Progress 04/01/16 to 08/31/18
Outputs
Target Audience:Semi-chronologically: Gave an oral presentation at the inaugural Planetary Health Alliance conference, held in April of 2017 on the Harvard campus in Boston, MA, on the development of the Dietary Environmental Index and its preliminary findings (DEX), which was attended by an international scientific community. Invited to give a guest lecture on diet sustainability and to run through a DEX simulation with students during a 2017 summer course on New and Controversial Topics in Nutrition for graduate students at the Friedman School of Nutrition Science and Policy. Presented a poster at the American Public Health Association annual conference, held in November 2017 in Atlanta, GA, on a related collaboration project evaluating qualitative responses describing environmental concerns associated with food and diet. Presented a poster at the second Planetary Health Alliance conference, held in May of 2018 on the University of Edinburgh campus in Edinburgh, Scotland, on the application of the DEX to assess nutritional quality vs environmental impact of dietary intakes reported in the National Health and Nutrition Examination Survey 2007-2008. Presented the culmination of the DEX project methodology and findings at my doctoral thesis defense in August, 2018. The seminar was open to my committee members and the academic community on location at the Friedman school of Nutrition, and was also live-streamed to allow for off-campus viewing - some viewers were internationally located. Volunteering with my town school district Green Schools initiatives focused on reducing the environmental footprint of the school meal program, working with the Parent Teacher Organization, the Director of the public school food program, and community volunteers. Invited to give a guest lecture on diet sustainability in a course on Environmental Health for MPH students at the University of Southern Maine in the Fall of 2018 - though the lecture had to be postponed due to a course schedule rearrangement, and is expected to occur in 2019. Changes/Problems:Though the number and variety of food Life Cycle Assessment (LCA) data utilized in these analyses exceed much of what has been done in diet studies published to date, with nearly 90% direct matching achieved between the 63 Food Intakes Converted to Research Commodities Database (FICRCD) commodities and the available LCA foods, the narrow options for food LCA data in general is a limitation in the field, and encompasses inherent uncertainties and generalizations. It is important to note a single LCA dataset is an imperfect representative of an entire food commodity. Every effort was made to include the most relevant environmental data, and consistency was prioritized by utilizing the WFLDB as the primary source of food LCA data, supplemented with data from Ecoinvent or Agribalyse only when a suitable representative was unavailable in the WFLDB. Overall, gaps in the food LCA data were addressed by the application of proxy foods or processing calculations. These limitations reflect the data sources available at this time, and are not considered a limitation of the approach, as the DEX may be easily adapted as additional data becomes available. What opportunities for training and professional development has the project provided? As project director I had the opportunity to function independently throughout the project duration, while at the same time receiving guidance and mentorship from my primary advisor Dr. Paul Jacques and the members of my doctoral committee: Dr. Chris Peters, Dr. Tim Griffin, and Dr. Mim Nelson. I benefited from critical review of my research methodology and preliminary findings from the academic community at the Friedman School of Nutrition. I had the opportunity to travel to national and international conferences to present my research methodology and findings, which have expanded my professional network and engendered some collaborative projects, as well as led to my current job position. I am submitting some of this research and its offshoots to three scientific conferences for 2019. My work on this project has provided me the opportunity to gain substantial expertise in the field of environmental impact of food systems and diet sustainability, which is highly relevant to current public and planetary health concerns related to climate change. This is an integral part of my career, but I am also utilizing my knowledge in this field and the database developed from this research to work on community projects focused on diet sustainability. How have the results been disseminated to communities of interest? Primarily through multiple conferences and one publication to date, with another being prepared in 2018 and 2 additional articles under preparation to be submitted in 2019, along with abstract submissions for conference presentations in 2019. My doctoral dissertation defense was attended by faculty and students at Tufts University with interest in environmental nutrition and diet sustainability, where I described the background of this project and research need, the methods of my research, the research findings and future directions. The dissertation publication was postponed so as to not conflict with upcoming journal publications based this work, but after August 2019 will be publicly available. Engagement in my local community to advise and support efforts related to diet sustainability, particularly in our local school public school system. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
Background The objective was to create an integrated assessment of nutritional and environmental impacts at the food level, and then identify and develop dietary patterns that maximize nutritional quality within reasonable environmental impact boundaries. Toward that end, this research was conducted in two stages: Aim 1 was to develop a method of evaluating nutritional quality in the context of environmental impact for a range of food products, through development of the Dietary Environmental Index (DEX). Results from Aim 1 were integrated at the food level by identifying the foods that optimize nutritional value with reduced environmental costs. Aims 2 and 3 were to apply the DEX to examine observed dietary intake as consumed in an American population sample, and to model food patterns aimed at improving sustainability, respectively. Summary of the Results At the core of Aim 1 was the development of the DEX as a data-driven system for evaluating dietary value versus environmental costs for a wide range of foods consumed in the United States, calculated as the ratio of an Environmental Impact Score (EIS) to a Nutrient Density Score (NDS). For the 8000 foods available in USDA food product datasets based on foods reported in the NHANES, the results demonstrated only a modest correlation between nutrient density of foods and their environmental impact, and substantial variation in DEX scores even within food groups and among similar foods. These findings affirm the importance of considering the relative nutrition-to-environmental impact of food choices in an integrated, comprehensive manner. EIS values of overall food groups demonstrated similar trends seen in other studies of food environmental impacts, with plant-based foods being the most benign, and animal-meats, particularly from ruminant animals, being the most environmentally burdensome. Animal products, such as dairy and eggs, generally lay somewhere along the spectrum of these two extremes. Analysis with the overall DEX, however, revealed intriguing insights and distinctions within these food groups. For instance, some of the heavier environmental burdens of certain foods were offset by their high nutritional value, such as for poultry, while poor nutrition countered the low environmental impact of other foods, such as refined grain products. Of particular interest was the assessment of mixed dishes, as these provided an opportunity to determine how ingredient proportion could influence the two component scores of the NDS and EIS within similar foods and, importantly, on the final DEX score. In Aim 2, DEX scoring was used to assess real-life reported dietary intake within a representative sample of non-institutionalized American adults. Standardizing the diets to 2000 kcal allowed for comparability of results among intakes of different energy levels for analysis with respect to nutritional and dietary recommendations. Assessment of complex survey-adjusted means of demographic characteristics with respect to DEX tertile category levels indicated that significantly greater proportions of the high DEX group were female, of older age (over the age 60), of Hispanic or multi-cultural background, and/or were educated with a college degree or higher. The high DEX group was associated with significantly higher scores of the Healthy Eating Index 2010, and, likewise, showed significantly higher levels than the low DEX group for most healthy food groups. However, even the high DEX group fell short of meeting some of the intake/restriction levels recommended in the 2015 DGA, and the low DEX group failed to meet most of them, indicating that the NHANES population, generalizable to the American public, is not adhering to national dietary recommendations. After deconstructing the dietary data into food commodity intake by mass, single-day food patterns were defined based on a diet group classification system of high, medium, and low meat-eaters, pesce-pollotarian (combined, as fish consumption in the US is low), and lacto-ovo vegetarian (combined with vegan, which was also low in this population) (Scarborough et al., 2014). Comparison of DEX, NDS, and EIS values across these food patterns yielded an interesting finding that the NDS distributions largely overlapped across food patterns, while EIS values ranged more widely, and the DEX thereby presenting as a subdued mirror image to the EIS. Our results were similar to those of other studies that higher meat proportion in the diet was associated with greater environmental impact, with lower DEX scores as a result. The lacto-ovo vegetarian diets benefited from reduced environmental impact due to the absence of meat but maintained dietary variety and key nutrient levels by the inclusion of dairy and eggs. Pesce-pollotarians and light-meat omnivores - those consuming red meat at 5% or less of total food consumption assessed - showed near overlapping ranges of both DEX and EIS scores, followed not too distantly by medium-meat omnivores. Interestingly, the distribution of these values indicate that in any of these categories the food intakes of some participants could fall above or below the upper or lower quartiles of the DEX score - one area that could be the subject of further examination in the future. Aim 3 methodology took advantage of the array of variables in the NHANES datasets to construct a unique approach for substituting more sustainable versions of original food products. The highest DEX score within each of the approximately 150 What We Eat In America (WWEIA) food categories was established as the value to which all other foods within the same category were compared, and any foods with a DEX score below the 75th percentile for that category were automatically eliminated. The remaining high-DEX foods that also showed at least 1% consumption within that category were manually reviewed to select the most appropriate food representative for each category - usually the highest DEX food, unless another food presented a higher consumption rate with similar DEX values. This approach was taken to avoid issues experienced by Macdiarmid et al., which describe an initial short-list of low-GHGe foods that were too limited and were not compatible with each other, such as where breakfast cereal was included, but not milk (Macdiarmid et al., 2012). Furthermore, DEX-modeling of the dietary intakes only replaced original foods if they fell below their WWEIA's 75th percentile of DEX, thereby maintaining more self-selection even within the modeled diets. Using foods from within the same WWEIA was also intended to help maintain food selection factors that are difficult to quantify and incorporate into a mathematical model, such as taste, social or cultural influences, and access. Though price point data was not available here, an intriguing area for future research would be the inclusion of food product costs into such substitution models. The results showed improvements in the modeled (Aim 3) versus observed (Aim 2) dietary values related to the DEX, NDS, and EIS scores, with higher intake of healthy food groups including legumes, vegetables, whole grains, and fruit, and lower intake of red meat in favor of poultry, and lower added sugar. This also translated to higher levels of nutrients to be encouraged, such as Vitamins A, C, and E, as well as minerals of iron, calcium, and magnesium, and some modest reductions in sugar and sodium. An assessment of the change in EIS showed a 7% reduction, and further analysis could be undertaken to examine how this translates to direct LCA environmental impacts.
Publications
- Type:
Journal Articles
Status:
Other
Year Published:
2019
Citation:
El-Abbadi NH, Blackstone NT, Peters C, Griffin T, Nelson M, Norris G, Jacques P. Development of a dietary environmental index to assess nutritional quality versus environmental impact of foods commonly consumed in the United States. In preparation 2018
- Type:
Theses/Dissertations
Status:
Accepted
Year Published:
2018
Citation:
El-Abbadi NH, 2018, Development and Application of the Dietary Environmental Index for the Assessment of Foods and Dietary Patterns in the United States, PhD Dissertation, Friedman School of Nutrition Science and Policy at Tufts University, Boston MA.
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2018
Citation:
N El-Abbadi, M Nelson, T Griffin, C Peters, N Tichenor, P Jacques. Application of the Dietary Environmental Index in USDA food patterns: a comparison of observed and recommended dietary patterns. Planetary Health Alliance 2018, poster presentation.
- Type:
Journal Articles
Status:
Published
Year Published:
2018
Citation:
Blackstone NT, El-Abbadi NH, McCabe MS, Griffin TS, Nelson ME. Linking sustainability to the healthy eating patterns of the Dietary Guidelines for Americans: a modeling study. The Lancet Planetary Health, Vol 2, Issue 8, pe344-e352, August 2018
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2017
Citation:
N El-Abbadi, M Karlsen, J Kurtz, M Nelson, C Peters, T Griffin, P Jacques, N McKeown. Environmental considerations influencing dietary choices: Exploring consumer attitudes. American Public Health Association 2017, poster presentation.
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Progress 04/01/16 to 03/31/17
Outputs
Target Audience:1. As part of my thesis proposal defense, I delivered a seminar to my committee members that was open to the academic community of the Friedman School of Nutrition. It was attended by my peers in the program, as well as other students and faculty at the Friedman School with research interests in dietary sustainability. 2. I have submitted abstract proposals of this work for presentation at two national conferences scheduled for 2017: Planetary Health Alliance inaugural meeting (April 2017) and the American Public Health Association annual meeting (November 2017). For the PHA, my abstract describing development of the dietary environmental index was one of a selected group of abstracts to be published by The Lancet in a booklet of "Top Abstracts in Planetary Health", to be released in conjunction with the PHA meeting in April where I will be one of the speakers. Notification regarding APHA will be received in June. 3. I have begun collaborative efforts with researchers at the Sustainability Institute at the University of New Hampshire, who will be applying the DEX database to their own separate and distinct evaluation of USDA food patterns. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? In the course of the first year of the project, I was able to successfully defend my thesis proposal and advance to 'doctoral candidate'. I have also submitted this work for presentation at two conferences. I have received a response from one of the two so far, where I was invited to give a research talk as one of the speakers at the event, as well as to participate in a networking session with the other speakers. I also accepted an invitation to mentor student attendees of the conference interested in this field of research. I was invited to join a research collaboration at the Sustainability Institute at the University of New Hampshire, to undertake further assessment of USDA food patterns using life cycle assessment analysis. How have the results been disseminated to communities of interest? As part of my thesis proposal defense, I delivered a 45-minute seminar on my project that went through the scientific background and research need, the proposed research methodologies, and preliminary results to my thesis committee members in a session that was open to the academic community of the Friedman School of Nutrition. It was attended by my peers in the program, as well as other students and faculty at the Friedman School with research interests in dietary sustainability. I have submitted abstract proposals of this work for presentation at two national conferences scheduled for 2017: the Planetary Health Alliance inaugural meeting (April 2017) and the American Public Health Association annual meeting (November 2017). For the PHA, my abstract describing development of the dietary environmental index was one of a selected group of abstracts to be published by The Lancet in a booklet of "Top Abstracts in Planetary Health", to be released in conjunction with the PHA meeting in April. Notification regarding APHA will be received in June. I have begun collaborative efforts with researchers at the Sustainability Institute at the University of New Hampshire, who will be applying the DEX database to their own separate and distinct evaluation of USDA food patterns. What do you plan to do during the next reporting period to accomplish the goals?Year 2 of the project will continue work with DEX for analysis of dietary patterns for the second and third objectives: Objective 2: Application of DEX to examine the nutritional quality versus environmental impact of observed and recommended dietary patterns. Approach 2: An average diet will be derived from NHANES to serve as the baseline/reference dietary pattern for typical American food consumption. Additionally, meal plans will be developed to represent the three recommended USDA food patterns within the 2015 DGA ("Healthy US-style eating pattern", "Healthy Mediterranean", and "Healthy Vegetarian"). The environmental impact for each of these dietary patterns will be examined. Expected Outcome 2: The nutrition-to-environmental impact scores of the observed and recommended diet patterns, to identify patterns with the highest DEX. Objective 3: Mathematically model more sustainable versions of diet patterns, and test the potential for environmental impact reduction. Approach 3: Sustainable meal plans to fit each of the 3 USDA dietary patterns will be constructed by iteratively substituting alternative foods with more favorable DEX scores. The environmental implications of such dietary shifts will be examined. Expected Outcome 3: Dietary pattern models optimized using DEX, to demonstrate environmental impact reductions through simulated dietary shifts.
Impacts
What was accomplished under these goals?
Year 1 of this project has met the first objective: Objective 1: to develop the Dietary Environmental Index (DEX) using primary environmental impact indicators as a standardized evaluation system of dietary value versus environmental costs for a wide range of foods commonly consumed in the US. Approach 1: A database composed of a nationally representative selection of commonly consumed foods was identified from NHANES, with nutrient profiles collated. Environmental assessment aggregated data forindicators of land and water resource use, climate change potential, and marine eutrophication for the selected foods, using data from life cycle assessments contributed by the World Food LCA Database. The ratio of a previously developed nutrient profile score (the Nutrient Rich Foods Index 9.3) to an aggregate environmental impact score was calculated for the selected foods. Outcome 1: Development of the Dietary Environmental Index (DEX) to provide the nutrient density to environmental impact for each examined food. The methodology and preliminary results is being written up for publication, and will be presented at the Planetary Health Alliance inaugural meeting in April 2017.
Publications
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2017
Citation:
The Dietary Environmental Index to assess nutritional quality versus environmental effect of foods and dietary patterns: development and preliminary results. N El-Abbadi, C Peters, T Griffin, M Nelson, P Jacques. The Lancet Planetary Health, April 2017
- Type:
Conference Papers and Presentations
Status:
Submitted
Year Published:
2017
Citation:
Application of the Dietary Environmental Index to assess diet quality versus environmental impact of USDA dietary patterns. N El-Abbadi, M Nelson, T Griffin, C Peters, P Jacques. American Public Health Association Annual Meeting, November 2017
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