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- Development of a tool to assess the compliance of cafeteria menus with the Mediterranean DietPublication . Silva, S. S.; Rocha, A.; Ferreira, L.; Neto, Beatriz; Dikmen, D.; Filipec, S. Vidacek; Satalic, Z.; Viegas, CláudiaBackground: The Mediterranean diet (MD) has been considered one of the healthiest dietary patterns, and an excellent model of sustainability. Higher Education food services present an excellent scenario to encourage students healthy eating habits and modulate food choices. The purpose of this work was to develop an index to evaluate MD compliance with cafeteria menus. Methods: Three major axes were considered: MD key points, existing indexes on individual adherence to the MD, and existing indexes on menu assessment. The index includes four levels: (I) assesses the availability (IA), variety, and frequency (IB) of food; (II) evaluates the menu's nutritional quality; (III) assesses the menu's quality through information provided in the dishes' technical specifications and (IV) allows a more detailed evaluation through on-site visits and documentation consultation. The components receive a score between - 2 and 3, according to the given answers. The final score may vary between - 33.5 and 41.5 points depending on the degree of compliance with the MD key points. The index was applied to 60 menus from different contexts using complete assessments of each menu, performed independently by 3 researchers, using the same pre-prepared Microsoft Excel® spreadsheet. Inter-rater reliability was assessed using Cohen's Kappa and internal consistency with Cronbach's alpha. Results: Assessment for level I) returned a Cohen's Kappa coefficient of 0.92 (p < 0.05) and a Cronbach's alpha coefficient of 0.88. Dimension I is mostly influenced by subdimension IB (r = 0,97). The availability of non-starchy vegetables and fresh fruits has a stronger correlation with IA (availability of foods), and the higher availability of fish, pulses, and fruit has a strong positive correlation with IB (variety and frequency of foods). Conclusion: Researchers believe that the index is a useful tool to assess compliance of menus to the MD and help identify the key points that need to be addressed and improved in cafeterias.
- Development of a tool to assess the compliance of canteen menus with the Mediterranean dietPublication . Neto, B.; Ferreira, L.; Rocha, Ada; Viegas, CláudiaThe Mediterranean Diet (MD) is one of the healthiest food patterns associated with important health benefits. Acknowledging this, it’s important to understand how the dietary patterns of the consumers align with the MD. Over time, different authors have formulated several indexes for this purpose. However, current indexes lack standardization, and they only evaluate the quality of the diet of individuals to be used by health professionals and political decision-makers. Although there are indexes to assess the food options at the restaurants, none of them assess the menu compliance with the MD. Due to the importance of food services in the food choices and dietary patterns of the consumers, this research developed an index to assess the alignment of food availability with the MD key points. To address this gap, after reviewing the existing indexes in the literature, the authors created a tool that assesses the degree of compliance of menus with the MD - MedCIn. This index is divided into 4 dimensions, the first one assesses the availability (part A) and variety (part B) of the food/food groups. The second dimension assesses the nutritional quality of the menus based on the nutritional declaration, the third dimension assesses the food portions and culinary options, and the fourth dimension allows the verification of the previous information on site. Although the use of all dimensions allows for a more comprehensive menu evaluation, dimension one can be used as a first approach to MD compliance. The index is meant to be applied in a 4-week cycle, though it can be adapted for each food service. Validation of this tool included construct validity, internal consistency, and inter-rater reliability, all of which returned high values (alpha-Cronbach¼0.88; Cohens Kappa¼0.92). The researchers consider this a reliable tool to easily assess compliance of menus with MD key points, allowing for the identification of issues to be addressed and improved.
- Promoting healthier and sustainable diets: evidence from the interdisciplinary MedDietMenus4CampusPublication . Viegas, Cláudia; Rocha, Ada; Prada, MaríliaFood service comprises the production of meals consumed outside the home, including consumers from all age groups and in different sectors. This service sector has evolved through the years, providing an increasing number of meals, which have been drifting away from the Mediterranean Food Pattern. Food service is an important setting for public health interventions, educating consumers, and modulating behaviors through the meals provided. Prior research on eating habits has mainly focused on a single stakeholder - typically consumers - and on a narrow set of outcome variables. Although these studies provide important clues about the determinants of adherence to food offers, research has yet to address this issue using an integrative approach of multiple stakeholders (e.g., the consumers, food providers, and decisors) across a set of different variables. Also, intervention initiatives, usually act only on the environment without strategies that efficiently engage all the stakeholders involved. In contrast, to promote behavioral change this research will focus on Social Marketing as it has been acknowledged as an effective strategy to enhance the health and well-being of consumers. Establishing and managing long-term partnerships that include different groups of stakeholders - consumers, government, retailers, and other players - are key elements in the application of mid and upstream social marketing to complex issues. The project’s main ambition is to change the food service paradigm, by creating and implementing a new healthy and sustainable food service concept complying with the Mediterranean diet, as well as solutions that comply with consumers’ new needs, and also developing and implementing strategies that engage all the stakeholders with this concept. We expect to create the reference in terms of food offer that will be demanded by consumers of the next generations and the standpoint to inspire the other food service sectors/ settings to achieve an effective and sustainable food offer change and positively influence food service consumers’ food patterns towards Mediterranean recommendations. In this workshop, the findings of the project will be presented focusing on examining the barriers and facilitators of adherence to the Mediterranean Diet in the menus offered in public high education institutes canteens in Portugal, Turkey, and Croatia. To promote the identification of effective intervention pathways, we take on an interdisciplinary approach, integrating the theoretical and methodological frameworks of Nutrition, Psychology, and Marketing.
- Food skills among the academic community of a Lisbon institute and their relation with Mediterranean diet adherencePublication . Mateus, Cátia; Carvalho, Patrícia; Borrego, Rute; Gouveia, Raquel; Costa, Vânia; Viegas, CláudiaHealthier eating habits are associated with a higher level of food and cooking skills (FCSk). The Mediterranean Diet (MD) is one of the healthiest diets in the world and it is defined by the high intake of plant-based foods and the habits it promotes. Among these, are cooking skills (CSk), a component of FCSk. Only 26% of the Portuguese (PT) population have a high MD adherence (MDA). This study aims to evaluate the level of FCSk among the academic community and to determine the existence of a correlation between FCSk level and MD adherence.
- MedDietMenus4Campus: integrating views from nutrition, marketing and psychology to improve dietsPublication . Viegas, Cláudia; Rocha, AdaFood service is an important setting for public health interventions, educating consumers, and modulating behaviors through the meals provided. Social Marketing is one of the strategies designed to promote behavior change, in which contributions to the health and well-being of consumers are widely recognized. This project aims to identify the compliance of food service menus with the Mediterranean Diet (MD) in public high education institutes (HEI) canteens, pinpointing opportunities to intervene, namely: 1) promoting changes in the food offer addressing proximity to the MD, creating, and offering plant-based meals, with seasonable and local food products and 2) developing tailored social marketing strategies to engage stakeholders to encourage healthier and sustainable food habits. It gathers a team comprised of nutrition experts on public health and food service, food technologists, gastronomy experts, psychologists, and marketers. To achieve the objectives researchers will: 1) develop an index to evaluate compliance of menus with the MD; 2) define priority stakeholders and define a methodology for engagement; 3) evaluate perceptions, barriers, and facilitators; 4) develop a meal plan framework; 5) develop a new food concept “student bag” (meal on the go) and test it for industry scale-up; 6) use previous diagnosis to develop social marketing strategies directed to stakeholders and consumers to achieve food behavior change and 7) measure the impacts of the implemented strategies. This research intends to create and implement a new healthy and sustainable food service concept, expecting to define the standpoint to inspire other food service settings to achieve an effective and sustainable food offer change and positively influence food service consumers’ food patterns towards Mediterranean recommendations, while addressing the Sustainable Development Goals (3 - good health and 12 - responsible consumption and production; 17 - partnerships for the goals).
- Strategies for increased adherence to the Mediterranean or healthy diet in university food services: a systematic reviewPublication . Silva, Sofia Sousa; Rocha, Ada; Viegas, CláudiaThe Mediterranean diet (MD) has been recognised as a healthy and sustainable diet model. Despite this, current eating habits diverge significantly from established dietary recommendations, namely the MD among young university students. The eating habits of young people are characterised by a high consumption of energy-dense foods and a low consumption of vegetables and fruit. Thus, university canteen food services are essential in promoting a healthy and sustainable diet. This systematic review aimed to identify the strategies for promoting adherence to the MD and healthy diets in Higher Education food service. This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Of the 39 studies that were retrieved, all focused on strategies to improve healthy eating, and none specifically used the term "Mediterranean". Studies were conducted in different countries worldwide. Architectural nudges, discounts on healthy food and nutritional information were identified as successful strategies, especially among females and students with higher nutrition education. A combination of nudging strategies in food service is a promising way to promote healthier food habits.