Diets influence our mental health and social wellbeing (MHSW) in multiple ways. A rising community concept, Eco-Regions, has gained interest. The research project “Indicators for assessment of health effects of consumption of sustainable, organic school meals in Ecoregions” (INSUM) aims to develop future-oriented research approaches to measure the potential health effects of more sustainable and healthy diets. This first part of the project focuses on MHSW with the goal to identify suitable study designs and indicators. The methodology is based on a 2-day workshop with an interdisciplinary group of experts. This paper describes commonly applied research methods on the nexus between diet and MHSW as presented by the experts and summarises key points from the discussions. The results show that the dominating tool to investigate MSHW is questionnaires. Questionnaires vary largely depending on the research design, such as participants or distribution channels. Cohort studies addressing families and including in-depth interventional and/or experimental studies may be suitable for an Eco-Region investigation. Those MHSW studies can be conducted and combined with measurements of somatic health effects. We conclude that indicators should be seen as complementary rather than independent. Explorative research designs are required to investigate complex Eco-Regions.
To solve the rising issue of how to feed our planet in the future, we need to enhance our knowledge of peoples' current eating patterns and analyze those in terms of their health and environmental impacts. Current studies about adherence to existing national and global dietary recommendations often lack the ability to cross-compare the results among countries. Therefore, this study aims to develop a methodology to evaluate adherence to food-based dietary guidelines (FBDGs) and the Planetary Health Diet (PHD) on a national level, which can be replicable in different countries. First, national dietary intake data was collected from surveys published by the respective responsible public institutions from five countries (Italy, Denmark, Germany, Morocco, and Poland). Second, food groups represented in the intake data and the FBDGs were mapped to establish a proposal for a new common grouping (i.e., comprehensive food groups) that enables cross-country comparison. Third, dietary intake was compared to the recommendations according to national FBDG and the PHD. The adherence to the recommended diets was assessed using an adapted version of the German Food Pyramid Index. Our results show that different ways of grouping foods may change adherence levels; when measuring adherence to the FBDGs with the food groups suggested in the FBDGs, average scores (45.5 ± 5.4) were lower than by using comprehensive food groups (46.9 ± 3.7). Higher adherence to the PHD (52.4 ± 6.1) was found also using the comprehensive food groups. Particularly the foods meats, eggs, and legumes in one group (i.e., protein equivalents) appear to influence the outcome of scores using the comprehensive food groups. This study developed a methodology to evaluate national dietary intake against national FBDGs and the PHD. Our study points out the fact that it is difficult to overcome the challenge that countries have different food grouping clusters. Yet, the combination of the methods developed enables cross-country comparisons and has the potential to be applied to different national settings globally.
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