Effect of food-related behavioral activation therapy on food intake and the environmental impact of the diet: results from the MooDFOOD prevention trial

Alessandra Grasso ,Matthew Owens,Corné Van Dooren,Ed Watkins,Gerard Van Grootheest,Elisabeth Kohls,Mieke Cabout,Marjolein Visser,Ulrich Hegerl,Margalida Gili,Margreet R Olthof,Miquel Roca,Brenda W.j.h Penninx ,Mariska Bot,Ingeborg A Brouwer

doi:10.1007/s00394-019-02106-1

Abstract

PurposeFood-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.MethodsIn 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.ResultsThe 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).ConclusionsA shift towards a healthier Mediterranean-style diet does not necessarily result in a diet with reduced environmental impact in a real-life setting.Trial registrationClinicalTrials.gov. Number of identification: NCT02529423. August 2015.

Highlights

A transition from traditional to current dietary patterns has contributed to a rise in global prevalence of chronic diseases and to unprecedented changes in ecosystems, both of which are threatening public health [1]
While contributing to 11.2 E%, total meat intake accounted for approximately 35.1% of daily dietassociated greenhouse gas emissions (GHGE), 39.1% of land use (LU) and 21.2% fossil energy use (FEU) in the food-related behavioral activation therapy (F-BA) group at baseline, with similar contributions in the control group (Table 3)
We found that the F-BA intervention led to changes in food intake among overweight adults with subsyndromal symptoms of depression according to the MooDFOOD dietary guidelines: significant increases in consumption were reported for some of the food groups promoted and a significant decrease was reported for one of the food groups discouraged by the guidelines

Summary

Introduction

A transition from traditional to current dietary patterns has contributed to a rise in global prevalence of chronic diseases and to unprecedented changes in ecosystems, both of which are threatening public health [1]. Food production contributes to approximately 16–25% of total global greenhouse gas emissions (GHGE) [3], and it is estimated that this will increase by 51% from 2005/07 to 2050 if dietary patterns. While sustainable intensification of agriculture is proposed as a solution to increase food production with reduced environmental risks, it will not prevent further agricultural expansion driven by the projected demand [7]. Dietary change has been identified as an essential counterpart to reduce the environmental pressures associated with the diet and to provide food security for future generations [8,9,10]

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