Author(s): Morgado, Joana Nazaré
Date: 2024
Persistent ID: http://hdl.handle.net/10400.5/98674
Origin: Repositório da Universidade de Lisboa
Subject(s): Dietas saudáveis e sustentáveis; Avaliação do Impacto os determinantes socioeconómicos; Avaliação do impacto na saúde; Inadequação de nutrientes; Doenças não transmissíveis; Healthy and sustainable diets; Socioeconomic determinants’ assessment; Health impact assessment; Nutrient inadequacy; Non-communicable diseases
Diets high in animal protein have been associated with adverse health effects and are considered environmentally unsustainable. Considering the socio-economic determinants that may influence a dietary change, it was proposed to reduce the adverse impact on human health and the environment by replacing red meat with legumes. This thesis aimed to: (1) investigate the socio-economic determinants of the adult Portuguese population where this dietary change would have a greater impact; (2) and also estimate the potential health impacts of a food substitution through a health impact assessment in this same population. The methodologies used were: hierarchical multiple linear regression and risk-benefit assessment - considering current consumption scenarios and an alternative scenario. Women were observed to have a higher consumption of pulses than men. An older age was also associated to higher consumption of pulses. Moreover, the higher the consumption of pulses the lower the consumption of (unprocessed) red meat. Higher consumptions of unprocessed red meat was higher for younger ages, particularly men. Education and income played a significant role in the transition to more legume-based foods. However, independent of the income, the level of pulses’ intake in the Portuguese population is still below the established one by the “Food Wheel” guidelines for both female and male genders. From the existing barriers to adhere to a higher pulses consumption, food literacy was considered the most important obstacle for a plant-based food transition. Despite this, recent studies at European level have revealed that the price of food is the biggest source of concern for access to healthy and sustainable food. Educational programs (e.g. promoting food literacy) and the systematic study of the relationship between food prices and the different oscillations of the national economy and consumer choices should be considered in the future. The overall health impact of the food substitution was quantified using "disability-adjusted life years" (DALYs). In the adult Portuguese population, about 1845 (95% IU: 2926; 765) DALYs/100,000 could be avoided per year by replacing 100% of unprocessed red meat with pulses (beans and chickpeas). An overall decrease in the consumption of vitamin B12, zinc and selenium was estimated, leading to a higher risk of inadequate consumption in the population. On the other hand, there was an increase in iron consumption and, consequently, a lower risk of its inadequacy in the same population. Thus, it was found that the total replacement of unprocessed red meat with pulses – although it may lead to a higher risk of some nutrients’ inadequacy – would have an overall beneficial impact on health.
