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The aim of this study was to explore and identify why young adults aged between 18 and 30 years in the UK and France do or do not consume dairy products. Several studies have associated dairy products with a healthy diet, and the production of soft dairy, i.e. milk, yoghurt, and soft cheese, as more environmentally friendly than some other animal-based products. Yet recent reports highlight that dairy intake is lower than recommended for health, especially among young adults. Using a qualitative methodology, forty-five participants aged 18–30 years (UK: n = 22; France: n = 23) were asked about their reasons for (non)consumption of a wide range of dairy products. Audio-recorded focus groups and individual interviews were conducted in English in the UK and in French in France, transcribed and coded. A thematic analysis found four themes and sixteen sub-themes (theme product-related: sub-themes sensory, non-sensory, composition; theme individual-related: sub-themes mode of consumption, preferences, personal reasons, knowledge, attitudes and concerns, needs or cravings; theme cultural aspects: sub-themes product categorization, social norms, use; theme market offering: sub-themes alternative, packaging, value for money, availability) to influence participants’ dairy (non)consumption in both countries. A seventeenth sub-theme (theme cultural aspects: sub-theme structure of the meal) was found to influence dairy consumption only in France. Further studies are needed to investigate these themes within larger samples, but these findings contribute to understanding dairy (non)consumption in young adults in the UK and France and may aid the development of strategies to improve young adults’ diets.

Background Several health organizations recommend lowering the consumption of sweet-tasting foods. The rationale behind this recommendation is that a lower exposure to sweet foods may reduce preferences for sweet tasting foods, thus lowering sugar and energy intake, and in turn aiding in obesity prevention. However, empirical data supporting this narrative are lacking. In fact, relatively little is known about the contribution of long-term sweet taste exposure on one’s sweetness preferences. Methods The primary objective of this randomized controlled trial is to assess the effect of low, regular and high dietary sweetness exposure on preference for sweet foods and beverages, and to compare these effects between intervention groups. One hundred and eighty adults aged 18–65 years with a BMI of 18.5–30.0 kg/m 2 will be recruited and randomly allocated to either: low dietary sweetness exposure (LSE) (10–15% daily energy from sweet tasting foods), regular dietary sweetness exposure (RSE) (25–30% daily energy from sweet tasting foods), or high dietary sweetness exposure (HSE) (40–45% daily energy from sweet tasting foods), for 6 months, followed by a 4-month follow up. Intervention foods are provided ad libitum, covering approximately 50% of the daily number of food items, to include sugar-sweetened, low-calorie-sweetener-sweetened and non-sweet foods. The primary outcome measure is the difference in change in sweetness preference from baseline to 6 months between intervention groups. Secondary outcomes include: change in sweet taste preferences at different time-points; taste intensity perception; behavioral outcomes: food choice and intake, sweet-liker type, food cravings, dietary taste preferences and dietary taste patterns; anthropometric outcomes: body composition, waist-hip circumference, body weight; and biochemical outcomes: glucose variability and biomarkers related to CVD and diabetes. Discussion This study will generate important data on the effect of dietary sweetness exposure on sweetness preferences in terms of effect size and change, duration of change and its impact on food intake, body weight status and associated health outcomes. Trial Registration The study protocol has been registered on ClinicalTrials.gov (ID no. NCT04497974, Registered 4 August 2020, https://clinicaltrials.gov/ct2/show/NCT04497974 ) and approved by Wageningen’s Medical Ethical Committee (ABR no. NL72134).

Background/Objectives: Sweet taste preferences are currently targeted to aid with reducing free sugar intakes, but associations between sweet taste liking, sweet food intakes, and sugar intakes are not well established. Methods: UK consumers (n = 179) who were consuming >5% of total energy intakes from free sugars provided several laboratory measures of sweet taste liking, laboratory test meal measures of sweet food choice and sugar intakes, and 3-day food diary measures of free-living free sugar and total sugar intakes. Liking measures included liking for a 1 M sucrose solution, and pleasantness, desire to eat, and sweet taste intensity ratings for seven foods of a range of sweet taste intensities in a taste test. Results: Wide individual differences in sweet taste liking, in liking for a high sweet taste intensity, and in the relationships between sweet taste intensity and sweet taste liking were found. The majority of participants confirmed high liking and increasing liking for increasingly sweet tastes, but differing patterns of responses were also found. Higher liking for sweet foods was associated with increased sweet food selection and consumption at the test meal, and to some degree with free sugar and total sugar consumption in this restricted scenario. However, we found no associations between sweet taste liking, regardless of measure, and either free-living free sugar or total sugar intakes. Conclusions: These findings cast doubt on assumptions that sweet taste preferences are high for all and that these high sweet taste preferences drive high free sugar intakes.

Previous meta-analyses of intervention studies have come to different conclusions about effects of consumption of low-calorie sweeteners (LCS) on body weight. The present review included 60 articles reporting 88 parallel-groups and cross-over studies ≥1 week in duration that reported either body weight (BW), BMI and/or energy intake (EI) outcomes. Studies were analysed according to whether they compared (1) LCS with sugar, (2) LCS with water or nothing, or (3) LCS capsules with placebo capsules. Results showed an effect in favour of LCS vs sugar for BW (29 parallel-groups studies, 2267 participants: BW change, −1.06 kg, 95% CI −1.50 to −0.62, I2 = 51%), BMI and EI. Effect on BW change increased with ‘dose’ of sugar replaced by LCS, whereas there were no differences in study outcome as a function of duration of the intervention or participant blinding. Overall, results showed no difference in effects of LCS vs water/nothing for BW (11 parallel-groups studies, 1068 participants: BW change, 0.10 kg, 95% CI −0.87 to 1.07, I2 = 82%), BMI and EI; and inconsistent effects for LCS consumed in capsules (BW change: −0.28 kg, 95% CI −0.80 to 0.25, I2 = 0%; BMI change: 0.20 kg/m2, 95% CI 0.04 to 0.36, I2 = 0%). Occurrence of adverse events was not affected by the consumption of LCS. The studies available did not permit robust analysis of effects by LCS type. In summary, outcomes were not clearly affected when the treatments differed in sweetness, nor when LCS were consumed in capsules without tasting; however, when treatments differed in energy value (LCS vs sugar), there were consistent effects in favour of LCS. The evidence from human intervention studies supports the use of LCS in weight management, constrained primarily by the amount of added sugar that LCS can displace in the diet.

Background Mediterranean diet (MD) interventions are demonstrated to significantly reduce cardiovascular disease (CVD) risk but are typically resource intensive and delivered by health professionals. There is considerable interest to develop interventions that target sustained dietary behaviour change and that are feasible to scale-up for wider public health benefit. The aim of this paper is to describe the process used to develop a peer support intervention to encourage dietary behaviour change towards a MD in non-Mediterranean adults at high CVD risk. Methods The Medical Research Council (MRC) and Behaviour Change Wheel (BCW) frameworks and the COM-B (Capability, Opportunity, Motivation, Behaviour) theoretical model were used to guide the intervention development process. We used a combination of evidence synthesis and qualitative research with the target population, health professionals, and community health personnel to develop the intervention over three main stages: (1) we identified the evidence base and selected dietary behaviours that needed to change, (2) we developed a theoretical basis for how the intervention might encourage behaviour change towards a MD and selected intervention functions that could drive the desired MD behaviour change, and (3) we defined the intervention content and modelled outcomes. Results A theory-based, culturally tailored, peer support intervention was developed to specifically target behaviour change towards a MD in the target population. The intervention was a group-based program delivered by trained peer volunteers over 12-months, and incorporated strategies to enhance social support, self-efficacy, problem-solving, knowledge, and attitudes to address identified barriers to adopting a MD from the COM-B analysis. Conclusions The MRC and BCW frameworks provided a systematic and complementary process for development of a theory-based peer support intervention to encourage dietary behaviour change towards a MD in non-Mediterranean adults at high CVD risk. The next step is to evaluate feasibility, acceptability, and diet behaviour change outcomes in response to the peer support intervention (change towards a MD and nutrient biomarkers) using a randomized controlled trial design.

Background Orthorexia Nervosa (ON) is a disordered eating style involving an unhealthy obsession with ‘healthy’ or ‘clean’ eating. Its aetiology is still poorly understood and is not yet recognised in diagnostic manuals. While ON has been associated with Obsessive Compulsive (OC) symptoms and perfectionism, no study to date has looked at the relationship between OC symptoms and ON tendencies via perfectionism, or the influence of two facets of perfectionism in this relationship, namely evaluative concern and achievement striving. Examining the potential role of perfectionism helps to understand the aetiology of ON as well as inform potential treatments tailored specifically for ON and comorbid OC symptoms. Methods In this cross sectional study, we tested 507 participants ( n  = 70 males, n  = 69 at risk of ON) on questionnaires measuring OC symptoms, perfectionism and ON symptoms. We ran two mediation analyses to look at the overall relationship between perfectionism and OC and ON symptoms (Model 1) as well as the specific contribution of evaluative concern and achievement striving in the relationship between OC and ON symptoms (Model 2). Results We found that perfectionism partially mediated the relationship between OC and ON symptoms. Specifically, we found that while achievement striving and evaluative concern were associated with OC symptoms, only achievement striving was significantly associated with ON symptoms, mediating the relationship between OC and ON symptoms. Conclusions This study highlighted the role of one key facet of perfectionism (achievement striving) in the aetiology of ON. The role of achievement striving was indicated as a transdiagnostic construct explaining the link between ON and OC symptoms. These findings are discussed in terms of their implications for treatment models, specifically in terms of the potential role of targeting perfectionism in ON treatment. Plain English summary Orthorexia Nervosa (ON) is a disordered eating style involving an obsession with extreme ‘healthy’ eating, causing the person distress and impairment. People with ON are more likely to have symptoms of Obsessive Compulsive Disorder (OCD), such as obsessive thoughts that are reduced by repetitive behaviours. There is also evidence that perfectionism (e.g. having very high personal standards) plays an important role in both ON and OCD. Our study of 507 participants looked at whether two aspects of perfectionism: (1) concern about being evaluated negatively by others; ‘evaluative concern’, and: 2) striving for very high standards; ‘achievement striving’ were linked to higher levels of orthorexic and obsessive-compulsive symptoms. Our research also looked at whether these aspects of perfectionism explained the link between orthorexic and obsessive-compulsive symptoms. We found that both aspects of perfectionism were linked to obsessive-compulsive symptoms. However, achievement striving specifically helped to explain the link between orthorexic and obsessive-compulsive symptoms. These findings suggest that treatment focusing on achievement striving might be particularly useful for people with ON, and for those who have both orthorexic and obsessive-compulsive symptoms.

Adding flavours can encourage food intake in older adults for health benefits. The use and attitudes of 22 community-dwelling UK older adults (15 females, aged 65–83 years) towards foods and products that add flavour, e.g., sauces and seasonings, were investigated. Participants used foods/products to add flavour when cooking and eating from 0 to 17 times/day. Taste and flavour were important, and foods/products could add flavour, make foods more pleasant and did not cause discomfort. There were concerns, however, over the healthiness of some foods/products, while consuming a healthy diet and one’s health were important. Reasons for adding flavours largely centred around ‘meal enhancement’, reasons for not adding flavours focused on ‘the product itself’ and ‘characteristics of the meal’, but there was ‘variation’ and many ‘individual differences’. Our findings highlight the benefits of adding flavours for food intakes, particularly the use of naturally flavoursome foods, such as herbs, spices, onion and garlic.

The topics of biodiversity loss and dietary impact have received extensive individual scrutiny within the scientific community. However, there is a notable gap in understanding the level of awareness among stakeholders regarding the impact of dietary choices on biodiversity. Using a systematic review approach, this paper will identify how different stakeholders perceive and engage with the interconnected dynamics of biodiversity conservation and dietary choice. Following systematic processes, 26 articles were identified as suitable for inclusion in a qualitative synthesis. Results delineated four distinct stakeholder categories: consumers, Indigenous populations, producers and policymakers, each with a unique understanding of the relationship between biodiversity and diet. This variation is more pronounced in regions where food sourcing is more closely linked to local environmental conditions and reflects cultural identities. In developed countries, consumer behaviour tends to prioritise individual autonomy in dietary choices, posing significant implications for biodiversity conservation. Indigenous communities view themselves as essential elements of the environment, upholding collective culture, emphasising community, heritage and shared values in conservation efforts. Producers play a critical role in preserving terrestrial biodiversity through informed land management decisions, and policymakers lead by enacting policies aligned with conservation goals and discontinuing harmful subsidies. This systematic review reveals a strong consensus among stakeholders on the critical link between biodiversity and dietary practices, highlighting the importance of traditional food systems, consumer education and policy support in promoting sustainable diets that protect biodiversity. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog.

The Mediterranean diet (MedDiet) has been linked with physical and mental health benefits. Previous research, however, suggests that adoption and adherence to a Mediterranean diet might be difficult for people who live outside of the Mediterranean region. The aim of this systematic review was to investigate the factors that influence adoption and adherence to a Mediterranean style diet in adults aged 18 years old and over, as identified in published observational and qualitative studies. Following registration of our protocol on PROSPERO (ID: CRD42018116515), observational and qualitative studies of adults’ perceptions and experiences relevant to following a Mediterranean style diet were identified using systematic searches of databases: MEDLINE, the Cochane Library, CINAHL, Web of Science and Scopus, over all years of records until February 2022. A narrative synthesis was then undertaken. Of 4559 retrieved articles, 18 studies fulfilled our inclusion criteria and were included. Factors influencing adoption and adherence to a MedDiet were identified and categorized as: financial, cognitive, socio-cultural, motivational, lifestyle, accessibility & availability, sensory & hedonic and demographic. Similar barriers and facilitators are often reported in relation to healthy eating or the consumption of specific healthy foods, with a few exceptions. These exceptions detailed concerns with specific components of the MedDiet; considerations due to culture and traditions, and concerns over a cooler climate. Suggestions for overcoming these barriers and facilitators specific to adoption and adherence to the Mediterranean diet are offered. These data will inform the development of future studies of robust methodology in eating behaviour change which offer pragmatic approaches for people to consume and maintain healthy diets.

Older adults may gain health benefits from the consumption of animal-based protein-rich foods, but environmental pressures suggest advocating some meat and dairy foods over others, and understanding the barriers and facilitators for consuming these different foods would be of value. Existing data on the barriers to and facilitators of the consumption of meat and dairy products were re-analysed for differing effects for white, red, and processed meat consumption and for yoghurt, soft cheese, and hard cheese consumption. White meat consumption was associated with fewer concerns over spoilage and waste and stronger perceptions that meat is convenient (smallest Beta = 0.135, p = 0.01), while red and processed meat consumption were positively associated with liking /taste, appearance, and convenience (smallest Beta = 0.117, p = 0.03). Yoghurt and soft cheese consumption were positively associated with liking/taste and medical concerns, and fewer concerns over ability and habit (smallest Beta = −0.111, p = 0.05), while hard cheese consumption was only associated with liking/taste (Beta = 0.153, p = 0.01). Taken together, these data suggest that enhancing or promoting the enjoyment, taste, visual appeal, and ease-of-consumption of the more sustainable meat and dairy options may be of value in encouraging the consumption of these foods in older adults.