To develop a web-based food-frequency questionnaire (FFQ) measuring intake of plant-based protein foods (PBP) among older adults from the province of Quebec, Canada.

The questionnaire was adapted from an existing self-administered FFQ and first underwent expert panel evaluation for face and content validity. Then, three phases of cognitive testing were conducted in French, using the probe and think aloud approaches. Between each phase, the questionnaire was modified based on participants’ feedback to improve the clarity and comprehension of the questions.

Quebec City, Quebec, Canada.

Twenty adults aged 65 years and older participated. Purposive sampling was used to maximise variation in sociodemographic characteristics, including gender, age, education level and PBP consumption.

The expert panel found the twenty-eight-item questionnaire to be a comprehensive measure of PBP intake and suggested minor changes to improve its clarity. The cognitive interviews showed that our PBP-FFQ was generally well understood and identified issues requiring modifications to improve comprehension and accuracy.

Our FFQ provides a comprehensive measure of PBP intake, is well understood by older adults in Québec and will support rigorous assessment of PBP intake in this population but requires further validation to confirm its validity and reproducibility.

To investigate the association between plant-based diets (PBD) and overweight/obesity compared to regular meat eaters in older women.

Cross-sectional analysis.

1946–1951 birth cohort of the Australian Longitudinal Study on Women’s Health (ALSWH). PBD were categorised as vegan, lacto-ovo vegetarian, pesco-vegetarian, semi-vegetarian and regular meat eaters. Outcomes included body weight (BW), BMI and waist circumference (WC).

Women who completed Survey 7 (n 9102) with complete FFQ data.

Compared to regular meat eaters, BW, BMI and WC were significantly lower in pesco-vegetarians (−10·2 kg (95 % CI −5·1, −15·2); −3·8 kg/m2 (95 % CI −2·0, −5·6); −8·4 cm (95 % CI −3·9, −12·9)) and BW and BMI lower in lacto-ovo vegetarians (−7·4 kg (95 % CI −1·2, −13·6); −2·9 kg/m2 (95 % CI −0·6, −5·1)). In regular meat eaters, individuals consuming meat daily or multiple times/d had significantly higher BW, BMI and WC compared to those consuming meat >2 times/week but <daily or multiple times/d (2·5 kg (95 % CI 1·5, 3·5); 0·9 kg/m2 (95 % CI 0·5, 1·3) and 2·2 cm (95 % CI 1·3, 3·1)) and those consuming meat >1 but ≤2 times/week (6·8 kg (95 % CI 1·8, 11·8); 2·1 kg/m2 (95 % CI 0·3, 4·0) and 6·0 cm (95 % CI 1·7, 10·4)). This association was dose-dependent such that for every increase in category of weekly meat intake (i.e. >1 time/week but ≤2 times/week; >2 times/week but less than daily, and daily or multiple times/d), an associated 2·6 kg (95 % CI 1·8, 3·4) increase in BW, 0·9 kg/m2 (95 % CI 0·6, 1·2) increase in BMI and 2·3 cm (95 % CI 1·6, 3·0) increase in WC was reported.

BW, BMI and WC are lower in women following PBD and positively associated with increasing meat consumption. Results were robust to adjustment for confounders including physical activity levels, smoking status, habitual alcohol intake, use of supplements, and hormone replacement therapy.

To explore adherence to a plant-based diet from the perspective of goals- and motivations-based systems.

A cross-sectional, survey-based study was conducted regarding eating patterns, goals and motivations for current eating habits.

Data were collected using an online survey platform, including the Goal Systems Assessment Battery (GSAB) and other survey tools.

University students were recruited, including thirty-three students reporting successful maintenance of a plant-based diet (Adherents) and sixty-three students trying to adhere to a plant-based diet (Non-adherents).

Using GSAB subscale scores, discriminant function analyses significantly differentiated adherents v. non-adherents, accounting for 49·0 % of between-group variance (χ2 (13) = 42·03, P < 0·000). It correctly classified 72·7 % of adherents and 88·9 % of non-adherents. Constructs including value, self-efficacy, planning/stimulus control and positive affect were significant and included in the discriminant function. Logistic regression results suggested that participants who successfully adhered to a plant-based diet were seventeen times more likely to report ‘To manage or treat a medical condition’ as motivation and almost seven times more likely to report ‘To align with my ethical beliefs’ as motivation compared with non-adherents. However, these participants were 94 % less likely to report ‘To maintain and/or improve my health’ as motivation compared with non-adherents. Controlling for motivations, hierarchical logistic regression showed that only planning as part of the GSAB self-regulatory system predicted adherence to a plant-based diet.

Values-based approaches to plant-based diets, including consideration for ethical beliefs, self-efficacy and proper planning, may be key for successful maintenance of this diet long-term.

To assess the biodiversity richness of plant foods of the Italian Food Composition Database (IFCDB) at the species and below the species level and its evolution over time.

The biodiversity richness of plant foods in the IFCDB was assessed by counting the number of species and by identifying and categorising biodiverse plant foods, i.e. foods described below the species level (subspecies, variety and cultivar) as well as wild and neglected and underutilised species. This assessment was also performed with the FAO Biodiversity Indicator.

This study analysed the current IFCDB that contains 900 records of food items, with 80 % of data derived from analytical determinations.

The 2019 IFCDB’s edition includes 114 plant species; among thirty two of them, one or more biodiverse foods were identified for a total of eighty-six records, corresponding to 21 % of the plant foods recorded. This marks a substantial increase from the 2000’s edition, which included 112 plant species and forty-eight biodiverse foods, corresponding to 16 % of the plant foods recorded.

The IFCDB demonstrates progress in integrating plant food biodiversity, crucial for promoting sustainable diets and, consequently, sustainable food systems. Enhanced access to food composition data of biodiverse plant foods is required for the development and labelling of biodiverse processed plant foods and to increase the biodiversity richness of menus in community catering. This study may stimulate efforts in assessing and enhancing biodiversity richness of food composition tables in other countries.

To determine the prevalence and characteristics of plant-based patterns in the Spanish population and assess their potential impact on individuals with similar socio-demographic backgrounds.

We estimated vegetarian and vegan individuals’ national and regional prevalence and analysed their socio-demographic characteristics and weekly dietary intake patterns. Individuals with a plant-based dietary pattern were matched to a control group (1:4) with similar socio-demographic characteristics. Associations with the prevalence risk of common chronic diseases, self-reported health status, lifestyle and healthcare use were analysed with unadjusted and adjusted logistic regression models.

A population-based survey of individuals residing in Spain.

Data from 22 072 participants were examined.

The prevalence of plant-based diets was 5·62‰ (95 % CI: 4·33, 7·28), and adherents were female (68·6 %), single (62·3 %) and university-educated 41·8 %) (P < 0·001). They reported higher rates of ‘never’ consuming snacks (50 % v. 35 %), fast food (58 % v. 36 %) and sweets (33 % v. 14 %). Lifestyle factors did not differ between the plant-based and omnivorous groups; however, adherence to plant-based diets was associated with a prevalence risk of depressive symptoms (OR 2·58, 95 % CI: 1·00, 6·65), stroke (OR 7·08, 95 % CI: 1·27, 39·46) and increased consultations for mental health and complementary medicine (OR 3·21, 95 % CI: 1·38, 7·43).

Plant-based diets are uncommon and are associated with specific socio-demographic profiles, particularly sex. When comparing individuals with similar socio-demographic characteristics, individuals with plant-based diets and omnivores had similar lifestyles. Addressing patient concerns regarding diet and personal well-being might prioritise healthy behaviours over specific dietary patterns.

To examine associations between three different plant-based diet quality indices, chronic kidney disease (CKD) prevalence and related risk factors in a nationally representative sample of the Australian population.

Cross-sectional analysis. Three plant-based diet scores were calculated using data from two 24-h recalls: an overall plant-based diet index (PDI), a healthy PDI (hPDI) and an unhealthy PDI (uPDI). Consumption of plant and animal ingredients from ‘core’ and ‘discretionary’ products was also differentiated. Associations between the three PDI scores and CKD prevalence, BMI, waist circumference (WC), blood pressure (BP) measures, blood cholesterol, apo B, fasting TAG, blood glucose levels (BGL) and HbA1c were examined.

Australian Health Survey 2011–2013.

n 2060 adults aged ≥ 18 years (males: n 928; females: n 1132).

A higher uPDI score was associated with a 3·7 % higher odds of moderate-severe CKD (OR: 1·037 (1·0057–1·0697); P = 0·021)). A higher uPDI score was also associated with increased TAG (P = 0·032) and BGL (P < 0·001), but lower total- and LDL-cholesterol (P = 0·035 and P = 0·009, respectively). In contrast, a higher overall PDI score was inversely associated with WC (P < 0·001) and systolic BP (P = 0·044), while higher scores for both the overall PDI and hPDI were inversely associated with BMI (P < 0·001 and P = 0·019, respectively).

A higher uPDI score reflecting greater intakes of refined grains, salty plant-based foods and added sugars were associated with increased CKD prevalence, TAG and BGL. In the Australian population, attention to diet quality remains paramount, even in those with higher intakes of plant foods and who wish to reduce the risk of CKD.

This study aimed to examine the association between protein intake and risk of sarcopenia, with a specific focus on protein sources, in middle-aged and older adults.

This was a 9-year follow-up study. Dietary protein intake was assessed by a validated FFQ with energy adjustment using the residual method. Sarcopenia was defined by using height-adjusted appendicular lean mass and grip strength. Adjusted OR for sarcopenia were calculated by multivariable logistic regression analysis.

Baseline surveys (2011–2014) for the Murakami and Uonuma cohorts assessed body size, lifestyle and medical history. Sarcopenia-related measurements were conducted in 2021–2022 in Murakami, Sekikawa, Uonuma and Minamiuonuma, Japan.

6232 individuals aged 40–74 years (mean age, 62·4 years; females, 54·8 %).

An inverse association between plant protein intake and sarcopenia was observed in males (Pfor trend = 0·018), although total and animal protein intakes were not. Animal-to-plant protein ratio was U-shaped in its association with sarcopenia; adjusted OR for the lowest and highest quintiles of the ratio compared to the middle quintile were 1·71 (95 % CI: 0·96, 3·07) and 1·97 (95 % CI: 1·10, 3·53), respectively, for males (Pfor quadratic term = 0·017), and 1·93 (95 % CI: 1·06, 3·51) and 1·65 (95 % CI: 0·90, 3·05), respectively, for females (Pfor quadratic term = 0·010).

An imbalanced intake of plant and animal proteins may increase the risk of sarcopenia, highlighting the importance of balanced protein intake.

This scoping review aimed to systematically map and describe the existing evidence regarding the knowledge, attitudes and practices of health professionals with regard to plant-based diets during pregnancy and to highlight areas for further research.

Following a pre-registered protocol, online databases were searched using a comprehensive search string, in addition to selected grey literature sources, and reference lists of included studies. The studies were independently screened for eligibility by two authors, SM and JM. Data from all eligible studies were charted by the first author, and a narrative summary was performed.

Maternal health care services.

Ten studies were included for review, from New Zealand (n 2), Australia (n 2), Germany, Netherlands, United Kingdom, France, Italy and Peru. Most of these studies were observational, employed various validated and non-validated survey instruments, interviews and one education intervention. Knowledge was the most frequently assessed outcome in the reviewed studies. Health professionals’ knowledge of plant-based nutrition in pregnancy was reported to be limited and frequently attributed to a lack of nutrition training. Participants’ personal dietary patterns and work specialisation appear to be closely associated with their knowledge, attitudes and practices regarding plant-based diets.

This review identified a significant research gap regarding health professionals’ practices in relation to plant-based diets during pregnancy. Additionally, this review has demonstrated the need for further research, awareness and practice protocols to promote high-quality care and education or professional development to address the prevalent lack of knowledge among this group.

To evaluate diets in terms of nutritional characteristics and quality from the perspectives of health, greenhouse gas emissions (GHGE) and possible associations with each other in a representative sample of students at a public university.

Cross-sectional. Dietary intake was evaluated with a validated FFQ, and diet quality was assessed through the Healthy Eating Index (HEI-2010) and MedDietScore (MDS). GHGE data were obtained from the literature. In addition, sex, socio-economic status (SES) and body fat (BF) status were analysed as covariates.

Basque Autonomous Community, Spain.

Totally, 26 165 healthy adults aged 18–28 years.

Student diets were characterised by low consumption of carbohydrates (38·72 % of total energy intake (TEI)) and a high intake of lipids (39·08 % of TEI). Over half of the participants had low dietary quality. The low-emitting diets were more likely to be consumed by subjects with low HEI-2010 scores (β: 0·039 kg eCO2/1000 kcal/d) and high MDS scores (β: −0·023 kg eCO2/1000 kcal/d), after controlling for sex, SES and BF status. Both the low-emitting and healthy diets were more likely to be consumed by women and by those with normal BF percentage.

UPV/EHU university students’ diets were characterised by moderate quality from a nutritional perspective and moderate variation in the size of carbon footprints. In this population, diets of the highest quality were not always those with the lowest diet-related GHGE; this relationship depended in part on the constructs and scoring criteria of diet quality indices used.

To analyse the feasibility and acceptability of a culinary nutritional intervention aimed at increasing plant-based foods consumption in the context of the Mediterranean diet in parent–child dyads.

The Nutritional and Culinary Habits to Empower Families (n-CHEF) is a 9-month feasibility study that included four culinary nutritional workshops (two face to face, two online) led by a chef and a dietitian-nutritionist. These workshops combined cooking with plant-based foods, with nutritional advice and experimental activities. The main outcomes were retention, quality of the intervention (monitoring workshops, acceptability and perceived impact) and changes in dietary and cooking habits.

Parent–child dyads, Spain.

Parent–child (aged 10–14 years) dyads.

Fifteen parent–child dyads were recruited, of which thirteen were retained during the 6-month follow-up. All but one parent–child dyads attended the four workshops. The overall assessment of the workshops was positive, although the online workshops were rated lower than the face to face. In general, parent–child dyads reported benefits in terms of nutrition and cooking aspects. Parents significantly increased their adherence to the Mediterranean diet, but non-significant changes were observed in children. However, children increased their consumption of vegetables and legumes and reduced snacks and ready meals. Parents also changed some of their culinary habits and increased their confidence in cooking at home.

The n-CHEF showed that the culinary nutritional intervention had good levels of recruitment, retention and acceptability among parent–child dyads. In addition, dietary and culinary knowledge and habits can be improved, although further studies are needed to know the long-term effects in larger populations.

To evaluate nudge strategies that increase the consumption of plant-based foods, defined as vegetarian or vegan food items, compared with meat-based options in post-secondary dining hall settings.

A pilot study.

This study took place in the University of British Columbia Vancouver Campus’s Gather Dining Hall (GDH) over a 6-week intervention period and two control periods. The intervention incorporated several nudges (proportion increases, item placement, taste-focused labelling, Chef’s featured special verbal prompts, social media and promotional posters) into the menu and dining hall area with the goal of increasing the purchases of plant-based items. Sales data from meals that were purchased during the intervention period were compared with sales data from the two control periods.

Students and staff who purchased meals in the GDH.

The proportion of plant-based items sold significantly increased during the intervention period (56·7 %; P < 0·01) compared with the last 6 weeks of term one (53·6 %) and the first 6 weeks of term two (53·4 %). The proportion of plant-based ‘main’ menu items was significantly higher in the intervention period (46·4; P < 0·01) when compared with the last 6 weeks of term one (40·9 %) and the first 6 weeks of term two (41·7 %).

The combination of nudges was effective at significantly increasing the selection of plant-based options over meat-based options in a post-secondary dining hall setting.

To examine the association between adherence to plant-based diets and mortality.

Prospective study. We calculated a plant-based diet index (PDI) by assigning positive scores to plant foods and reverse scores to animal foods. We also created a healthful PDI (hPDI) and an unhealthful PDI (uPDI) by further separating the healthy plant foods from less-healthy plant foods.

The VA Million Veteran Program.

315 919 men and women aged 19–104 years who completed a FFQ at the baseline.

We documented 31 136 deaths during the follow-up. A higher PDI was significantly associated with lower total mortality (hazard ratio (HR) comparing extreme deciles = 0·75, 95 % CI: 0·71, 0·79, Ptrend < 0·001]. We observed an inverse association between hPDI and total mortality (HR comparing extreme deciles = 0·64, 95 % CI: 0·61, 0·68, Ptrend < 0·001), whereas uPDI was positively associated with total mortality (HR comparing extreme deciles = 1·41, 95 % CI: 1·33, 1·49, Ptrend < 0·001). Similar significant associations of PDI, hPDI and uPDI were also observed for CVD and cancer mortality. The associations between the PDI and total mortality were consistent among African and European American participants, and participants free from CVD and cancer and those who were diagnosed with major chronic disease at baseline.

A greater adherence to a plant-based diet was associated with substantially lower total mortality in this large population of veterans. These findings support recommending plant-rich dietary patterns for the prevention of major chronic diseases.

While plant-based dietary practices (PBDPs) have been recommended to improve both population health and environmental sustainability outcomes, no nationally representative Canadian studies have described the prevalence or correlates of excluding animal source foods. The current study therefore: (1) created operationalised definitions of PBDPs based on animal source food exclusions to estimate the prevalence of Canadians who adhere to PBDPs and (2) examined key correlates of PBDPs.

Population representative, cross-sectional data were from the 2015 Canadian Community Health Survey–Nutrition. Respondents’ PBDPs were categorised as: (1) vegan (excluded red meat, poultry, fish, eggs and dairy); (2) vegetarian (excluded red meat, poultry and fish); (3) pescatarian (excluded red meat and poultry) and (4) red meat excluder (excluded red meat). Descriptive statistics and multivariable regression analyses were used to examine the prevalence and correlates of these PBDP categories.

All ten provinces in Canada.

Canadians aged 2 years and above (n 20 477).

In 2015, approximately 5 % of Canadians reported adhering to any PBDP (all categories combined) with the majority (2·8 %) categorised as a red meat excluder, 1·3 % as vegetarian, 0·7 % as pescatarian and 0·3 % as vegan. South Asian cultural identity (OR 19·70 (95 % CI 9·53, 40·69)) and higher educational attainment (OR 1·97 (95 % CI 1·02, 3·80)) were significantly associated with reporting a vegetarian/vegan PBDP.

Despite growing public discourse around PBDPs, only 5 % of Canadians reported PBDPs in 2015. Understanding the social and cultural factors that influence PBDPs is valuable for informing future strategies to promote environmentally sustainable dietary practices.

Describe how dietary intake patterns of US young adults align with the EAT-Lancet Planetary Health Diet (PHD) sustainable diet goals and identify personal, behavioural, and socio-environmental correlates of sustainable intake.

Data on past-year dietary intake were captured using a FFQ. The PHD was applied to specific food groups, and a total PHD score was calculated. Linear regression models were used to identify associations between personal, behavioural and socio-environmental factors and PHD scores.

This cross-sectional analysis uses data from the second wave of EAT 2010–2018 (Eating and Activity over Time), a population-based longitudinal study recruited in Minnesota.

Ethnically/racially diverse group of participants (n 1308) with a mean age of 22·1 (sd 2·0) years.

The mean PHD score was 4·1 (sd 1·4) on a scale of 0–14, with 14 representing the most sustainable. On average, participants consumed fewer whole grains, fish, legumes, soya, and nuts than ideal for a sustainable diet, and an excess of eggs, added sugar, and meat. The PHD score was higher for participants with higher socio-economic status (SES) and greater educational attainment. Higher home availability of healthy food (β = 0·24, P < 0·001) and less frequent fast-food consumption (β = –0·26, P < 0·001) were the strongest correlates of PHD scores.

Results suggest that a high percentage of participants may not be achieving the sustainable diet goals defined by the PHD. Reductions in meat consumption and increases in plant-based foods are necessary to increase the sustainability of US young adults’ diets.

The aim of the present study was to investigate the differences between the consumption of plant-based v. animal-based protein-rich diets on successful ageing, as well as to identify the optimal combination of dietary protein intake for facilitating successful ageing in people aged >50 years.

A combined analysis was conducted in older adults of the ATTICA and MEDIS population-based cross-sectional studies. Anthropometrical, clinical and sociodemographic characteristics, lifestyle parameters, dietary habits and level of protein intake were derived through standard procedures. Successful ageing was evaluated using the validated Successful Aging Index (SAI) composed of ten health-related social, lifestyle and clinical characteristics.

Athens area and twenty Greek islands.

A total of 3349 Greek women and men over 50 years old.

Participants with high consumption of plant proteins were more likely to be male, physically active, with higher daily energy intake, higher adherence to the Mediterranean diet and higher level of SAI (P < 0·001). Participants with ‘Low animal & High plant’ and ‘High animal & High plant’ protein consumption had a 6 and 7 % higher SAI score, respectively, compared with the other participants (P < 0·001). In contrast, ‘Low animal & Low plant’ and ‘High animal & Low plant’ protein intake was negatively associated with SAI as compared to the combination of all other consumption categories (P < 0·02).

The consumption of a plant-based protein-rich diet seems to be a beneficial nutritional choice that should be promoted and encouraged to older people since it may benefit both individual’s health and prolong successful ageing.

Are diets with a greater environmental impact less healthy? This is a key question for nutrition policy, but previous research does not provide a clear answer. To address this, our objective here was to test whether American diets with the highest carbon footprints predicted greater population-level mortality from diet-related chronic disease than those with the lowest.

Baseline dietary recall data were combined with a database of greenhouse gases emitted in the production of foods to estimate a carbon footprint for each diet. Diets were ranked on their carbon footprints and those in the highest and lowest quintiles were studied here. Preventable Risk Integrated Model (PRIME), an epidemiological modelling software, was used to assess CVD and cancer mortality for a simulated dietary change from the highest to the lowest impact diets. The diet–mortality relationships used by PRIME came from published meta-analyses of randomised controlled trials and prospective cohort studies.

USA.

Baseline diets came from adults (n 12 865) in the nationally representative 2005–2010 National Health and Nutrition Examination Survey.

A simulated change at the population level from the highest to the lowest carbon footprint diets resulted in 23 739 (95 % CI 20 349, 27 065) fewer annual deaths from CVD and cancer. This represents a 1·83 % (95 % CI 1·57 %, 2·08 %) decrease in total deaths. About 95 % of deaths averted were from CVD.

Diets with the highest carbon footprints were associated with a greater risk of mortality than the lowest, suggesting that dietary guidance could incorporate sustainability information to reinforce health messaging.

This study examines secular changes in diet-related greenhouse gas emissions (GHGE) in younger and older Swedish adults, since the turn of this century.

Two cross-sectional health examination surveys were conducted in 2001–2004 (T1) and 2014–2018 (T2). At both times, an eighty-six-item FFQ was embedded in the survey. From the food frequencies and age-standardised portion sizes, GHGE estimates (kg CO2e/year) were calculated. GHGE was modelled as a function of time period and covariates, for five distinct age groups.

The municipality of Gothenburg, in western Sweden.

Women and men aged 25–34, 35–44, 45–54, 55–64 and 65–75 years were randomly selected from the population registry and recruited for examinations. After exclusion of participants with incomplete dietary data, the analytic sample consisted of 2569 individuals at T1 and 2119 at T2.

Lower dietary GHGE scores were observed at T2 compared with T1, in each age group, adjusting for sex, BMI and education. The largest differences in GHGE were observed in the youngest age group (approximately 30 % reduction). Decreasing trends in GHGE from animal-based foods were observed at all ages and were accompanied by smaller increases from plant-based sources in younger groups only. At all ages, GHGE from discretionary foods decreased, and prevalence of overweight remained stable.

Optimal dietary trends should support both human health and planetary health. Our results suggest that Swedish adults have moved in this direction, e.g. through less intake of red meat products and stable weight status.

This study aimed to explore barriers and facilitators of the provision of dairy and plant-based dairy alternatives (PBDA) by parents of preschool-age children, a previously unexplored area of research.

Five focus groups of parents were conducted and audio-recorded. Verbatim transcripts were analysed using thematic analysis.

University of Guelph, in Guelph, ON, Canada in 2019.

Thirty-two (n 19 mothers, 13 fathers) parents of preschool-age children. Most (59 %) were university or college educated.

Facilitators common to both dairy and PBDA provision included perceived nutritional benefits, such as dairy’s Ca, protein and fat content, and PBDA’s protein content, and the perception that PBDA adds variety to the diet. Facilitators unique to dairy v. PBDA provision included the taste of, familiarity with, and greater variety and accessibility of dairy products, specifically child-friendly products. A facilitator unique to PBDA v. dairy provision was ethical concerns regarding dairy farming practices. Barriers common to both dairy and PBDA provision included perceived cost, concerns regarding the environmental impact of production, and high sugar content. Barriers specific to dairy included use of antibiotics and hormones in dairy production. A barrier specific to PBDA was the use of pesticides.

Behaviour change messages targeting parents of preschoolers can emphasise the nutrition non-equivalence of dairy and some PBDA and can educate parents on sources of affordable, unsweetened dairy and PBDA.