An evaluation of food sustainability knowledge and attitudes toward the EAT-lancet dietary pattern among Turkish adults

Sustainable nutrition has gained increasing importance in recent years, with the aim of reducing environmental impacts and creating positive health outcomes. The EAT-Lancet diet index is a tool used to define healthy and environmentally sustainable diets. The aim of this study is to evaluate food sustainability knowledge and attitudes toward the EAT-Lancet dietary pattern among Turkish adults. The study included 3446 individuals aged 19 to 65 years, employed in various occupations. This cross-sectional study collected data using a demographic questionnaire and the Food Sustainability Knowledge and Attitudes Questionnaire. A Food Frequency Questionnaire was administered to calculate the EAT-Lancet index. The EAT-Lancet index is based on the frequency of food consumption across 14 components, with scores ranging from 0 (low adherence) to 3 (high adherence), and the total score (0 to 42) is divided into four quartiles (Q1 to Q4), representing increasing levels of adherence. Statistical analysis was performed using SPSS 24. No significant difference was observed in participants’ EAT-Lancet index scores based on their belief regarding whether a sustainable diet is equivalent to a healthy diet ( p = 0.240). However, individuals who perceived animal-based foods such as meat, milk, and eggs as environmentally harmful had notably higher EAT-Lancet index scores ( p < 0.05 for all comparisons). The mean EAT-Lancet index score among all participants was calculated as 23.41 ± 3.61. A very weak yet statistically significant positive correlation emerged between the willingness to pay more for sustainably sourced foods and EAT-Lancet index adherence, whereas no meaningful relationship was found between the index scores and participants’ sustainability-related knowledge or attitudes. Regression analysis revealed that marital status, alcohol use, presence of chronic conditions, and body mass index (BMI) were significantly linked to adherence levels to the EAT-Lancet dietary pattern. This study highlights that adherence to the EAT-Lancet diet among Turkish adults is shaped by a combination of knowledge, attitudes, and specific sociodemographic and lifestyle factors. While traditional demographic variables like age, sex, and education were not significant, factors such as marital status, BMI, chronic disease status, and environmental awareness showed meaningful associations. gov ID: NCT06941051-04/16/2025