Adherence to- and factors influencing- healthy and sustainable dietary choices across Europe: a study protocol.

Abstract Background Current food systems in Europe negatively impact the environment, public health, and the public sector, while favoring large food companies, leading to a “Lose-Lose-Lose-Win” scenario. Moreover, food systems have contributed to health inequalities across the EU, perpetuating disparities in access to healthy and sustainable food. Addressing these challenges requires understanding the complex dynamics of food systems which involve a combination of internal mechanisms and external influences. This study, part of the FEAST project (Food systems that support transitions to hEalthy And Sustainable dieTs), aims to inform European policies by investigating individual dietary behaviors focusing on micro-level factors, analyzing geographical, socio-economic, behavioral and cultural influences and dietary preferences across different European regions and vulnerable groups. Methods The study employs a quantitative cross-sectional research design involving 27000 adults (18–85+) from 27 European countries across FEAST’s five food regions (Anglo-Saxon, Central European, Scandinavian, Southern Europe and Eastern Europe). To achieve our target of 27,000 participants we have relied on the services of a market-insights gathering platform, with an extensive reach of panel members across Europe. Data collection utilizes a comprehensive questionnaire of 88 items covering dietary patterns, purchasing behaviors, drivers and barriers of healthy and sustainable eating, the perceived sustainability of dietary behaviors, policy opinions, and socio-demographic details. Statistical analyses will provide insights into factors influencing healthy and sustainable diets. Discussion The study's findings will contribute to understanding individual dietary habits and inform multi-level strategies for promoting healthier and more sustainable food consumption. Our data will provide an overview of the interaction between the final consumer and the food supply chain, shedding light on the nature of the food environments in which the interaction takes place. By providing insights into consumer behaviors and preferences, the research aims to support the creation of 'Win-Win-Win-Win' food systems across Europe that benefit all key stakeholders.