Abstract

Background

Revealing motivations in food choice and investigating the potential role of sustainable healthy eating behavior, ecological footprint awareness and food security in food choice are important points for a sustainable life. This study was conducted with 5285 adults aged 19鈥�65 residing in Turkey to investigate their food choice motivations in terms of sustainable and healthy eating behavior, ecological footprint awareness, and the food insecurity perspective.

Methods

In this context, the Food Choice Questionnaire, the Sustainable and Healthy Eating Behaviors Scale, the Awareness Scale for Reducing Ecological Footprint and the Household Food Insecurity Access Scale were used. Pearson correlation analysis was used to examine relationships between scales. The effects of sustainable and healthy eating behaviors, ecological footprint awareness, and household food insecurity on food choice motivations were examined via path analysis.

Results

A moderate positive (r鈥�=鈥�0.47, p鈥�<鈥�0.05) relationship was found between the participants鈥� awareness levels of sustainable and healthy eating behaviors and reducing the ecological footprint. A weak negative (r=-0.22, p鈥�<鈥�0.05) relationship was found between their awareness levels of ecological footprint reduction and household food insecurity, and a weak negative (r=-0.16, p鈥�<鈥�0.05) relationship was found between sustainable and healthy eating behaviors and household food insecurity. The explanatory power of ecological footprint awareness, sustainable and healthy eating behaviors, and household food insecurity for food choices was 27.2%. It was observed that ecological footprint awareness (尾鈥�=鈥�0.21, p鈥�<鈥�0.05) and sustainable and healthy eating behaviors (尾鈥�=鈥�0.38, p鈥�<鈥�0.05) significantly and positively affected food choices.

Conclusions

The variables influencing food choices the most were sustainable and healthy eating behavior, ecological footprint awareness, and household food insecurity. Although there are various data in the literature on the multiple factors that determine food choices, a consensus on the effectiveness of these factors has yet to be reached. A comprehensive examination of this issue, including all the components, is needed.

Background

The World Health Organization (WHO) and the Food and Agriculture Organization (FAO) define sustainable healthy nutrition as 鈥渁 form of nutrition that aims to ensure a healthy life, provides food and nutrition security, and can be passed on to future generations with a low environmental impact鈥� [1]. Sustainable and healthy eating is a multifaceted concept. In addition to engaging in ecological behaviors such as avoiding food waste and consuming local and seasonal foods, it also encompasses animal welfare, healthy and balanced eating, consuming low-fat foods, and reducing meat consumption, all of which are related to healthy eating [2]. Sustainable diets refer to dietary patterns that are protective, respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically just and affordable, nutritionally adequate, safe, healthy, and optimized for natural and human resources [3].

The Committee on Economic, Social, and Cultural Rights of the United Nations defines the right to food as 鈥渢he ability to access food in sufficient quantity and quality, free from harmful elements, produced in an acceptable and sustainable manner, and without hindering the enjoyment of other human rights鈥� [4]. Food security concerns sustainable concepts that meet the needs of current and future generations, depending on environmental and socioeconomic dimensions [5]. The 鈥�2030 Agenda for Sustainable Development,鈥� adopted at the United Nations Sustainable Development Summit, includes goals related to promoting sustainable and healthy nutrition and ensuring global food security [6]. Sustainable nutrition and food security are closely related and should be considered together [4, 7].

Dietary choices affect both human health and the environment. Current dietary patterns are associated with various sustainability concerns, such as environmental and animal welfare concerns and ethical considerations. Food choices are an important factor in dietary sustainability. Therefore, gaining insight into consumer food choices is crucial to achieving sustainability goals [8]. The environmental consequences and scope of the sustainability of various dietary patterns vary. Compared with animal-based protein sources, the production of plant-based protein sources requires less land, water, and energy and results in lower greenhouse gas emissions. The current food system is responsible for 20鈥�30% of anthropogenic greenhouse gas emissions that contribute to climate change and cause various environmental issues, such as biodiversity loss, deforestation, and land-use changes [9]. A plant-based diet has a lower ecological footprint. The ecological benefits arise from the entire food chain system, including production, processing, distribution, cooking, and consumption. Preference for plant-based, regional, seasonal (and organic) foods helps protect biodiversity, conserve the environment, and sustain local economies [10]. Western and high-protein diets have been found to have high environmental footprints, whereas the Mediterranean diet has lower water usage and greenhouse gas emissions [11]. Since the world population is expected to reach 10 billion in the next 25 years and environmental pressure from the food system is projected to increase by 50鈥�92%, modifying the current food system to be more environmentally friendly and healthier for both the planet and human health is necessary [12, 13].

To achieve sustainable and healthy nutrition, it is necessary to analyze consumer behaviors [14]. Food choice is associated with climate change, as it affects the supply-demand balance of food production and the type and quantity of food waste and serves as a symbolic expression of concern for human and planetary health [15]. Individual food choice can accelerate societal movements. Individuals adopting and supporting food choice behaviors aimed at reducing climate change can influence others鈥� behavior, creating a social impact [15]. Identifying factors that influence food choice in communities is a crucial step in developing food systems that benefit human and planetary health and designing and implementing effective and sustainable programs and policies [15]. Sustainable food consumption patterns not only have beneficial effects on human health but can also positively affect the impact of human factors on the environment. This has led to a healthier diet and the consumption of culturally appropriate and nutritious local, seasonal foods, helping to reverse the global health crisis. It has the potential for sustainability for present and future generations without endangering the natural environment or the security of food resources. Therefore, sustainable healthy eating behaviors, ecological footprint awareness and food security can be closely linked to food choices [16]. Understanding food choices is the key to achieving sustainable living. It is possible to manage this process by understanding food choices. Understanding food choice motivations enables the ability to manage and change positive or negative dietary patterns that affect sustainable living. Although studies on sustainable healthy eating behaviors, food security, food choices, and ecological footprint awareness exist in the literature, to the best of our knowledge, no study has examined the combined impact of these factors on food choices. The purpose of this study is to investigate the impacts of sustainable and healthy eating behavior, food security, and ecological footprint awareness on food choice motivations.

Methods

Research sample and design

This study was conducted between June 2023 and September 2023 with 5,285 adults aged between 19 and 65 years who reside in Turkey and who voluntarily agreed to participate via a voluntary sampling method. The requirements for participation were being within the specified age range (19鈥�65 years), not having any chronic health conditions or psychological disorders, agreeing to participate, and not following any special diet or nutrition regimen. Individuals who were pregnant, breastfeeding, outside the age limits, or followed a special diet were excluded from the study. Since food choice motivations were examined in a healthy population, individuals with health problems and special diets that could affect food choice were not included in the study. It was deemed appropriate to exclude these individuals from the study because they may have greater health motivations and be more conscious of sustainable healthy eating behaviors. This study is a voluntary sampling study. In this method, individuals who agreed to participate in the research were included in the study. The participants were included in the study on a voluntary basis through open calls made through online platforms (Facebook, Instagram, WhatsApp, etc.). The participants who volunteered were informed about the study鈥檚 aim and scope via an online written statement, and their consent was obtained. Data collection tools were uploaded to the Google survey system, survey links were shared on social media platforms to provide wide access online, and the participants answered the online questionnaire through Google Forms. The study protocol was approved by the Istanbul Medipol University Non-Interventional Clinical Research Ethics Committee with decision number 521 on June 8, 2023, and conducted according to the ethical principles of the World Medical Association Declaration of Helsinki.

Data collection

Data were obtained on the basis of participants鈥� self-reports. The online survey form consisted of five sections and included questions on participants鈥� sociodemographic characteristics (age, sex, marital and educational status, profession, region of residence, and anthropometric measurements such as height and weight). It also includes four main scales: the Sustainable and Healthy Eating Behaviors Scale, the Household Food Insecurity Access Scale, the Food Choice Questionnaire, and the Awareness Scale for Reducing the Ecological Footprint.

Assessment of food choice

The Food Choice Questionnaire developed by Steptoe et al. [17] and adapted to Turkish by Dikmen et al. [18] with verified reliability and validity (Cronbach鈥檚 alpha鈥�=鈥�0.90) was applied. The scale consists of nine subcomponents (health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concerns) and 36 items. The health and mood subcomponents include six items, five convenience items, four sensory appeal items, and three other subcomponents. The items are rated on a four-point Likert scale (1鈥�=鈥塶ot important at all to 4鈥�=鈥塿ery important). The score for each subcomponent is calculated by averaging the scores of the relevant questions, whereas the total scale score is calculated by averaging the scores of all subcomponents [18].

Assessment of sustainable and healthy eating behaviors

To assess sustainable and healthy eating behaviors, the Sustainable and Healthy Eating Behavior Scale developed by 呕akowska-Biemans et al. [14] and the Turkish adaptation, validity and reliability study were conducted by K枚ksal et al. [19]. The scale consists of 32 items and 7 factors (healthy and balanced diet, local food and low fat, quality labels, seasonal food and avoiding food waste, meat reduction, and animal welfare), and each item is rated on a 7-point Likert scale from 1 to 7 (never to always). The score for each factor is calculated by averaging the scores of the relevant questions (ranging from 1 to 7), whereas the total scale score is calculated by averaging the scores of all factors (ranging from 1 to 7) [19]. Higher scores on the total scale and subcomponents indicate more sustainable and healthy eating behaviors [19].

Assessment of awareness in reducing the ecological footprint

The Awareness Scale for Reducing the Ecological Footprint, developed by Tekindal et al. [20] and validated in Turkish (Cronbach鈥檚 alpha鈥�=鈥�0.96), was used. The scale consists of six dimensions, including energy, recycling, transportation, water consumption, food, and legislation, and 30 items. The energy subcomponent consists of eight items, while the legislation, water consumption, and food subcomponents each consist of four items, and the recycling and transportation subcomponents each consist of five items. Each item is rated on a five-point Likert scale (strongly disagree to strongly agree), and the score for each subcomponent is calculated by averaging the relevant items. The total score is obtained by averaging the subcomponents. Higher total and subcomponent scores indicate greater awareness of reducing the ecological footprint [20].

Assessment of household food insecurity

The Household Food Insecurity Access Scale (HFIAS), developed by Coates et al. [21] and adapted to Turkish by Bor [22] with validated reliability and validity (Cronbach鈥檚 alpha鈥�=鈥�0.87), was used. The scale measures the degree of food insecurity in the household over the past four weeks through 18 questions. Each occurrence question has two answers (0鈥�=鈥塶o, 1鈥�=鈥墆es), whereas the frequency question (1鈥�=鈥塺arely, 2鈥�=鈥塻ometimes, 3鈥�=鈥塷ften) has three options. If the participant answers 鈥渘o鈥� to an occurrence question, they skip the corresponding frequency question and proceed to the next occurrence question. The HFIAS score is calculated by summing the scores of the frequency questions. The lowest possible score is 0, and the highest is 27. A higher HFIAS score indicates more severe food insecurity in the household [21, 22].

Data analysis

Data analysis was performed via the Statistical Package for the Social Sciences (SPSS) 26.0. Descriptive statistics for categorical variables are presented as frequencies and percentages, whereas numerical variables are presented as the means and standard deviations for normally distributed data and as medians and interquartile ranges (IQRs) for nonnormally distributed data. Chi-square tests and independent t tests were used for binary group comparisons. Pearson correlation analysis was used to examine relationships between scales. The correlation coefficient was interpreted as follows: 0.00鈥�0.30 (low), 0.30鈥�0.70 (moderate), and 0.70鈥�1.00 (high). The effects of sustainable and healthy eating behaviors, ecological footprint awareness, and household food insecurity on food choice were examined via path analysis in AMOS 24. A statistical significance level of p鈥�<鈥�0.05 was set.

Results

The general characteristics of the participants are presented in Table 1. The mean age of the participants in the study was 27.9鈥壜扁��10.99 years (n鈥�=鈥�5285), with the majority (67.3%) being women and unmarried (69.5%). When examining income levels, 41.2% of the participants reported earning below the minimum wage, whereas 40.8% reported earning above it. A significant majority of the participants (72.7%) had education levels at the undergraduate or postgraduate level. 45% of the participants were students, 42% of whom lived in the city in Central Anatolia and 20% of whom lived in the city in the Mediterranean region.

Table 1 General characteristics of the participants

The participants鈥� food choices, sustainable and healthy eating behavior, household food insecurity, and awareness of reducing the ecological footprint are shown in Table 2. The total score for food choice was 2.7鈥壜扁��0.62, the total score for sustainable and healthy eating behavior was 4.0鈥壜扁��1.29, the total score for the HFIAS was 6.1鈥壜扁��6.22, and the total score for the Ecological Footprint Awareness Scale was 3.6鈥壜扁��0.94. Sensory appeal was the leading motivation for food choice (score鈥�=鈥�3.0), followed by price and mood (both scores of 2.8). All scale scores, except for the total HFIAS, animal welfare, local food, price and familiarity scores for women, were significantly higher for women than for men (p鈥�&濒迟;鈥�0.05).

Table 2 Participants鈥� awareness of reducing their ecological footprint, sustainable and healthy eating behavior, household food insecurity and food choices

The relationships among food choices, sustainable and healthy eating behavior, and awareness of reducing the ecological footprint are presented in Table 3. A positive and significant relationship was found between food choices and sustainable and healthy eating behavior (r鈥�=鈥�0.483) and awareness of reducing the ecological footprint (r鈥�=鈥�0.397) (p鈥�&濒迟;鈥�0.001). When evaluated in terms of subcomponents, a significant relationship was observed in all subdimensions. A negative and significant relationship was found between food choices and the HFIAS (r=鈭�0.13, p鈥�&濒迟;鈥�0.001).

Table 3 The relationship between food choices and sustainable and healthy eating behavior awareness of reducing the ecological footprint and household

A diagram showing the path analysis results, the effects of sustainable and healthy eating behavior, awareness of reducing the ecological footprint, and household food insecurity on food choices is shown in Fig. 1. Figure 1 presents the correlation results between sustainable and healthy eating behavior, awareness of reducing the ecological footprint, and household food insecurity. According to these data, a weak negative relationship (r鈥�=鈥�0.22) was found between participants鈥� awareness of reducing the ecological footprint and household food insecurity, and a weak negative relationship (r鈥�=鈥�0.16) was found between participants鈥� sustainable and healthy eating behaviors and household food insecurity. Additionally, a moderate positive relationship (r鈥�=鈥�0.47) was found between participants鈥� sustainable and healthy eating behaviors and their awareness of reducing the ecological footprint.

Fig. 1

Diagram showing the path analysis results of the variables. Two-way arrows represent the correlation (r) between the scales, and the one-way arrows represent the standardized beta coefficients (尾). The term 鈥渆鈥� represents the margin of error, whereas the number in the dependent variable represents the explanatory variance of the independent variables in the dependent variable

The path analysis results examining the effects of participants鈥� sustainable and healthy eating behavior, ecological footprint awareness, and household food insecurity on food choice motivations are presented in Table 4. In line with these results, the rate of explaining food choice motivations by awareness of reducing the ecological footprint, sustainable and healthy eating behavior, and household food insecurity was 27.2%. The participants鈥� awareness of reducing the ecological footprint (尾鈥�=鈥�0.21, p鈥�<鈥�0.05) and sustainable and healthy eating behaviors (尾鈥�=鈥�0.38; p鈥�<鈥�0.05) significantly and positively affected their food choice motivations. The participants鈥� household food insecurity levels were found to significantly and negatively affect their food choice motivations (尾=鈭�0.02, p鈥�&濒迟;鈥�0.05). When standardized beta coefficients were examined, the variables that influenced the participants鈥� food choices at the maximum level were sustainable and healthy eating behavior, awareness of ecological footprint reduction, and household food insecurity.

Table 4 Pathway analysis results examining the effects of sustainable and healthy eating behavior, ecological footprint awareness and household food insecurity on participants鈥� food choices

Discussion

Evaluating the ecological footprint provides information on the resources consumed and the waste produced, as well as the requirements for producing necessities and eliminating existing waste. The ecological footprint explains the impact and demands created by individuals鈥� consumption habits in nature and their usage beyond these needs [23]. Several studies have reported that the concept of the ecological footprint is an interesting tool that influences consumption preferences [23,24,25]. Awareness of the environmental impacts of food production and consumption is insufficient [26]. Recently, the environmental footprint of food has gained increasing attention in EAT-Lancet reports [27]. However, information does not always translate into behavior, and even with a basic understanding of the environmental impact of food, various factors, such as high prices, taste expectations, and limited food accessibility, can prevent consumers from purchasing environmentally friendly options [25]. In a study on adult food preferences (n鈥�=鈥�40), participants who scored higher on the ecological knowledge scale created more environmentally friendly menus during a meal experiment than those who scored lower [25]. Similarly, another study (n鈥�=鈥�585) reported that environmental factors and health were the strongest factors determining the food choices of Italian consumers [28]. A recent study investigating food choice and the carbon footprint among young adults (n鈥�=鈥�47) revealed that all participants were climate conscious in their food consumption practices and were conscious of the environmental impact of different food choices. Their knowledge that foods contribute to a high or low carbon footprint also highlights their awareness of the environmental consequences of their dietary decisions [29]. Another study in young adults (n鈥�=鈥�1333) revealed that following a Mediterranean diet was associated with more sustainable and healthy dietary behaviors and greater awareness of reducing the ecological footprint [30]. In our study, a moderate positive relationship (r鈥�=鈥�0.47) was found between participants鈥� sustainable and healthy eating behaviors and their awareness of reducing the ecological footprint, and awareness of reducing the ecological footprint had a significant and positive effect on food choice motivations (尾鈥�=鈥�0.21, p鈥�&濒迟;鈥�0.05). This confirms that as environmental awareness increases, food choice motivations are also affected. The young age and high education level of the population might have influenced these results. Since participation in our study was provided on a voluntary basis, the sample aimed to represent the adult population in Turkey, but it was accepted that there may be limitations in representation due to the sampling method. Owing to the limitations inherent in the study, this topic needs to be investigated in depth, covering all age groups called adults and taking into account the level of education. Because the evaluation was performed on the basis of self-reports and food choices were not assessed experimentally, these results need to be investigated in more detail. When various intervention-based randomized controlled studies are evaluated, experimental studies yield clearer results in influencing food choices [31,32,33,34]. Despite these limitations, the strength of our study is its large sample size. It can be concluded that ecological footprint awareness and sustainability concepts may affect food choice. However, food choice should be considered together with more than one factor. There are several recommendations to guide future ecologically based food choice practices. It has been suggested that sustainability-themed food labels may encourage young adults to prepare more sustainable meals with lower carbon and water footprints. Ecological labels are thought to trigger environmentally friendly decision-making options in food choices and may also be important in guiding individuals to consider the sustainability of their food choices [35]. In addition, designing and implementing programs that support the development of food literacy, starting in early childhood and covering the whole society, can contribute to the development of healthier and sustainable eating habits [36].

In our study, the explanatory power of ecological footprint awareness, sustainable and healthy eating behaviors, and household food insecurity for food choices was 27.2%. Food choices are manipulated by numerous stimuli, and the existing choices are shaped by the characteristics of nutrition (taste, calorie content, naturalness, healthiness, etc.), the individual鈥檚 current psychological state (hunger-satiety level), and the memories related to consuming such food in the past (pleasure, disgust, or nausea) [37]. Food choices are affected by a combination of various factors, including biological determinants (e.g., appetite and taste), physiological determinants, social determinants (e.g., culture), psychological determinants (e.g., stress and mood), and economic determinants (e.g., cost and income). Attitudes, beliefs and knowledge toward food also have an effect on food choices [28]. It is suggested that food choices are made on the basis of abstract and basic food-related characteristics. Two particularly prominent traits are reflective and impulsive. It has been suggested that food choices are shaped on the basis of whether the decision is made according to information and values (healthiness, environmental friendliness, or other abstract qualities) or motivational orientations (rewarding factors such as taste, flavor, or other fundamental qualities) [38]. Both food choices and the characteristics of sustainable diets depend on various factors, such as sociodemographic and economic status, attitudes, norms, culture, and beliefs [39]. Understanding the sustainability motivations underlying food choices is still difficult [8]. However, it has been suggested that adopting a sustainable diet is directly linked to individuals鈥� motivations for sustainable food choices, as these motivations lie at the root of dietary behavior [8]. In a study conducted with a young population (mean age 23.21 years, n鈥�=鈥�467), a standardized regression analysis revealed a positive and significant relationship between the food choice scale score and the level of knowledge of sustainable nutrition (B鈥�=鈥�0.45, p鈥�<鈥�0.01) and between the food choice scale score and sustainable and healthy eating behaviors (B鈥�=鈥�0.54, p鈥�<鈥�0.01) [8]. Conversely, another study with a small sample size (n鈥�=鈥�33) reported that only a small portion of the components defined in the field of sustainable nutrition were effective in terms of participants鈥� food choices [40]. In another study (n鈥�=鈥�450), the mediating effect of environmental concerns on food choices was investigated, and it was found that environmental knowledge and environmental concerns positively and significantly improved environmentally responsible food choices [41]. In a study in Turkey, a high level of sustainable nutrition knowledge and environmentally friendly food choices were found to be associated with compliance with the Mediterranean diet (1 unit increase, 0.125 and 0.148 points increase, respectively, p鈥�<鈥�0.005) [42]. This research also revealed that sustainable and healthy eating behaviors (尾鈥�=鈥�0.38; p鈥�<鈥�0.05) significantly and positively affected food choices. It has been reported that individuals who are more concerned about the environmental impact of their behavior choose sustainable foods [43]. A sustainable or healthy diet has gained an important place in society through sociocultural changes, food movements, and traditional cuisines. The various food movements adopted by society include a range of movements in the production, purchase, and use of food and are based on multiple social values. Some values 鈥嬧�媏ncompass ethical and moral reasons that create a strong emotional bond with consumers. Food movements come to the forefront by supporting collective identities and creating shared emotional experiences. In Western countries, progressive food movements aim to promote sustainable healthy diets. This movement may use multiple values, 鈥嬧�媠uch as sensory pleasure, naturalness, origin, justice, and environmental impact [44].

A study investigating the determinants of sustainable food consumption in ecological, social, economic, and health terms revealed that in terms of sustainable food consumption, ecological aspects were the most important, followed by economic and social aspects [45]. It is suggested that price is the main determinant of food choice for a population with low income or education [46, 47]. Another study reported that the most important dimensions of food choice are sensory appeal, price, and mood [48]. It is suggested that individuals鈥� preferences when purchasing food depend on access to reliable information about the cost and benefits of the food [49]. There is a relationship between food accessibility and nutrition practices [50]. Economic factors such as prices and income affect food choices and food security, as well as access to and availability of food [51]. It has been reported that economic motivations significantly influence food choices and behaviors related to food consumption [52]. The increase in the price of food products particularly complicates access to food products for low-income households [53]. In our study, the level of household food insecurity significantly and negatively affected food choices (尾=鈭�0.02, p鈥�<鈥�0.05), and the variables that most influenced food choices were sustainable and healthy eating behavior, awareness of reducing the ecological footprint, and household food insecurity. Although food security is an important determinant of food choices, important steps need to be taken to ensure that food choices are environmentally friendly and health-supporting. Sustainable development, which targets a sustainable environment, sustainable economy and sustainable sociality, also includes policies aimed at ensuring food security and sufficient food. It is important to create and implement policies on a national basis to ensure sustainable development. Within the scope of sustainable development, training should be provided on sustainable food production, food safety and food choices, and all food producers, from local to global, should be encouraged to produce in an environmentally friendly manner [54]. Consumers should be informed and made aware that food consumption and food security should be ensured. Policies should be developed, and public education activities should be carried out to ensure healthy, sustainable and environmentally friendly food choices.

Conclusion

These findings suggest that in addition to food insecurity, both sustainable eating behaviors and ecological footprint awareness significantly influence food choices. In addition to providing new insights into the relationship between ecological footprint awareness and food choices, this research can also guide future policies by drawing attention to sustainable development concepts (ecological footprint awareness, sustainable healthy dietary behaviors, food security) in food choices. There is a need for a more detailed examination of the role of multiple factors in food choice. Experimental food preference studies reveal the cause鈥抏ffect relationship and reveal whether the mentioned factors are effective. In this context, conducting high-sample experimental food choice studies will be important in shedding light on this issue.