Sustainable-psycho-nutritional intervention programme for a sustainable diet (the ‘NutriSOS’ study) and its effects on eating behaviour, diet quality, nutritional status, physical activity, metabolic biomarkers, gut microbiota and water and carbon footprints in Mexican population: study protocol of an mHealth randomised controlled trial

Abstract

Mexico is going through an environmental and nutritional crisis related to unsustainable dietary behaviors. Sustainable diets could solve both problems together. This study protocol aims to develop a 3-stages, 15 weeks mHealth randomized controlled trial (RCT) of a sustainable-psycho-nutritional intervention program to promote Mexican population adherence to a sustainable diet and to evaluate its effects on health and environmental outcomes. In stage 1, the program will be designed using the sustainable diets, behavior change wheel, and COM-B models. A sustainable food guide, recipes, meal plans, and a mobile application will be developed. In stage 2, the intervention will be implemented for seven weeks, and a 7-weeks follow-up period in a young Mexican adults (18 to 35 years) sample, randomly divided (1:1 ratio) into a control group (n=50) and an experimental group (n=50), that will be divided in two arms at week 8. Outcomes will include health, nutrition, environment, behavior, and nutritional-sustainable knowledge. Additionally, socioeconomics and culture will be considered. Thirteen behavioral objectives will be included using successive approaches in online workshops twice a week. The population will be monitored using the mobile application consisting of behavioral change techniques. In stage 3, the effects of the intervention will be assessed using mixed-effect models on dietary intake and quality, nutritional status, physical activity, metabolic biomarkers (serum glucose and lipid profile), gut microbiota composition, and dietary water and carbon footprints of the evaluated population. Improvements in health outcomes and a decrease in dietary water and carbon footprints are expected.

Towards the characterisation of sustainable diet’s gut microbiota composition and functions: A narrative review

“…It also comprises protein-rich seeds such as pumpkin seeds, chia, amaranth, and peanuts, and healthy fats like avocado. Fermented drinks, homemade cheese, and insects are also present in that diet (Lares-Michel et al, 2022;Valerino-Perea et al, 2019).…”

“…The sustainability of the Mexican traditional diet has been recently claimed and proposed as an alternative for promoting human and planetary health in specific regions like Mexico, meanwhile promoting cultural and affordable diets (Almaguer Lares-Michel et al, 2022;. Nevertheless, the principal problem regarding recovering traditional diets is to ensure that the population adheres to these kinds of dietary patterns.…”

“…Fortunately, currently an RCT is being performed in Mexico, where a diet is being mathematically optimised to design a healthy, sustainable diet for Mexico's context based on its traditional diet (Lares-Michel et al, 2023). The study will report the effects of this diet on specific bacteria such as Bacillota, Bacteroidota, Lactobacillus, Bifidobacterium, F. prausnitzii, A. muciniphila, P. copri, B. wadsworthia, Clostridium coccoides, and Streptococcus thermophilus.…”

“…The study will report the effects of this diet on specific bacteria such as Bacillota, Bacteroidota, Lactobacillus, Bifidobacterium, F. prausnitzii, A. muciniphila, P. copri, B. wadsworthia, Clostridium coccoides, and Streptococcus thermophilus. Besides, it includes environmental indicators and will cover all sustainable diet dimensions (Lares-Michel et al, 2023). When this research's results are available, the gut microbiota effects of a personalised region-specific sustainable diet could be characterised for the first time.…”

“…This confirms the importance of personalised and precision nutrition. Besides, behavioural elements of individuals must be considered in healthy diet promotion to be considered sustainable dietary patterns (Lares-Michel et al, 2023).…”