Food Sustainability Knowledge and EAT-Lancet Adherence in Turkish Adults

Evaluation of Food Sustainability Knowledge and Attitudes Toward the EAT-Lancet Dietary Pattern Among Turkish Adults

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.

Study Overview

• Status: Completed
• Conditions: Health Adults

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 3446

Contacts and Locations

Study Locations

• Turkey
  • Ankara, Turkey, 06760
    • Ankara Yıldırım Beyazıt University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Community sample in Türkiye

Description

Inclusion Criteria:

• Individuals residing in Türkiye,
• Aged between 19 and 64 years,
• Voluntarily agreed to participate in the study,
• Completed the questionnaire in full,
• Provided complete anthropometric, demographic, and dietary data.

Exclusion Criteria:

• Individuals with alcohol or substance dependence,
• Those diagnosed with chronic diseases (e.g., diabetes, hypertension, cardiovascular disease),
• Illiterate individuals,
• Participants with incomplete questionnaire responses or missing anthropometric or dietary data.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	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

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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
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.	Baseline

Collaborators and Investigators

• Sponsor: Ankara Yildirim Beyazıt University

Study record dates

Study Major Dates

• Study Start (Actual): December 30, 2024
• Primary Completion (Actual): April 1, 2025
• Study Completion (Actual): April 15, 2025

Study Registration Dates

• First Submitted: April 16, 2025
• First Submitted That Met QC Criteria: April 16, 2025
• First Posted (Actual): April 23, 2025

Study Record Updates

• Last Update Posted (Actual): April 23, 2025
• Last Update Submitted That Met QC Criteria: April 16, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: Sustainable nutrition; EAT-Lancet; Food sustainability knowledge
• Other Study ID Numbers: AYBUELİBOL008

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No