Stakeholder-driven transformative adaptation is needed for climate-smart nutrition security in sub-Saharan Africa.

Improving nutrition security in sub-Saharan Africa under increasing climate risks and population growth requires a strong and contextualized evidence base. Yet, to date, few studies have assessed climate-smart agriculture and nutrition security simultaneously. Here we use an integrated assessment framework (iFEED) to explore stakeholder-driven scenarios of food system transformation towards climate-smart nutrition security in Malawi, South Africa, Tanzania and Zambia. iFEED translates climate-food-emissions modelling into policy-relevant information using model output implication statements. Results show that diversifying agricultural production towards more micronutrient-rich foods is necessary to achieve an adequate population-level nutrient supply by mid-century. Agricultural areas must expand unless unprecedented rapid yield improvements are achieved. While these transformations are challenging to accomplish and often associated with increased greenhouse gas emissions, the alternative for a nutrition-secure future is to rely increasingly on imports, which would outsource emissions and be economically and politically challenging given the large import increases required.

Assessing the impact of energy and fuel poverty on health: a European scoping review.

BACKGROUND: The burden of energy and fuel poverty (EFP) in Europe is increasing in the face of the cost-of-living crisis, the Russian invasion of Ukraine, the coronavirus disease 2019 (COVID-19) pandemic and the climate emergency. While the health impacts of EFP are often the driving reason for addressing it, EFP's association with health is poorly delineated. This review aims to scope the evidence of EFP's association with health in Europe. METHODS: A scoping review based on Arksey and O'Malley's framework was conducted using search terms relevant to EFP, health and Europe. Five databases were searched, in addition to hand searching. Review selection was performed by two independent reviewers, and articles were thematically analyzed. RESULTS: Thirty-five articles published between January 2000 and March 2022 were included. The literature varied in definitions and measurements of EFP and in the health indicators examined. The review revealed a negative association between EFP and health, specifically, general unspecified poor health (9 articles), excess winter mortality (3 articles), communicable diseases (3 articles), non-communicable diseases (11 articles), mental health (15 articles) and well-being (12 articles). While women were reported to be at a higher risk of EFP than men, children and older adults were identified as particularly vulnerable to EFP's adverse health repercussions. CONCLUSIONS: This scoping review illustrates a significant and complex association between EFP and various domains of health. Though heterogeneity across research makes it difficult to compare findings, our review supports the use of health as a justification to address EFP and urges public health to be more involved in EFP mitigation.

Evolution of energy and nutrient supply in Zambia (1961-2013) in the context of policy, political, social, economic, and climatic changes.

An adequate supply of energy, micronutrients and macronutrients is essential to achieve food and nutrition security to prevent malnutrition. Socio-economic, political, and climatic events, however, can affect the supply of food and nutrients. We assessed country-level supply trends of food and nutrients and their sources within the context of policy changes and political, socio-economic and climatic events from 1961 to 2013 in Zambia. Due to the lack of national food consumption data, food supply data from the FAO food balance sheets, matched to food composition tables, were used to estimate the energy, macronutrient and micronutrient content of 264 food items available to Zambia. We calculated historical nutrient supplies based on demographic characteristics and population-level dietary requirements. Results showed that Zambia was nutrition insecure from 1961 to 2013 for key micronutrients vitamin A, folate, riboflavin, vitamin B12, calcium, zinc, iron, and energy-deficient from the late-1980s. The diet has not substantially changed over time, with maize being the dominant food source. However, refined energy-dense food has steadily increased in the diet coupled with a reduction in fibre. These nutrient supply and dietary pattern trends coincide with specific socio-economic, policy, political, and climatic events from the 1970s to the early-mid 2000s, such as population growth, maize subsidy and crop diversification policies, regime change and drought. This study shows how policy, political and climatic events have been central features shaping nutrient supplies and the consequences for nutrition security. The study provides a context to inform future food policies to improve food and nutrition security. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-022-01329-1.

Modelling population responses to workplace minimum dietary standards introduced as workers return after social lockdowns.

BACKGROUND: Diet norms are the shared social behaviours and beliefs about diets. In many societies, including the UK, these norms are typically linked to unhealthy diets and impede efforts to improve food choices. Social interactions that could influence one another's food choices, were highly disrupted during the lockdowns in response to the COVID-19 pandemic. A return to workplaces and re-establishment of eating networks may present an opportunity to influence dietary norms by introducing minimum dietary standards to in workplaces, which could then spread through wider home and workplace networks. METHODS: An agent-based model was constructed to simulate a society reflecting the structure of a city population (1000 households) to explore changes in personal and social diet-related norms. The model tracked individual meal choices as agents interact in home, work or school settings and recorded changes in diet quality (range 1 to 100). Scenarios were run to compare individuals' diet quality with the introduction of minimum dietary standards with degrees of working from home. RESULTS: The more people mixed at work the greater the impact of minimum standards on improving diet norms. Socially isolated households remained unaffected by minimum standards, whereas household members exposed directly, in workplaces or schools, or indirectly, influenced by others in the household, had a large and linear increase in diet quality in relation to minimum standards (0.48 [95% CI 0.34, 0.62] per unit increase in minimum standards). Since individuals regressed to the new population mean, a small proportion of diets decreased toward lower population norms. The degree of return to work influenced the rate and magnitude of change cross the population (-2.4 points [-2.40, -2.34] in mean diet quality per 20% of workers isolating). CONCLUSIONS: These model results illustrate the qualitative impact social connectivity could have on changing diets through interventions. Norms can be changed more in a more connected population, and social interactions spread norms between contexts and amplified the influence of, for example, workplace minimum standards beyond those directly exposed. However, implementation of minimum standards in a single type of setting would not reach the whole population and in some cases may decrease diet quality. Any non-zero standard could yield improvements beyond the immediate adult workforce and this could spill between social contexts, but would be contingent on population connectivity.

Estimating the environmental impacts of 57,000 food products.

Understanding and communicating the environmental impacts of food products is key to enabling transitions to environmentally sustainable food systems [El Bilali and Allahyari, Inf. Process. Agric. 5, 456-464 (2018)]. While previous analyses compared the impacts of food commodities such as fruits, wheat, and beef [Poore and Nemecek, Science 360, 987-992 (2018)], most food products contain numerous ingredients. However, because the amount of each ingredient in a product is often known only by the manufacturer, it has been difficult to assess their environmental impacts. Here, we develop an approach to overcome this limitation. It uses prior knowledge from ingredient lists to infer the composition of each ingredient, and then pairs this with environmental databases [Poore and Nemecek Science 360, 987-992 (2018); Gephart et al., Nature 597, 360-365 (2021)] to derive estimates of a food product's environmental impact across four indicators: greenhouse gas emissions, land use, water stress, and eutrophication potential. Using the approach on 57,000 products in the United Kingdom and Ireland shows food types have low (e.g., sugary beverages, fruits, breads), to intermediate (e.g., many desserts, pastries), to high environmental impacts (e.g., meat, fish, cheese). Incorporating NutriScore reveals more nutritious products are often more environmentally sustainable but there are exceptions to this trend, and foods consumers may view as substitutable can have markedly different impacts. Sensitivity analyses indicate the approach is robust to uncertainty in ingredient composition and in most cases sourcing. This approach provides a step toward enabling consumers, retailers, and policy makers to make informed decisions on the environmental impacts of food products.

Effect of different food groups on energy intake within and between individuals.

PURPOSE: Energy intake varies day-to-day because we select different foods, and different amounts of these foods. Energy balance is not tightly regulated over the short-term, and the variability in diet results in an energy surplus or deficit. The aim of this study was to explore how consuming more, or less, than usual amounts of foods contributed towards balancing of total energy intake (TEI) within a day. METHODS: Four-day food records came from 6155 adult participants of the National Diet and Nutrition Survey to study these effects. Within-individual regression models of the energy from 60 food groups on TEI were calculated. Energy intake variation within-individuals was regressed separately on the variation in amounts of each food group. Regression models were also fitted to individual four day means. RESULTS: Within-individual coefficients ranged from about 0 for high-fibre breakfast cereals to 1.7 for sugar preserves and spreads. Three food groups (e.g. low-calorie soft drinks) tended to reduce TEI, and 13 food groups (e.g. margarine and other spreads, and alcoholic drinks) tended to elevate TEI above the energy content of the food group when more than usual amounts were consumed. Foods groups of higher energy densities, or lower fibre content (e.g. typical "snack" foods, low-fibre bread, and processed meat) tended to promote greater TEI more so than did food groups of lower energy densities (e.g. meat, fish, high-fibre foods, and potatoes). CONCLUSION: Different food groups vary considerably in the extent to which they affect TEI in free-living adults. The associations between consuming more, or less, than usual amounts of foods and the effects on TEI are consistent with those found in laboratory studies. Importantly, the present study found similar associations, but using a different methodology and in observational data, providing novel information on energy intake compensation.

Food and nutrition security under global trade: a relation-driven agent-based global trade model.

This paper addresses the highly relevant and timely issues of global trade and food security by developing an empirically grounded, relation-driven agent-based global trade model. Contrary to most price-driven trade models in the literature, the relation-driven agent-based global trade model focuses on the role of relational factors such as trust, familiarity, trade history and conflicts in countries' trade behaviour. Moreover, the global trade model is linked to a comprehensive nutrition formula to investigate the impact of trade on food and nutrition security, including macro and micronutrients. Preliminary results show that global trade improves the food and nutrition security of countries in Africa, Asia and Latin America. Trade also promotes a healthier and more balanced diet, as countries have access to an increased variety of food. The effect of trade in enhancing nutrition security, with an adequate supply of macro and micronutrients, is universal across nutrients and countries. As researchers call for a holistic and multifactorial approach to food security and climate change (Hammond and Dubé 2012 Proc. Natl Acad. Sci. USA 109, 12 356-12 363. (doi:10.1073/pnas.0913003109)), the paper is one of the first to develop an integrated framework that consists of socio-economic, geopolitical, nutrition, environmental and agri-food systems to tackle these global challenges. Given the ongoing events of Brexit, the US-China trade war and the global COVID-19 pandemic, the paper will provide valuable insights on the role of trade in improving the food and nutrition security across countries.

Self-reported food intake decreases over recording period in the National Diet and Nutrition Survey.

From 2008, the UK's National Diet and Nutrition Survey (NDNS) changed the method of dietary data collection from a 7-d weighed diary to a 4-d unweighed diary, partly to reduce participant burden. This study aimed to test whether self-reported energy intake changed significantly over the 4-d recording period of the NDNS rolling programme. Analyses used data from the NDNS years 1 (2008/2009) to 8 (2015/2016) inclusive, from participants aged 13 years and older. Dietary records from participants who reported unusual amounts of food and drink consumed on one or more days were excluded, leaving 6932 participants. Mean daily energy intake was 7107 kJ (1698 kcal), and there was a significant decrease of 164 kJ (39 kcal) between days 1 and 4 (P < 0·001). There was no significant interaction of sex or low-energy reporter status (estimated from the ratio of reported energy intake:BMR) with the change in reported energy intake. The decrease in reported energy intake on day 4 compared with day 1 was greater (P < 0·019) for adults with higher BMI (>30 kg/m2) than it was for leaner adults. Reported energy intake decreased over the 4-d recording period of the NDNS rolling programme suggesting that participants change their diet more, or report less completely, with successive days of recording their diet. The size of the effect was relatively minor, however.

Association between hours worked in paid employment and diet quality, frequency of eating out and consuming takeaways in the UK.

OBJECTIVE: To examine associations between hours worked and diet quality, frequency of eating out and consuming takeaways. DESIGN: Data were taken from the National Diet and Nutrition Survey (2008-2014). Associations between hours worked in paid employment and diet quality, assessed using the Diet Quality Index (DQI) and selected foods and nutrients, were tested using linear regression models. Associations between hours worked and frequency of eating out and consuming takeaways were tested using ordinal logistic regression models. All models were adjusted for sex, age, equivalised household income, household composition and household food role. SETTING: UK. PARTICIPANTS: Adults (n 2154) aged 19-64 years in employment. RESULTS: Mean (95 % CI) hours worked per week was 36·1 (35·6, 36·6) and mean DQI score was 41·9 (41·2, 42·5) %. Hours worked was not associated with DQI score, frequency of eating out or consuming takeaways. Hours worked was positively associated with consuming red meat, processed meat and alcohol intake. Adults working more hours had lower intake of fibre but higher total fat and saturated fat intakes if they lived in households with children. CONCLUSIONS: Working hours may not be the main factor driving poor-quality diets among this sample of UK adults in employment. Focusing on consumption of foods prepared outside the household may not be the most efficient way to improve diet quality as effort is needed at all levels. Although it is unclear what is driving the differences in nutrient intakes according to household composition, they are important to consider when developing interventions to improve healthy eating.

Healthy and sustainable diets that meet greenhouse gas emission reduction targets and are affordable for different income groups in the UK.

OBJECTIVE: To model dietary changes required to shift the UK population to diets that meet dietary recommendations for health, have lower greenhouse gas emissions (GHGE) and are affordable for different income groups. DESIGN: Linear programming was used to create diets that meet dietary requirements for health and reduced GHGE (57 and 80 % targets) by income quintile, taking account of food budgets and foods currently purchased, thereby keeping dietary change to a minimum.Setting/ParticipantsNutrient composition, GHGE and price data were mapped to 101 food groups in household food purchase data (UK Living Cost and Food Survey (2013), 5144 households). RESULTS: Current diets of all income quintiles had similar total GHGE, but the source of GHGE differed by types of meat and amount of fruit and vegetables. It was possible to create diets with a 57 % reduction in GHGE that met dietary and cost restraints in all income groups. In the optimised diets, the food sources of GHGE differed by income group due to the cost and keeping the level of deviation from current diets to a minimum. Broadly, the changes needed were similar across all groups; reducing animal-based products and increasing plant-based foods but varied by specific foods. CONCLUSIONS: Healthy and lower-GHGE diets could be created in all income quintiles but tailoring changes to income groups to minimise deviation may make dietary changes more achievable. Specific attention must be given to make interventions and policies appropriate for all income groups.

Greenhouse gas emissions and water footprints of typical dietary patterns in India.

Agriculture is a major contributor to India's environmental footprint, particularly through greenhouse gas (GHG) emissions from livestock and fresh water used for irrigation. These impacts are likely to increase in future as agriculture attempts to keep pace with India's growing population and changing dietary preferences. Within India there is considerable dietary variation, and this study therefore aimed to quantify the GHG emissions and water usage associated with distinct dietary patterns. Five distinct diets were identified from the Indian Migration Study - a large adult population sample in India - using finite mixture modelling. These were defined as: Rice & low diversity, Rice & fruit, Wheat & pulses, Wheat, rice & oils, Rice & meat. The GHG emissions of each dietary pattern were quantified based on a Life Cycle Assessment (LCA) approach, and water use was quantified using Water Footprint (WF) data. Mixed-effects regression models quantified differences in the environmental impacts of the dietary patterns. There was substantial variability between diets: the rice-based patterns had higher associated GHG emissions and green WFs, but the wheat-based patterns had higher blue WFs. Regression modelling showed that the Rice & meat pattern had the highest environmental impacts overall, with 0.77 (95% CI 0.64-0.89) kg CO2e/capita/day (31%) higher emissions, 536 (95% CI 449-623) L/capita/day (24%) higher green WF and 109 (95% CI 85.9-133) L/capita/day (19%) higher blue WF than the reference Rice & low diversity pattern. Diets in India are likely to become more diverse with rising incomes, moving away from patterns such as the Rice & low diversity diet. Patterns such as the Rice & meat diet may become more common, and the environmental consequences of such changes could be substantial given the size of India's population. As global environmental stress increases, agricultural and nutrition policies must recognise the environmental impacts of potential future dietary changes.

Attitudes towards, and purchasing of, Scottish beef and beef products in Scotland - A short communication.

Attitudes and preferences of the main shopper in households (n = 203) across Scotland towards beef and beef products that were produced in Scotland were assessed by questionnaire. Consumer panel purchase data from the preceding six-months were collected for those households by Kantar Worldpanel. Beef products from Scotland accounted for 39% (by value) of all beef purchases, with an additional 46% from Great Britain and 9% from Ireland. Participants tended to report that being locally produced was an important factor when they bought beef and beef products, although this was not reflected in higher proportions of these products being purchased. Participants who rated local production of higher importance did not buy a higher proportion of beef from Scotland than did participants who rated it as less important (41% and 37% respectively, P = 0.448). Stated preferences for locally produced beef and beef products are not translated into higher amounts purchased.

Assessing national nutrition security: The UK reliance on imports to meet population energy and nutrient recommendations.

Nutrition security describes the adequacy of the food supply to meet not only energy but also macronutrient and micronutrient requirements for the population. The aim of this study was to develop a method to assess trends in national nutrition security and the contribution of imports to nutrition security, using the UK as a case study. Food supply data from FAO food balance sheets and national food composition tables were used to estimate the nutrient content of domestically produced food, imported food and exported food. Nutrition security was defined as the total nutrient supply (domestic production, minus exports, plus imports) to meet population-level nutrient requirements. The results showed that the UK was nutrition secure over the period 1961-2011 for energy, macronutrients and key micronutrients, with the exception of total carbohydrates and fibre, which may be due to the loss of fibre incurred by processing cereals into refined products. The supply of protein exceeded population requirements and could be met with domestic production alone. Even excluding all meat there was sufficient protein for population requirements. The supply of total fat, saturated fat and sugar considerably exceeded the current dietary recommendation. As regards nutrition security in 2010, the UK was reliant on imported foods to meet energy, fibre, total carbohydrate, iron, zinc and vitamin A requirements. This analysis demonstrates the importance of including nutrients other than energy to determine the adequacy of the food supply. The methodology also provides an alternative perspective on food security and self-sufficiency by assessing the dependency on imports to meet population level nutritional requirements.

Effect of increasing fruit and vegetable intake by dietary intervention on nutritional biomarkers and attitudes to dietary change: a randomised trial.

PURPOSE: Low fruit and vegetable consumption is linked with an increased risk of death from vascular disease and cancer. The benefit of eating fruits and vegetables is attributed in part to antioxidants, vitamins and phytochemicals. Whether increasing intake impacts on markers of disease remains to be established. This study investigates whether increasing daily intake of fruits, vegetables and juices from low (approx. 3 portions), to high intakes (approx. 8 portions) impacts on nutritional and clinical biomarkers. Barriers to achieving the recommended fruit and vegetable intakes are also investigated. METHOD: In a randomised clinical trial, the participants [19 men and 26 women (39-58 years)] with low reported fruit, juice and vegetable intake (<3 portions/day) were randomised to consume either their usual diet or a diet supplemented with an additional 480 g of fruit and vegetables and fruit juice (300 ml) daily for 12 weeks. Nutritional biomarkers (vitamin C, carotenoids, B vitamins), antioxidant capacity and genomic stability were measured pre-intervention, at 4-, 8- and 12 weeks throughout the intervention. Samples were also taken post-intervention after a 6-week washout period. Glucose, homocysteine, lipids, blood pressure, weight and arterial stiffness were also measured. Intake of fruit, fruit juice and vegetables was reassessed 12 months after conducting the study and a questionnaire was developed to identify barriers to healthy eating. RESULTS: Intake increased significantly in the intervention group compared to controls, achieving 8.4 portions/day after 12 weeks. Plasma vitamin C (35%), folate (15%) and certain carotenoids [α-carotene (50%) and ß-carotene (70%) and lutein/zeaxanthin (70%)] were significantly increased (P < 0.05) in the intervention group. There were no significant changes in antioxidant capacity, DNA damage and markers of vascular health. Barriers to achieving recommended intakes of fruits and vegetables measured 12 months after the intervention period were amount, inconvenience and cost. CONCLUSION: While increasing fruit, juice and vegetable consumption increases circulating level of beneficial nutrients in healthy subjects, a 12-week intervention was not associated with effects on antioxidant status or lymphocyte DNA damage. TRIAL REGISTRATION: This trial was registered at Controlled-Trials.com; registration ISRCTN71368072.

Dietary patterns and non-communicable disease risk in Indian adults: secondary analysis of Indian Migration Study data.

OBJECTIVE: Undernutrition and non-communicable disease (NCD) are important public health issues in India, yet their relationship with dietary patterns is poorly understood. The current study identified distinct dietary patterns and their association with micronutrient undernutrition (Ca, Fe, Zn) and NCD risk factors (underweight, obesity, waist:hip ratio, hypertension, total:HDL cholesterol, diabetes). DESIGN: Data were from the cross-sectional Indian Migration Study, including semi-quantitative FFQ. Distinct dietary patterns were identified using finite mixture modelling; associations with NCD risk factors were assessed using mixed-effects logistic regression models. SETTING: India. SUBJECTS: Migrant factory workers, their rural-dwelling siblings and urban non-migrants. Participants (7067 adults) resided mainly in Karnataka, Andhra Pradesh, Maharashtra and Uttar Pradesh. RESULTS: Five distinct, regionally distributed, dietary patterns were identified, with rice-based patterns in the south and wheat-based patterns in the north-west. A rice-based pattern characterised by low energy consumption and dietary diversity ('Rice & low diversity') was consumed predominantly by adults with little formal education in rural settings, while a rice-based pattern with high fruit consumption ('Rice & fruit') was consumed by more educated adults in urban settings. Dietary patterns met WHO macronutrient recommendations, but some had low micronutrient contents. Dietary pattern membership was associated with several NCD risk factors. CONCLUSIONS: Five distinct dietary patterns were identified, supporting sub-national assessments of the implications of dietary patterns for various health, food system or environment outcomes.

Socio-economic differences in diet, physical activity and leisure-time screen use among Scottish children in 2006 and 2010: are we closing the gap?

OBJECTIVE: To investigate socio-economic differences in children's diet, activity and inactivity and changes in these differences over 4 years during which new policies on food in schools were introduced. DESIGN: Two cross-sectional surveys in which diet was assessed by FFQ and physical activity and inactivity were assessed by interviewer-administered questionnaire. Socio-economic status was assessed by the area-based Scottish Index of Multiple Deprivation. SETTING: Scotland, 2006 and 2010. SUBJECTS: Children aged 3-17 years (n 1700 in 2006, n 1906 in 2010). RESULTS: In both surveys there were significant linear associations between socio-economic deprivation and intakes of energy, non-milk extrinsic sugars (NMES) as a percentage of food energy, sugar-sweetened beverages, confectionery, crisps and savoury snacks and leisure-time screen use (all higher among children in more deprived areas), while intakes of fruit, fruit juice and vegetables showed the opposite trend. In 2010 children in more deprived areas engaged in more physical activity out of school than those in more affluent areas, but between 2006 and 2010 there was an overall reduction in physical activity out of school. There were also small but statistically significant overall reductions in intakes of confectionery, crisps and savoury snacks, energy and NMES and saturated fat as a percentage of food energy, but no statistically significant change in socio-economic gradients in diet or activity between the two surveys. CONCLUSIONS: Interventions to improve diet and physical activity in children in Scotland need to be designed so as to be effective in all socio-economic groups.

Greenhouse gas emissions from agricultural food production to supply Indian diets: Implications for climate change mitigation.

Agriculture is a major source of greenhouse gas (GHG) emissions globally. The growing global population is putting pressure on agricultural production systems that aim to secure food production while minimising GHG emissions. In this study, the GHG emissions associated with the production of major food commodities in India are calculated using the Cool Farm Tool. GHG emissions, based on farm management for major crops (including cereals like wheat and rice, pulses, potatoes, fruits and vegetables) and livestock-based products (milk, eggs, chicken and mutton meat), are quantified and compared. Livestock and rice production were found to be the main sources of GHG emissions in Indian agriculture with a country average of 5.65 kg CO2eq kg-1 rice, 45.54 kg CO2eq kg-1 mutton meat and 2.4 kg CO2eq kg-1 milk. Production of cereals (except rice), fruits and vegetables in India emits comparatively less GHGs with <1 kg CO2eq kg-1 product. These findings suggest that a shift towards dietary patterns with greater consumption of animal source foods could greatly increase GHG emissions from Indian agriculture. A range of mitigation options are available that could reduce emissions from current levels and may be compatible with increased future food production and consumption demands in India.

Buying less and wasting less food. Changes in household food energy purchases, energy intakes and energy density between 2007 and 2012 with and without adjustment for food waste.

OBJECTIVE: Consumers in the UK responded to the rapid increases in food prices between 2007 and 2009 partly by reducing the amount of food energy bought. Household food and drink waste has also decreased since 2007. The present study explored the combined effects of reductions in food purchases and waste on estimated food energy intakes and dietary energy density. DESIGN: The amount of food energy purchased per adult equivalent was calculated from Kantar Worldpanel household food and drink purchase data for 2007 and 2012. Food energy intakes were estimated by adjusting purchase data for food and drink waste, using waste factors specific to the two years and scaled for household size. SETTING: Scotland. SUBJECTS: Households in Scotland (n 2657 in 2007; n 2841 in 2012). RESULTS: The amount of food energy purchased decreased between 2007 and 2012, from 8·6 to 8·2 MJ/adult equivalent per d (P<0·001). After accounting for the decrease in food waste, estimated food energy intake was not significantly different (7·3 and 7·2 MJ/adult equivalent per d for 2007 and 2012, respectively; P=0·186). Energy density of foods purchased increased slightly from 700 to 706 kJ/100 g (P=0·010). CONCLUSIONS: While consumers in Scotland reduced the amount of food energy that they purchased between 2007 and 2012, this was balanced by reductions in household food and drink waste over the same time, resulting in no significant change in net estimated energy intake of foods brought into the home.