there is a lack of these types of studies to date. Such studies should be conducted in different regions using the Planetary Health Diet adapted to the local, cultural, geographical, and demographical aspects of a particular region. Full article

Background/Objectives: The global syndemic of obesity, undernutrition, and climate change highlight the complex health and environmental challenges faced by young adults. These challenges may intensify during the transition to university. As a matter of fact, limited budgets, time constraints, and insufficient culinary skills often lead to unbalanced diets and increased risk of obesity. University cafeterias, serving large numbers of students, represent an ideal setting to promote healthier and more sustainable eating behaviors. The FOOD-HACK Project aimed to design and implement a cafeteria-based intervention using nudging strategies to promote healthier and more sustainable lunch choices among university students. Methods: This pilot study employed a pre–post design with two independent phases in the Polo Cravino cafeteria at the University of Pavia. Food consumption was assessed over 12 non-consecutive days across four weeks. During the intervention, three nudging strategies were implemented: (1) choice architecture, (2) salient labeling, highlighting healthy and sustainable options, and (3) educational prompts. Results: Across both phases, 2400 tray photographs were collected. Post-intervention, the proportion of trays aligned with the Harvard Healthy Eating Plate and EAT-Lancet Planetary Diet models increased, reflecting higher consumption of vegetables and fruit. Legume-based first courses increased; however, legumes did not substantially replace animal proteins as the main protein source, and meat remained predominant in second courses. Reductions in trays containing multiple carbohydrate sources were also observed. Conclusions: The nudging intervention improved overall meal quality, demonstrating that subtle environmental modifications can guide students toward healthier dietary choices, particularly by increasing fruit and vegetable intake. However, the persistent preference for animal proteins highlights the challenge of shifting protein consumption toward more sustainable sources. These findings suggest that nudging can be an effective tool to promote healthier and more balanced eating behaviors in university settings, though complementary strategies may be needed to foster substantial changes in protein choices. Full article

Background/Objectives: To investigate the associations between educational attainment and 20-year cardiovascular disease (CVD) incidence, mortality, lifetime risk, and burden, and to explore the mediating role of healthy and sustainable dietary habits through a sex-specific lens. Methods: A total of 3042 CVD-free adults from the ATTICA Study were included at the 2001/2002 baseline. Educational level was treated as both continuous and ordinal variable. Adherence to the EAT–Lancet diet pattern (EAT-LDP) was assessed at baseline. Participants were followed for 20 years, with complete data on CVD outcomes available for 1988 individuals. Generalized structural equation and nested Cox regression models were used to estimate the direct and indirect effects between education attainment and 20-year CVD incidence. Moderation analysis was also conducted by incorporating interaction terms in Cox models. Results: An inverse educational gradient in CVD risk and burden was observed, particularly among females for lifetime risk estimates. Each additional year of education was associated with higher EAT-LDP adherence (β = 0.45, 95% CI: 0.40–0.50) and increased odds of physical activity (OR: 1.01, 95% CI: 1.00–1.01). These behaviors mediated part of the relationship between education and long-term CVD incidence. Among females, the cardioprotective role of EAT-LDP adherence was more evident at lower educational levels, suggesting potential effect modification. Conclusions: Educational disparities in long-term CVD outcomes are partly mediated by sustainable dietary habits. These findings highlight the need for gender-responsive and equity-focused strategies in cardiovascular prevention. Full article

The EAT-Lancet diet is an outstanding model of a healthy, environmentally sustainable diet. However, its effects on the gut microbiota remain poorly explored. This study assessed the asso-ciation between adherence to the EAT-Lancet diet in habitual intake and the relative abundance of selected gut bacteria in a Mexican subpopulation. Fifty-four young adults (18–35 years) completed a validated Food Frequency Questionnaire (FFQ) and were nutritionally assessed. Participants were grouped into low, moderate, and high adherence levels to the EAT-Lancet diet. Blood samples were analysed for glucose and lipid profiles, and gDNA from faecal samples was analysed using Real-time qPCR to quantify gut bacteria. While no significant differences in bacterial abundance were observed across adherence levels, correlations emerged with increased adherence. Notably, Bifidobacterium negatively correlated with beef and lamb intake (rho −0.5, p < 0.05), and Akkermansia muciniphila negatively correlated with fish intake (rho −0.8, p < 0.05). Bilophila wadsworthia positively correlated with triglycerides, while Prevotella copri and Faecalibacterium prausnitzii negatively correlated with body fat and blood pressure, respectively. In addition, a non-significant trend toward a higher abundance of Firmicutes, Akkermansia muciniphila, and Prevotella copri was observed in the high-adherence group, whereas Lactobacillus tended to be more abundant in participants with low and moderate adherence. These findings suggest that adherence to the EAT-Lancet diet modulates gut microbiota composition. However, further controlled interventional studies are needed to confirm these effects and their implications for human health. Full article

Background: The escalating prevalence of food allergies, alongside the global call for environmentally sustainable dietary transitions, has drawn attention to plant-based dietary models—particularly those inspired by the EAT-Lancet Commission. These frameworks not only reduce reliance on animal-sourced foods, benefiting planetary health, but may also play a role in modulating immune tolerance and allergic responses. Methods: This scoping review followed PRISMA guidelines and included 53 peer-reviewed studies published between 2000 and 2024, retrieved from PubMed, Scopus, and Google Scholar. Eligible articles were classified into two thematic domains: prevention of food allergy onset (n = 31) and modulation of allergic symptoms in sensitized individuals (n = 22). Included studies comprised randomized controlled trials (n = 6), observational studies (n = 17), systematic reviews and meta-analyses (n = 11), and narrative/scoping reviews (n = 19). Results: Sustainable plant-based diets were consistently associated with a lower incidence of allergic sensitization and reduced symptom severity. These effects were partly due to the exclusion of common allergens (e.g., dairy, eggs, and shellfish) but more importantly due to immunomodulatory mechanisms. Fermentable fibers can enhance short-chain fatty acid (SCFA)-producing bacteria (e.g., Faecalibacterium prausnitzii), elevating butyrate and acetate levels, which interact with G-protein-coupled receptors 43 and 109A (GPR43 and GPR109A) to induce regulatory T cells (Tregs) and reinforce epithelial integrity via tight junction proteins such as occludin and claudin-1. Polyphenols (e.g., quercetin and luteolin) can inhibit Th2-driven inflammation by stabilizing mast cells and downregulating IL-4 and IL-1. Conclusions: Following sustainable dietary guidelines such as those proposed by the EAT-Lancet Commission may confer dual benefits: promoting environmental health and reducing the burden of allergic diseases. By emphasizing plant-based patterns rich in fiber and polyphenols, these diets support microbiota-mediated immune education, mucosal barrier function, and immunological tolerance. When properly supervised, they represent a promising tool for allergy prevention and symptom management. Larger randomized trials and long-term population studies are needed to confirm and operationalize these findings in clinical and public health contexts. Full article

Background/Objectives: The EAT-Lancet Commission proposed a healthy and sustainable ‘planetary health diet’ (PHD) based on the nutritional needs of adults, but recommended for all population groups over the age of two years. This study investigated the extent to which UK adolescent diets meet these recommendations, and the association between meeting recommendations and nutritional intake. Methods: Dietary intake data collected from students aged 11–15 years between 2019 and 2022 as part of the Food provision, cUlture and Environment in secondary schooLs (FUEL) study was used. Specifically, 24 h intakes of food groups and key nutrients were summarised for each participant, and micronutrient intake was expressed as a percentage of the reference nutrient intake (RNI). The proportion of participants meeting each PHD recommendation was calculated. A PHD index score was developed to measure the overall adherence to recommendations. Multilevel linear regression models were fitted to explore the association between the PHD score and intake of each nutrient. Results: No participants fully met the recommendations. The mean PHD score was 14.2 (3.3) out of 39. Adherence was low for the emphasised foods, and lowest for nuts (1.3%) and unsaturated oils (0.2%). Higher PHD index scores were associated with lower intakes of all micronutrients, with the largest association for vitamin B12 [regression coefficient: −12.9% (95% CI: −16.3, −9.4) of RNI] and the smallest for vitamin D [regression coefficient: −0.4 (95% CI: −0.7, −0.2) of RNI]. Conclusions: Substantial dietary changes are needed for this population group to meet the PHD guidelines. Further research should focus on why these recommendations may lead to the inadequate intake of some nutrients in this age group. We propose that the PHD guidance needs to be reviewed and potentially adapted for this specific population, with consideration of the typical dietary behaviours of this age group. Full article