Oecotrophologie · Facility Management (OEF)
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Background: Establishing a healthy lifestyle has a great potential to reduce the prevalence of non-communicable diseases (NCDs) and their risk factors. NCDs contribute immensely to the economic costs of the health care system arising from therapy, medication use, and productivity loss.
Aim: The aim of this study was to evaluate the effect of the Healthy Lifestyle Community Program (cohort 2; HLCP-2) on medication use and consequently on medication costs for selected NCDs (diabetes, hypertension, and dyslipidemia).
Methods: Data stem from a 24-month non-randomised, controlled intervention trial aiming to improve risk factors for NCDs. Participants completed questionnaires at six measurement time points assessing medication use, from which costs were calculated. The following medication groups were included in the analysis as NCD medication: glucose-lowering medications (GLM), antihypertensive drugs (AHD) and lipid-lowering drugs (LLD). Statistical tests for inter- and intra-group comparison and multiple regression analysis were performed.
Results: In total, 118 participants (intervention group [IG]: n = 79; control group [CG]: n = 39) were considered. Compared to baseline medication use decreased slightly in the IG and increased in the CG. Costs for NCD medication were significantly lower in the IG than in the CG after 6 (p = 0.004), 12 (p = 0.040), 18 (p = 0.003) and 24 months (p = 0.008). After multiple regression analysis and adjusting for confounders, change of costs differed significantly between the groups in all final models.
Conclusion: The HLCP-2 was able to moderately prevent an increase of medication use and thus reduce costs for medication to treat NCDs with the greatest impact on AHD.
A synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.
As a salutogenic concept, “consumption corridors” aims to support what is necessary for sustainable wellbeing to be achieved in relation to the Earth system, with a deep consideration for justice and equity. Living in consumption corridors is a representation of everyday life whereby people live within limits, so that all people – now and in the future – can access what is needed to live a good life. In this special issue, a series of scholars and practitioners have come together to further develop the concept, engage with its ethodological implications, and relate it to consumption domains and policy implications. We begin by introducing how the concept emerged, in relation to the complexity of grappling with the societal transformations required for achieving more sustainable forms of consumption. We then present the different contributions, which demonstrate the importance of considering both maximum and minimum consumption standards, the relevance of human-need theories, as well as the difference between achieving wellbeing and the means necessary for doing so. We conclude by opening up to areas that merit further deliberation: how to relate consumption corridors to everyday-life dynamics, but also to the critical question of power relations at play in implementing consumption corridors.
Despite widespread recognition of the need to transition toward more sustainable production and consumption and numerous initiatives to that end, global resource extraction and corresponding socio-ecological degradation continue to grow. Understanding the causes of this persistent failure is a necessary step towards more effective action. This article contributes to that understanding by synthesizing theory and evidence that links unsustainable production-consumption systems to power and inequality. While sustainable consumption and production research and action mostly focuses on technological or behavioral change, the socio-ecological inequalities driving production-consumption systems built into the organization of our global political economy, remain largely overlooked. In response, we propose a structural political economy orientation that seeks explicitly to reduce these inequalities and advance environmental justice and, thus, create the conditions for sustainable production-consumption systems. We then propose three important arenas of research and action towards sustainable production-consumption systems: justice, governance, and co-production of knowledge and action. These arenas, collectively and individually, can serve as entry points to study and act on the dynamics of (un)sustainable production-consumption systems. This can be done at the micro level, with respect to specific commodity chains or systems of provisioning, or at meso and macro levels with respect to national and global production networks. Our proposed orientation helps distinguish research and practice proposals into those emphasizing management and compensation resulting often in persistence of unsustainability, from those proffering structural changes in unsustainable production-consumption systems. We invite critique and collaboration to develop this research and action agenda further.
Background: Stress and cortisol dysregulation are linked to NCDs. Moreover, stress favours unhealthy lifestyle patterns, which increase the risk for NCDs. The role of the Cortisol Awakening Response (CAR) and the effect of lifestyle interventions on the same remain unclear. Methods: The impact of the intensive 8-week phase of the Healthy Lifestyle Community Programme (HLCP, cohort 1) on parameters of the CAR, ie cortisol values 0 (sample [S]1), 30), 45 and 60 minutes post-awakening, average peak, S1-peak delta and area under the increase curve (AUCI), and perceived stress levels (PSL) was evaluated in a non-randomized, controlled trial. Covariates of the CAR (eg sleep measures) and irregularities in sampling were assessed. The intervention focussed on stress management, a healthy diet, regular exercise, and social support. Participants were recruited from the general population. Multiple linear regression analyses were conducted. Results: 97 participants (age: 56 ± 10 years; 71% female), with 68 in the intervention group (IG; age: 55 ± 8, 77% female) and 29 participants in the control group (CG; age: 59 ± 12, 59% female), were included in the analysis. The baseline characteristics of both groups were comparable, except participants of IG were younger. On average, the PSL at baseline was low in both groups (IG: 9.7 ± 5.4 points; CG: 8.5 ± 6.9 points; p = .165), but 22% (n = 15) in the IG and 20% (n = 6) in the CG reported a high PSL. Most participants reported irregularities in CAR sampling, eg interruption of sleep (IG: 80% CG: 81%). After 8 weeks, most CAR parameters and the PSL decreased in the IG and CG, resulting in no differences of change between the groups. In the IG only, a decrease of PSL was linked to an increase of CAR parameters, eg AUCI (correlation coefficient = −0.307; p = .017). Conclusion: The HLCP may potentially reduce PSL and change the CAR, but results cannot be clearly attributed to the programme. Methodological challenges and multiple confounders, limit suitability of the CAR in the context of lifestyle interventions. Other measures (eg hair-cortisol) may give further insights. Trial registration: German Clinical Trials Register (DRKS); DRKS00018821; www.drks.de
Stress-eating (eating more or more unhealthily in order to accommodate to stress), contributes to the development and maintenance of obesity. The effect of comprehensive weight loss interventions on changes in stress-eating as well as the contributing role of stress-eating on weight reduction has not been examined. The impact of the 8-week intensive phase of the Healthy Lifestyle Community Programme (HLCP, cohort 1) on emotional, external and restrained eating, as expressions of stress-eating was evaluated in a non-randomized controlled trial. Intervention: 14 seminars (twice per week, including practical units), complemented by stress-regulation and cooking workshops and coaching sessions empowering participants to change their behaviour towards a healthy plant-based diet (ad libitum), stress regulation, regular exercise and to focus on social support. Participants were recruited from the general population. In the intervention group, 91 participants (IG; age: 56 ± 10, 77% female) and in the control group, 52 (CG; age: 62 ± 14, 57% female) were enrolled. At baseline, participants of the IG reported higher levels of stress (9.7 ± 5.4 points [P] vs. 7.6 ± 6.2; p < 0.011), and of emotional eating (27.9 ± 9.4 vs. 20.0 ± 7.1; p < 0.001) and external eating (29.1 ± 4.9 vs. 25.5 ± 5.6; p < 0.001) than participants of the CG. Within 8 weeks, in the IG, scores of emotional eating (− 3.5 ± 5.4 P) and external eating significantly decreased (= − 2.0 ± 3.8 P), while restrained eating increased (2.7 ± 5.0 P; p for all < 0.001). Weight change was negatively correlated with change of external eating (R2 = 0.045; CC = − 0.285; p = 0.014), indicating that a greater weight change was associated with a smaller change of external eating. This is the first study to prospectively investigate the role of stress-eating on the weight reduction effect of comprehensive lifestyle interventions. Our data confirm that overweight is associated with EE and external eating and suggest that the HLCP is capable to reduce both, weight and stress-eating.
Purpose: Organic food processing must include organic principles to be authentic. This qualitative study aims to understand the processors' understanding of organic food processing quality.
Design/methodology/approach: This study is based on semi-structured expert interviews with eight employees of six purely or partly organic dairies from Germany and Switzerland. Interview themes are (1) quality of organic milk processing in general, (2) assessment of specific processing techniques, (3) product quality of organic milk and (4) flow of information between producer and consumer. The interviews have been audio-recorded, transcribed verbatim and thematically analysed.
Findings: (1) Experts prefer minimal processing; some prefer artisanal processing, whilst others stress the advantages of mechanisation. (2) High temperature short time (HTST) pasteurisation and mechanical processing techniques are accepted; ultra-high-temperature (UHT) milk processing is partly rejected. (3) Traditional taste and valuable ingredients should be present in the final product. Natural variances are judged positively. (4) Consumers' low level of food technology literacy is challenging for communication.
Research limitations/implications: The results cannot be generalised due to the qualitative study design. Further studies, e.g. qualitative case analyses and studies with a quantitative design, are necessary to deepen the results.
Practical implications: The paper shows which processing technologies experts consider suitable or unsuitable for organic milk. The paper also identifies opportunities to bridge the perceived gap between processors' and consumers' demands.
Originality/value: The study shows the challenges of processors in expressing the processors' understanding of process quality.
Organic food quality is based on processing. While the EU organic production regulation focuses on agricultural production, private standards provide more detailed information about further processing. For the development of organic processing, practitioner perspectives can provide valuable input. To get insight into practitioner perspectives, we conducted semi-structured expert interviews with nine employees of seven partly organic juice processing companies from Germany and Austria. Interview topics were (i) quality of organic juice processing in general, (ii) assessment of specific processing techniques, (iii) product quality of organic juice and (iv) flow of information between producer and consumer. We conducted a thematic analysis. We found that the experts’ understanding of process quality mostly includes more aspects than the EU organic production regulation. It covers the whole food chain plus aspects of social and environmental sustainability. The experts prefer directly bottled juice of local raw materials but chiefly accept juice made from concentrate of exotic raw materials because of environmental concerns. Organic juice is preferred when it is cloudy and natural fluctuations are interpreted as an indicator of natural quality. The experts report that consumer information is challenging because of low food literacy. Raising this might help reduce the number of processed juices on the market.