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This study aimed to evaluate the knowledge and attitudes of Turkish adults toward food sustainability and assess their adherence to the EAT-Lancet dietary pattern. A cross-sectional study was conducted among 3,446 adults aged 19-65 in Türkiye. Data were collected using a demographic questionnaire, the Food Sustainability Knowledge and Attitudes Questionnaire (FSKAQ), and a food frequency questionnaire to calculate EAT-Lancet index scores. Statistical analyses included Kruskal-Wallis tests, chi-square tests, and multinomial logistic regression.
Objective:
This study aimed to evaluate the knowledge and attitudes of Turkish adults regarding food sustainability and to assess their level of adherence to the EAT-Lancet dietary pattern, a model developed to promote both human health and environmental sustainability.
Methods:
A descriptive, cross-sectional study was conducted across Türkiye with a sample of 3,446 individuals aged between 19 and 65 years. Participants were recruited through voluntary participation, and individuals with chronic illnesses, alcohol or substance dependency, or illiteracy were excluded. Data were collected using a structured questionnaire that included demographic variables (e.g., age, gender, marital status, income, physical activity), anthropometric measurements (height and weight), and dietary intake.
Participants' knowledge and attitudes toward food sustainability were assessed using the Food Sustainability Knowledge and Attitudes Questionnaire (FSKAQ), which has been validated in Turkish. This instrument consists of four sub-dimensions addressing different aspects of sustainability knowledge and attitudes but does not yield a total score. Each sub-dimension is evaluated individually.
Dietary intake was assessed using a food frequency questionnaire (FFQ), and adherence to the EAT-Lancet dietary pattern was calculated using the EAT-Lancet index. This index includes 14 food components categorized as "emphasized" or "restricted" foods and assigns scores from 0 to 3 for each, with higher total scores indicating greater adherence. Final scores were divided into quartiles (Q1-Q4) to classify adherence levels.
All statistical analyses were conducted using SPSS 26.0. Descriptive statistics were used to summarize participant characteristics. The Kruskal-Wallis H test and chi-square tests were used for group comparisons, and multinomial logistic regression was applied to identify factors associated with higher EAT-Lancet index adherence. A significance level of p < 0.05 was considered statistically significant.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Health adults | Group/Cohort Description: The study included 3446 individuals aged 19-65. Data were collected using a demographic survey and Food Sustainability Knowledge and Attitudes Questionnaire. Food Consumption Frequency was used to calculate the EAT lancet index. |
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| Measure | Description | Time Frame |
|---|---|---|
| Food Sustainability Knowledge and Attitudes Questionnaire | This scale was designed to assess participants' knowledge and attitudes toward sustainable nutrition and consists of a total of 7 questions (5 related to knowledge and 2 to attitudes). The scale includes four sub-dimensions: Knowledge of Sustainability and Sustainable Nutrition (9 items), Knowledge of Statements Defining a Sustainable Diet (12 items), Knowledge of Planetary Health and Sustainability (10 items), and Attitudes Toward Sustainable Nutrition (2 items). The scale does not yield a total score; only specific sub-dimensions are scored independently. The "Knowledge of Statements Defining a Sustainable Diet" sub-dimension, designed in Likert type, is scored item by item. In the "Knowledge of Planetary Health and Sustainability" dimension, only the second section is scored. In the "Attitudes Toward Sustainable Nutrition" sub-dimension, each of the two items is scored separately. The remaining questions are not scored. | Baseline |
| EAT-Lancet Index | EAT-Lancet Index: The EAT-Lancet Index evaluates adherence to a sustainable and healthy diet through 14 food components, categorized as either "restricted" (e.g., red meat, poultry, eggs, added sugars) or "emphasized" (e.g., fruits, vegetables, legumes, whole grains, nuts, fish). Intakes are assessed in grams per day (uncooked weight). Each component is scored from 0 (low adherence) to 3 (high adherence), with a total possible score ranging from 0 to 42. Scores were divided into quartiles (Q1-Q4) to indicate adherence levels. Food frequency questionnaire data were used for calculation. | Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Food Consumption Frequency | It was used to determine how often and how much of food groups or nutrients were consumed. Consumption frequency was given as day, month or week. Food groups include milk and dairy products, meat-egg-legumes, vegetables and fruits, grains and oilseeds. Participants were asked how often they consumed which food (everyday, 5-6 times a week, 3-4 times a week, 1-2 times a week, 1 time in 15 days, 1 time in a month, 1 time in 3 months, 1 time in 6 months, never) and used for EAT lancet index calculation. |
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Inclusion Criteria:
Exclusion Criteria:
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Community sample in Türkiye
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Yıldırım Beyazıt University | Ankara | Ankara | 06760 | Turkey (Türkiye) |
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| Baseline |
| Sociodemographic characteristics | Sociodemographic characteristics will be assessed using a structured questionnaire developed by the researchers. The questionnaire will include items measuring age, gender, education level, and income status. The results will be presented as numbers and percentages for each characteristic. | Baseline |