Abstract
PURPOSE: Food-based dietary guidelines are proposed to not only improve diet quality, but to also reduce the environmental impact of diets. The aim of our study was to investigate whether food-related behavioral activation therapy (F-BA) applying Mediterranean-style dietary guidelines altered food intake and the environmental impact of the diet in overweight adults with subsyndromal symptoms of depression.
METHODS: In total 744 adults who either received the F-BA intervention (F-BA group) or no intervention (control group) for 12 months were included in this analysis. Food intake data were collected through a food frequency questionnaire at baseline and after 6 and 12 months. Greenhouse gas emissions (GHGE), land use (LU), and fossil energy use (FEU) estimates from life-cycle assessments and a weighted score of the three (pReCiPe score) were used to estimate the environmental impact of each individual diet at each timepoint.
RESULTS: The F-BA group reported increased intakes of vegetables (19.7 g/day; 95% CI 7.8-31.6), fruit (23.0 g/day; 9.4-36.6), fish (7.6 g/day; 4.6-10.6), pulses/legumes (4.0 g/day; 1.6-6.5) and whole grains (12.7 g/day; 8.0-17.5), and decreased intake of sweets/extras (- 6.8 g/day; - 10.9 to - 2.8) relative to control group. This effect on food intake resulted in no change in GHGE, LU, and pReCiPe score, but a relative increase in FEU by 1.6 MJ/day (0.8, 2.4).
CONCLUSIONS: A shift towards a healthier Mediterranean-style diet does not necessarily result in a diet with reduced environmental impact in a real-life setting.
TRIAL REGISTRATION: ClinicalTrials.gov. Number of identification: NCT02529423. August 2015.
| Original language | English |
|---|---|
| Pages (from-to) | 2579-2591 |
| Number of pages | 13 |
| Journal | European journal of nutrition |
| Volume | 59 |
| Issue number | 6 |
| Early online date | 23 Oct 2019 |
| DOIs | |
| Publication status | Published - Sept 2020 |
Funding
Funding for this article is provided by the European Union 7th Framework Program (FP) MooDFOOD Project \u2018Multi-country cOllaborative project on the rOle of Diet, FOod-related behaviour, and Obesity in the prevention of Depression\u2019 (grant agreement no. 613598). This work is supported in the UK by the National Institute for Health Research (NIHR), through the Primary Care Research Network and the NIHR Exeter Clinical Research Facility. The authors would like to thank all participants for their participation in the trial. The members of the MooDFOOD prevention trial investigators are: MooDFOOD project coordination, VU University Amsterdam, Department of Health Sciences, the Netherlands. Prof. Marjolein Visser, Ph.D.\u2014Principle Investigator of the MooDFOOD project and the MooDFOOD prevention trial. Prof. Ingeborg A Brouwer, Ph.D.\u2014Co-Principle Investigator of the MooDFOOD project and the MooDFOOD prevention trial. Mieke Cabout\u2014Project manager of the MooDFOOD project. Trial Centers: VU Medical Center, Amsterdam, the Netherlands, Prof. Brenda Penninx, Ph.D.\u2014Field Center Principal Investigator. Dr. Mariska Bot, Ph.D.\u2014Field Center Co-Investigator. Nadine Paans\u2014Field Center therapist and research assistant. Carisha Thesing\u2014Field Center therapist. Deborah Gibson-Smith\u2014Field Center research assistant. Melany Horsfall\u2014Field Center coordinator. Lena Weiss\u2014Field Center research assistant. University of Exeter, Exeter, United Kingdom, Prof. Ed Watkins, Ph.D.\u2014Field Center Principal Investigator, lead for developing the MooDFOOD Food-related Behavioural Change Intervention. Dr. Matthew Owens, Ph.D.\u2014Field Center Co-Investigator. Dr. Amy Romijn, Ph.D.\u2014Field Postdoctoral Research Associate. Hannah Bunce\u2014Field Center Associate Research Fellow. Owain Winfield\u2014Field Center Researcher and Therapist. University of Balearic Islands, Palma de Mallorca, Spain: Prof. Miquel Roca, Ph.D., MD\u2014Field Center Principal Investigator. Prof. Margarita Gili, Ph.D.\u2014Field Center Co-Investigator, co-lead for developing the MooDFOOD Food-related Behavioural Change Intervention. Prof. Miquel Tortella, Ph.D.\u2014Field Center-Co-Investigator, co-lead for developing the MooDFOOD Food-related Behavioural Change Intervention. Clara Homar Covas\u2014Field Center Researcher and therapist, Margalida Vives Forteza\u2014Field Center Research assistant, Adoraci\u00F3n Castro Gracia\u2014Field Center Research assistant. Maria Angeles P\u00E9rez-Ara\u2014Field Center Research assistant. Jos\u00E9 Luis Reig\u2014Field Center therapist. University Leipzig, Leipzig, Germany: Prof. Ulrich Hegerl, MD\u2014Field Center Principal Investigator, Dr. Elisabeth Kohls, Ph.D.\u2014Field Center Co-Investigator, Jana Hoesel\u2014Field Center study nurse, Ezgi Dogan, MD\u2014Field Center research fellow, Sabrina Baldofski\u2014Field Center therapist, Nicole Mauche\u2014Field Center therapist. Data Management, GGZ inGeest, Amsterdam the Netherlands: Prof. Brenda Penninx, Ph.D.\u2014Principal investigator, Gerard van Grootheest\u2014Data management coordinator, Bep Verkerk\u2014Data manager The trial was performed in accordance with the principles of Good Clinical Practice. Institutional review board approval was obtained from the Research Ethics Committee Govern de les Illes Balears, Palma, Spain (10th of March 2015), the Ethics Committee of the University of Leipzig, Germany (2nd of April 2015), VU Medical Center Amsterdam, the Netherlands (8th of July, 2015) and the NHS National Research Ethics Service (NRES) Committee, SouthWest, UK (Research Ethics Committee number-15/SW/0153) for University of Exeter (3th of August 2015). All individuals gave their informed consent prior to inclusion in the study.
| Funders | Funder number |
|---|---|
| European Union 7th Framework Program | |
| NIHR Exeter Clinical Research Facility | |
| National Institute for Health and Care Research | |
| Margalida Vives Forteza | |
| University of Exeter | |
| University of Leipzig | |
| European Commission | |
| VU Medical Center Amsterdam | |
| NIHR Exeter Clinical Research Facility | |
| April | |
| Universitat de les Illes Balears | |
| FPInnovations | |
| Seventh Framework Programme | 613598 |
| National Research Ethics Service | number-15/SW/0153 |
