Sustainable diets in the UK—developing a systematic framework to assess the environmental Impact, cost and nutritional quality of household food purchases

Sustainable diets should not only respect the environment but also be healthy and affordable. However, there has been little work to assess whether real diets can encompass all three aspects. The aim of this study was to develop a framework to quantify actual diet records for health, affordability and environmental sustainability and apply this to UK food purchase survey data. We applied a Life Cycle Assessment (LCA) approach to detailed food composition data where purchased food items were disaggregated into their components with traceable environmental impact data. This novel approach is an improvement to earlier studies in which sustainability assessments were based on a limited number of “food groups”, with a potentially high variation of actual food items within each group. Living Costs and Food Survey data for 2012, 2013 and 2014 were mapped into published figures for greenhouse gas emissions (GHGE, taking into account processing, transport and cooking) and land use, a diet quality index (DQI) based on dietary guidelines and food cost, all standardised per household member. Households were classified as having a ‘more sustainable’ diet based on GHGE, cost and land use being less than the median and DQI being higher than the median. Only 16.6% of households could be described as more sustainable; this rose to 22% for those in the lowest income quintile. Increasing the DQI criteria to >80% resulted in only 100 households being selected, representing 0.8% of the sample. The framework enabled identification of more sustainable households, providing evidence of how we can move toward better diets in terms of the environment, health, and costs

Time to address the double inequality of differences in dietary intake between Scotland and England

Geographical disparities in health outcomes have been evident across the UK for decades. There is limited recent analysis on the dietary differences between Scotland and England that might go some way to explain these health differences. This study aimed to assess whether, and to what degree, aspects of diet and nutrition differ between Scottish and English populations, specifically between those with similar household incomes. Twelve years of UK food purchase data (2001-2012) were pooled and used to estimate household level consumption data for Scotland and England. Population mean food consumption and nutrient intakes were estimated, adjusting for known confounders (year, age of household reference person, age they left full-time education and income). Comparison was also made within equivalised income quintiles. Analysis showed that the foods and nutrients that should be increased in the diet (highlighted in the Scottish Dietary Goals) were lower in Scotland than England (e.g. fruit and vegetables 267g/day (99%CI 259-274g/day) vs. 298g/day (99%CI 296-301g/day), P<0.001). Likewise, foods and drinks linked with poor health outcomes were higher in Scotland. These regional inequalities in diet were even more pronounced in the lower income groups (e.g. red and processed meat consumption in the lowest income quintile was 65g/day (99% CI 61-69g/day) in Scotland vs. 58g/day (99% CI 57-60g/day) in England, P<0.001, but similar in the highest income quintile (58g/day (99%CI 54-61 g/day) vs. 59g/day (99% CI 58-60 g/day) respectively). A poorer diet in Scotland compared to England, particularly among disadvantaged groups, may contribute to differences in excess mortality between countries

Identifying dietary differences between Scotland and England:a rapid review of the literature

Rates of premature mortality have been higher in Scotland than in England since the 1970s. Given the known association of diet with chronic disease, the study objective was to identify and synthesise evidence on current and historical differences in food and nutrient intakes in Scotland and England.A rapid review of the peer-reviewed and grey literature was carried out. After an initial scoping search, Medline, CINAHL, Embase and Web of Science were searched. Relevant grey literature was also included. Inclusion criteria were: any date; measures of dietary intake; representative populations; cross-sectional or observational cohort studies; and English-language publications. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. A narrative synthesis of extracted information was conducted.Fifty publications and reports were included in the review. Results indicated that children and adults in Scotland had lower intakes of vegetables and vitamins compared with those living in England. Higher intakes of salt in Scotland were also identified. Data were limited by small Scottish samples, difficulty in finding England-level data, lack of statistical testing and adjustment for key confounders.Further investigation of adequately powered and analysed surveys is required to examine more fully dietary differences between Scotland and England. This would provide greater insight into potential causes of excess mortality in Scotland compared with England and suitable policy recommendations to address these inequalities

An Analysis of the Consumption of Sausages in Scotland using Supermarket Data

This paper addresses consumers’ choices by looking into: current food choices made by different socio-economic groups; price barriers for diet improvement; and ways in which marketing may affect product choice. The study seeks: first, to analyze the differences in consumption of sausages of different nutritional composition among different socio-demographic and lifestage groups; and second, to measure whether it is possible to improve diet quality without affecting household expenditure. Sausages represent a relatively high proportion of red and processed meat purchases in Scotland, contributing significantly to the fat and sodium in the Scottish diet. The data used consisted of two-years of weekly information from a top-4, UK supermarket. The results suggest that it is possible to purchase similar quantities of a lower saturated fat or lower sodium sausage for the same price as a higher saturated fat or sodium sausage. However, it would cost more for some the groups to replace both a lower saturated fat and a lower sodium sausage in the household’s food basket.Scotland, saturated fats, sodium, consumer choices, sausages consumption, Food Consumption/Nutrition/Food Safety, D1,

An Analysis of the Consumption of Sausages in Scotland using Supermarket Data

This paper addresses consumers’ choices by looking into: current food choices made by different socio-economic groups; price barriers for diet improvement; and ways in which marketing may affect product choice. The study seeks: first, to analyze the differences in consumption of sausages of different nutritional composition among different socio-demographic and lifestage groups; and second, to measure whether it is possible to improve diet quality without affecting household expenditure. Sausages represent a relatively high proportion of red and processed meat purchases in Scotland, contributing significantly to the fat and sodium in the Scottish diet. The data used consisted of two-years of weekly information from a top-4, UK supermarket. The results suggest that it is possible to purchase similar quantities of a lower saturated fat or lower sodium sausage for the same price as a higher saturated fat or sodium sausage. However, it would cost more for some the groups to replace both a lower saturated fat and a lower sodium sausage in the household’s food basket.Scotland, saturated fats, sodium, consumer choices, sausages consumption, Food Consumption/Nutrition/Food Safety,

Sociodemographic characteristics and frequency of consuming home-cooked meals and meals from out-of-home sources: cross-sectional analysis of a population-based cohort study.

OBJECTIVE: To identify sociodemographic characteristics associated with frequency of consuming home-cooked meals and meals from out-of-home sources. DESIGN: Cross-sectional analysis of a population-based cohort study. Frequency of consuming home-cooked meals, ready meals, takeaways and meals out were derived from a participant questionnaire. Sociodemographic characteristics regarding sex, age, ethnicity, working overtime and socio-economic status (SES; measured by household income, educational attainment, occupational status and employment status) were self-reported. Sociodemographic differences in higher v. lower meal consumption frequency were explored using logistic regression, adjusted for other key sociodemographic variables. SETTING: Cambridgeshire, UK. SUBJECTS: Fenland Study participants (n 11 326), aged 29-64 years at baseline. RESULTS: Eating home-cooked meals more frequently was associated with being female, older, of higher SES (measured by greater educational attainment and household income) and not working overtime. Being male was associated with a higher frequency of consumption for all out-of-home meal types. Consuming takeaways more frequently was associated with lower SES (measured by lower educational attainment and household income), whereas eating out more frequently was associated with higher SES (measured by greater educational attainment and household income) and working overtime. CONCLUSIONS: Sociodemographic characteristics associated with frequency of eating meals from different out-of-home sources varied according to meal source. Findings may be used to target public health policies and interventions for promoting healthier diets and dietary-related health towards people consuming home-cooked meals less frequently, such as men, those with lower educational attainment and household income, and overtime workers

What can secondary data tell us about household food insecurity in a high-income country context?

In the absence of routinely collected household food insecurity data, this study investigated what could be determined about the nature and prevalence of household food insecurity in Scotland from secondary data. Secondary analysis of the Living Costs and Food Survey (2007–2012) was conducted to calculate weekly food expenditure and its ratio to equivalised income for households below average income (HBAI) and above average income (non-HBAI). Diet Quality Index (DQI) scores were calculated for this survey and the Scottish Health Survey (SHeS, 2008 and 2012). Secondary data provided a partial picture of food insecurity prevalence in Scotland, and a limited picture of differences in diet quality. In 2012, HBAI spent significantly less in absolute terms per week on food and non-alcoholic drinks (£53.85) compared to non-HBAI (£86.73), but proportionately more of their income (29% and 15% respectively). Poorer households were less likely to achieve recommended fruit and vegetable intakes than were more affluent households. The mean DQI score (SHeS data) of HBAI fell between 2008 and 2012, and was significantly lower than the mean score for non-HBAI in 2012. Secondary data are insufficient to generate the robust and comprehensive picture needed to monitor the incidence and prevalence of food insecurity in Scotland.</p

Estimation of food and nutrient intakes from food purchase data in Scotland, 2001-2015: report to Food Standards Scotland.

The aim of this study was to update annual trends in food consumption and nutrient intakes using the same robust secondary analysis methodology previously developed to convert purchase to consumption. This work is part of a rolling programme to update annual trends in food consumption and nutrient intakes. The purpose of this work was to obtain robust estimates of food consumption and nutrient intakes for 2013 to 2015 and update the report published in May 2015 for 2001 to 2012. Data since 2001 were combined for analysis in 3 year blocks. Key findings on the change between 2001-2003 and 2013- 2015. There was no significant change in intakes of fruit and vegetables, oil rich fish, totals fat and dietary fibre. Intakes of red and processed meat decreased. There was a reduction in free sugars. There was a small reduction in saturated fat. There was a small increase in energy density The results show the very slow rate of progress towards a diet that will improve and support the health of the Scottish population. Intakes of fruit and vegetables, oil rich fish, totals fat and dietary fibre remain too low and free sugars, total fats and saturated fats remain too high in relation to the Scottish Dietary Goals.The lack of progress toward most of the goals was apparent even amongst households in the least deprived areas

Frequency and socio-demographic correlates of eating meals out and take-away meals at home: cross-sectional analysis of the UK national diet and nutrition survey, waves 1-4 (2008-12)

Background: Food prepared out-of-home tends to be less healthful than food prepared at home, with a positive association between frequency of consumption and both fat intake and body fatness. There is little current data on who eats out-of-home food. We explored frequency and socio-demographic correlates of eating meals out and take-away meals at home, using data from a large, UK, population representative study. Methods: Data were from waves 1–4 of the UK National Diet and Nutrition Survey (2008–12). Socio-demographic variables of interest were gender, age group, and socio-economic position. Self-reported frequency of consuming meals out and take-away meals at home was categorised as: less than once per week and once per week or more. Analyses were performed separately for adults (aged 18 years or older) and children. Results: Data from 2001 adults and 1963 children were included. More than one quarter (27.1%) of adults and one fifth (19.0%) of children ate meals out once per week or more. One fifth of adults (21.1%) and children (21.0%) ate take-away meals at home once per week or more. There were no gender differences in consumption of meals out, but more boys than girls ate take-away meals at home at least weekly. The proportion of participants eating both meals out and take-away meals at home at least weekly peaked in young adults aged 19–29 years. Adults living in more affluent households were more likely to eat meals out at least once per week, but children living in less affluent households were more likely to eat take-away meals at home at least once per week. There was no relationship between socio-economic position and consumption of take-away meals at home in adults. Conclusions: One-fifth to one-quarter of individuals eat meals prepared out-of-home weekly. Interventions seeking to improve dietary intake by reducing consumption of out-of-home food may be more effective if tailored to and targeted at adults aged less than 30 years. It may also be important to develop interventions to help children and adolescents avoid becoming frequent consumers of out-of-home food

Maternal feeding behaviour and young children's dietary quality: A cross-sectional study of socially disadvantaged mothers of two-year old children using the Theory of Planned Behaviour

Background: Having breakfast, eating food 'cooked from scratch' and eating together as a family have health and psychosocial benefits for young children. This study investigates how these parentally determined behaviours relate to children's dietary quality and uses a psychological model, the Theory of Planned Behaviour (TPB), to investigate socio-cognitive predictors of these behaviours in socially disadvantaged mothers of young children in Scotland. Method: Three hundred mothers of children aged 2 years (from 372 invited to participate, 81% response rate), recruited via General Practitioners, took part in home-based semi-structured interviews in a cross-sectional survey of maternal psychological factors related to their children's dietary quality. Regression analyses examined statistical predictors of maternal intentions and feeding behaviours. Results: Mothers of children with poorer quality diets were less likely than others to provide breakfast every day, cook from 'scratch' and provide 'proper sit-down meals'. TPB socio-cognitive factors (intentions, perceived behavioural control) significantly predicted these three behaviours, and attitudes, norms, and perceived behavioural control significantly predicted mothers' intentions, with medium to large effect sizes. Conclusions: Interventions to improve young children's dietary health could benefit from a focus on modifying maternal motivations and attitudes in attempts to improve feeding behaviours