Energy intakes assessed by 7-d weighted dietary records (EI-WDRs) and diet histories (EI-DHs) were compared with concurrent estimates of total energy expenditure (TEE) by the doubly labeled water method in 78 subjects aged 3-18 y. EI-WDRs were not obtained from the 3- and 5-y-old subjects. EI-WDRs in the 7- and 9-y-old children were 108 +/- 25% (n = 12) and 97 +/- 15% (n = 12), respectively, of corresponding TEE values showing good agreement. However in the 12-, 15-, and 18-y-old subjects EI-WDR averaged 89 +/- 12% (n = 12), 78 +/- 18% (n = 12), and 73 +/- 25% (n = 10), respectively, of corresponding TEE values. The difference was greater than or equal to 20% in 13 adolescents. Mean EI-DHs were 114 +/- 19% (3 y), 111 +/- 19% (5 y), 111 +/- 23% (7 y), 106 +/- 9% (9 y), 114 +/- 17% (12 y), 101 +/- 21% (15 y), and 98 +/- 21% (18 y) of TEE estimates. Differences were significant in the 3-, 9-, and 12-y-old subjects. Results suggest that 7-d EI-WDRs tend to underestimate food intake of adolescents. Although EI-DHs were biased towards overestimation in most age groups and individual measurements lacked precision, EI-DHs were more representative of habitual intake than were EI-WDRs.

Total energy expenditure (TEE) was measured simultaneously in 36 free-living children aged 7, 9, 12, and 15 y over 10-15 d by the doubly labeled water (DLW) method and for 2-3 separate days by heart-rate (HR) monitoring. The 95% confidence limits of agreement (mean difference +/- 2SD) were -1.99 to +1.44 MJ/d. HR TEE discrepancies ranged from -16.7% to +18.8% with 23 values lying within +/- 10% of DLW TEE estimates. Boys and girls spent 462 +/- 108 and 318 +/- 120 min/d, respectively, in total physical activity (P less than 0.01). Time spent in moderate and vigorous physical activity (MVPA) was 68 +/- 37 min/d by younger children (7-9 y) and 34 +/- 24 min/d by older children (12-15 y) (P less than 0.001). Younger boys engaged in MVPA (91 +/- 33 min/d) and vigorous physical activity (VPA) (35 +/- 15 min/d) significantly longer than younger girls (MVPA, 39 +/- 16 min/d, P less than 0.001; VPA, 10 +/- 4 min/d, P less than 0.01) as did older boys (MVPA, 52 +/- 21 min/d; VPA, 30 +/- 18 min/d) compared with older girls (MVPA, 15 +/- 10 min/d; VPA, 8 +/- 5 min/d). HR monitoring provides a close estimation of the TEE of population groups and objective assessment of associated patterns of physical activity.

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This review assessed the effects of environmental labels on consumers’ demand for more sustainable food products. Six electronic databases were searched for experimental studies of ecolabels and food choices. We followed standard Cochrane methods and results were synthesized using vote counting. Fifty-six studies ( N = 42,768 participants, 76 interventions) were included. Outcomes comprised selection ( n = 14), purchase ( n = 40) and consumption ( n = 2). The ecolabel was presented as text ( n = 36), logo ( n = 13) or combination ( n = 27). Message types included: organic ( n = 25), environmentally sustainable ( n = 27), greenhouse gas emissions ( n = 17), and assorted “other” message types ( n = 7). Ecolabels were tested in actual ( n = 15) and hypothetical ( n = 41) environments. Thirty-nine studies received an unclear or high RoB rating. Sixty comparisons favored the intervention and 16 favored control. Ecolabeling with a variety of messages and formats was associated with the selection and purchase of more sustainable food products.

Background High meat consumption, particularly red meat and processed meat, negatively affects our health, while meat production is one of the largest contributors to global warming and environmental degradation. The aim of our study was to explore trends in meat consumption within the UK and the associated changes in environmental impact. We also aimed to identify any differences in intake associated with gender, ethnicity, socioeconomic status, and year of birth. MethodsOur study aimed to describe consumption of red, white, and processed meat within the UK, using data from the National Diet and Nutrition Survey rolling programme (2008-09 to 2018-19), and the associated changes in environmental impact. Meat consumption was based on disaggregated meat data, from 4 day food diaries that excluded all non-meat components of composite dishes. For each year surveyed, trends for meat intake were reported as mean grams per capita per day and linear-regression models were used to test for trends. We used multivariable linear-regression models to examine differences among consumers, as a percentage of food energy, by gender, ethnicity, equivalised household income, and year of birth. FindingsFrom 2008 to 2019, average meat consumption per capita per day decreased from 103•7 g (SE 2•3) to 86•3 g (2•9) per day (p trend <0•0001), including an absolute reduction in red-meat consumption of 13•7 g (p trend <0•0001), an absolute reduction in processed meat consumption of 7•0 g (p trend <0•0001), and a 3•2 g increase (p trend =0•0027) in white-meat consumption. Collectively, these changes were associated with a significant reduction in all six environmental indicators over the whole period. The two middle birth-year groups (people born in 1960-79 and 1980-99) and White individuals were the highest meat consumers. Meat intake increased over time among people born after 1999, was unchanged among Asian and Asian British populations, and decreased in all other population subgroups. We found no difference in intake with gender or household income.Interpretation Despite the overall reduction in meat intake, reaching meat-consumption targets that align with sustainable diets will require a substantial acceleration of this trend.

People with serious mental illness (SMI) have identified barriers to engaging in behavioral weight management interventions (BWMIs). We assessed whether BWMIs that addressed these barriers were more effective. First, we systematically reviewed qualitative literature and used a thematic analysis to identify the characteristics of BWMIs that promote engagement for adults with SMI. Second, we systematically reviewed randomized controlled trials (RCTs) of BWMIs in adults with SMI. Data on the characteristics that promoted engagement and weight outcomes were extracted. We then used a crisp-set qualitative comparative analysis (CsQCA) to identify which characteristics were associated with weight loss. For the qualitative review, 20 studies in 515 people with SMI were analyzed and nine characteristics were reported to promote engagement in BWMIs. For the systematic review, 34 RCTs testing 36 interventions in 4305 participants were included. The active interventions resulted in more weight loss (mean = À4.37 to +1 kg at 6 weeks to 18 months follow-up) compared with controls (À1.64 to +3.08 kg). The CsQCA showed BWMIs that offered regular contact, tools to support enactment, and tailored materials were associated with effectiveness. As these are all supplementary strategies, it may be possible to augment BWMIs available for the general population to engage people with SMI.

Background Reducing meat consumption could bring health and environmental benefits, but there is little research to date on effective interventions to achieve this. A non-randomised controlled intervention study was used to evaluate whether prominent positioning of meat-free products in the meat aisle was associated with a change in weekly mean sales of meat and meat-free products. Methods and findings Weekly sales data were obtained from 108 stores: 20 intervention stores that moved a selection of 26 meat-free products into a newly created meat-free bay within the meat aisle and 88 matched control stores. The primary outcome analysis used a hierarchical negative binomial model to compare changes in weekly sales (units) of meat products sold in intervention versus control stores during the main intervention period (Phase I: February 2019 to April 2019). Interrupted time series analysis was also used to evaluate the effects of the Phase I intervention. Moreover, 8 of the 20 stores enhanced the intervention from August 2019 onwards (Phase II intervention) by adding a second bay of meat-free products into the meat aisle, which was evaluated following the same analytical methods. During the Phase I intervention, sales of meat products (units/store/week) decreased in intervention (approximately −6%) and control stores (−5%) without significant differences (incidence rate ratio [IRR] 1.01 [95% CI 0.95–1.07]. Sales of meat-free products increased significantly more in the intervention (+31%) compared to the control stores (+6%; IRR 1.43 [95% CI 1.30–1.57]), mostly due to increased sales of meat-free burgers, mince, and sausages. Consistent results were observed in interrupted time series analyses where the effect of the Phase II intervention was significant in intervention versus control stores. Conclusions Prominent positioning of meat-free products into the meat aisle in a supermarket was not effective in reducing sales of meat products, but successfully increased sales of meat-free alternatives in the longer term. A preregistered protocol (https://osf.io/qmz3a/) was completed and fully available before data analysis.

Background Reducing meat consumption could protect the environment and human health. Objectives We tested the impact of a behavioral intervention to reduce meat consumption. Design Adult volunteers who regularly consumed meat, were recruited from the general public and randomized 1:1 to an intervention or control condition. The intervention comprised free meat substitutes for four weeks, information about the benefits of eating less meat, success stories, and recipes. The control group received no intervention or advice on dietary change. The primary outcome was daily meat consumption after four weeks, assessed by a 7-day food diary, and repeated after eight weeks as a secondary outcome. Other secondary and exploratory outcomes included the consumption of meat substitutes, cardiovascular risk factors, psychosocial variables related to meat consumption, and the nutritional composition of the diet. We also estimated the intervention's environmental impact. We evaluated the intervention using generalized linear mixed effects models. Results Between June 2018 and October 2019, 115 participants were randomized. Baseline meat consumption was 134 g/d in the control and 130 g/d in the intervention group. Relative to the control, the intervention reduced meat consumption at 4 weeks by 63 g/d (95%CI: 44, 82, P&lt;0.0001, N = 114) and at eight weeks by 39 g/d (95%CI: 16, 62, P = 0.0009, N = 113), adjusting for sex and baseline consumption. The intervention significantly increased the consumption of meat substitutes without changing the intake of other principal food groups. The intervention increased intentions, positive attitudes, perceived control, and subjective norms of eating a low meat diet and using meat substitutes, and decreased attachment to meat. At 8 weeks, 55% of intervention recipients identified as “meat-eaters” compared to 89% in the control. Conclusions A behavioral program involving free meat substitutes can reduce meat intake and change psychosocial constructs consistent with a sustained reduction in meat intake.