Anthony Fardet

Since 1992, food-based dietary guidelines (FBDGs) have been developed worldwide to help consumers and society on a larger scale make informed food choices for their health. However, the global prevalence of chronic diseases continues to increase, raising questions about the effectiveness of FBDGs in addressing the broader determinants of health, and in promoting sustainable food systems. Therefore, this policy and practice review intends to identify and summarize the main shortcomings of the current FBDGs. The more detailed focus on sustainability and food processing issues showed that these two dimensions are still lacking or insufficiently considered in current FBDGs, hindering the formulation of robust recommendations for protecting global health. Based on this analysis, we propose several paradigms shifts to increase the relevance and coherence of future FBDGs: moving from food pyramids to technological pyramids; shifting from the currently excessive quantitative and food group-based recommendations toward more qualitative and holistic guidance; emphasizing the role of the food matrix rather than isolated nutrients; and integrating sustainability and regenerative agricultural practices more explicitly. The overarching challenge lies in designing FBDGs that adopt a systems-oriented, holistic approach—one that reflects the interconnectedness of human, environmental, and societal wellbeing, and that organizes and hierarchizes nutritional information from broad dietary patterns down to specific nutrients.

A growing standardisation of eating behaviours worldwide is observed, especially in children, notably characterised by the increasing consumption of both unsustainable animal- and plant-based ultra-processed foods (UPFs). The objective of this study was to identify five high-impact eating behaviours (HIBs) in a French child population (living in Clermont-Ferrand city and surroundings, n = 92, aged 6–15), that is, behaviours to change for the strongest positive impact on health and sustainability. For this, both multidisciplinary top-down and participatory bottom-up approaches has been carried out. First, from European and French dietary guidelines, desk research, European researchers’ evaluation, and expert interviews and workshops the technical potential (for their impact on health and environment), plasticity and feasibility of 40 HIB were first quantified (top-down approach). Secondly, in the French living lab (LL), from photo-voice and focus groups with children, online surveys, meetings with families and children, interviews with stakeholders, and assessments of the behavioural change potential of the French LL children’s target, five HIB were finally selected (bottom-up approach). Therefore, among the initial 342 European recommended eating behaviours, the selected HIBs for our specific population were: limiting the consumption of UPFs (notably those high in added salt, sugars and/or fats), eating 0–3 servings of meat/week, eating three servings of legumes/week, choosing primarily wholegrain than refined cereals, and choose water instead of sweetened beverages. These five HIBs constitutes a solid basis to perform next LL participatory actions, notably to test HIB feasibility/plasticity, and implement them in real life conditions through transversal actions with non-researcher.

The ultra‐processed food (UPF) concept first emerged 15 years ago, and is now studied worldwide in different contexts, for example, human health, food behavior, socio‐economic, food consumption, food scoring, and food system sustainability. Briefly, UPFs are defined as containing at least one marker of ultra‐processing (MUP). MUPs are (1) cosmetic additives, (2) aromas, (3) some highly processed carbohydrates, proteins, fats, and/or fiber, and (4) drastic processes directly applied to food such as extrusion cooking or puffing. The first three categories of MUPs are on the food packaging in the list of ingredients, and are extracted, then purified, from raw foods or coming from artificial syntheses, leading to a‐matrix/a‐cellular compounds. Therefore, the core paradigm to define MUP is extreme food matrix degradation , and for UPF, matrix artificialization . Besides, UPFs are more than just junk food, encompassing numerous industrialized foods, falsely presented as healthy, for example, animal‐based food analogs, but also organic, vegan, gluten‐free, micronutrient‐enriched, and/or light foods. In this way, UPFs are “high‐quality junk foods.” Otherwise, UPF being a holistic and indivisible concept by essence, we propose in this review to analyze ultra‐processing at four holistic levels corresponding to four important scientific issues: the food matrix, the dietary pattern, food system, and food scoring. We reached the main conclusion that UPFs should be first studied with a holistic and scientifically based approach, not a reductionist one. Otherwise, we take the risk of performing greenwashing and create still more new health threats at a global level.

Early detection of obesity-promoting dietary behavior patterns improves the identification of at-risk families and the implementation of interventions. This is accomplished through the use of the Child Eating Behavior Questionnaire (CEBQ). No study has been conducted using the CEBQ in children followed in Essonne’s Maternal–Infant Protection (PMI) centers. We investigated, in a cross-sectional design, the differences in children’s eating behavior with PMI follow-up according to their weight status. A questionnaire addressed to parents was collected in PMI centers. Multiple hierarchical regression analysis was used to investigate the predictability of the child’s CEBQ on body mass index (BMI). From January to April 2022, 850 children were selected, from which 500 (aged 1–6 years) were included, and of whom 10.6% were obese. There was a significant positive association between ‘Food Responsiveness’, ‘Enjoyment of Food’ and BMI. In contrast, there was a significant negative association between ‘Satiety Responsiveness’, ‘Slowness in Eating’ and BMI. Besides, ‘Food approach’ and ‘food avoidance’ behaviors were positively and negatively related to BMI z-scores, respectively. Due to significant differences in children’s eating behavior according to their weight, it is needed to raise awareness among parents about their impact on them.

In the agri‐food chain, while the impact of producers and consumers on sustainability has been well studied, food processing has been less explored. This position paper aims to discuss the potential of food processing to address all food and nutrition security (FNS) outcomes in order to achieve improved food system sustainability. First, FNS dimensions and the four pillars of agro‐food industry sustainability are defined, with a focus on ultra‐processed foods. Second, the food matrix concept is developed as a new paradigm to holistically address all FNS. It is concluded that food processing should become more involved in circular food systems and bioeconomy, and that we need to relocate food production, processing, and consumption to be more aligned with regional food production specificities. For this, minimal processing to preserve food matrices should be preferred. Therefore, the strong current tendency to develop reductionist and siloed innovative solutions to improve the sustainability of food systems should be questioned.

The diet of individuals is influenced by social and cultural factors. Children's food tastes and representations, being principally transmitted by their parents, are likely to depend on their social backgrounds. As it is known that parents' feeding strategies and food education differ depending on their social positions, this study aimed at examining how food representations and tastes vary among children. A qualitative sociological study, using semi-structured interviews, was conducted with 40 children, aged from 9 to 11 years, from four French elementary schools. Results showed that children from disadvantaged social backgrounds mentioned less foods, seemed to have a less varied diet, to consume less vegetables, and to enjoy eating ultra-processed foods more than other children. Different food habitus were found, that can be put into perspective using Bourdieu's distinction theory, including different preoccupations regarding health and necessity among social groups. Disparities in children's food habitus could be theoretically linked with observed and growing social inequalities in health, when taking into consideration the potential practises that these habitus imply, and their probable effects on health. Participatory food education classes at school could aim to reduce such disparities, although some concerns and limits must be acknowledged.

The Indian diet is becoming westernized with a potential threat to human health. This ecological study aimed at analyzing the nutritional transition in India during the 1990–2019 period within the framework of the newly developed 3V index, considering the degree of processing starting with industrially processed foods (IPFs, i.e., the Real/’Vrai’ metric 1), plant/animal calorie ratio (i.e., the Vegetal metric 2), and diversity of food intake (i.e., the Varied metric 3). Total and food group (n = 14) caloric intakes, percentages of animal and IPF calories, adequacy to the Indian Recommended Dietary Allowances, and prevalence of chronic diseases were retrieved from web databases (e.g., OECD.Stats, Our World in Data and FAO-STAT) and Indian food composition table. The total calorie intake increased by 31% over thirty years, being mainly linked to increased consumption of dairy products and IPF, but still remains below the average recommended intake in 2019. The IPF and animal calorie shares increased from 3.6 to 11.6% and 15.1 to 24.3%, respectively, while micronutrient intakes improved in 2019. In the same time, prevalence of overweight/obesity and type 2 diabetes, and cardiovascular disease mortality increased. In conclusion, the evolution of the Indian diet deviates from metrics 1 and 2 and improves in metric 3, which may not be a sufficient metric in terms of the alleviation of chronic diseases. Therefore, while improving food diversity and replacing refined with wholegrain cereals, Indians should also curb increasing their consumption of IPF and animal calories.