2019 Master Thesis Consumer readiness towards plant-based consumption in selected Latin American Countries. MARÍA ALEJANDRA BRETTI ROBERT SUPERVISOR: Associate Professor F.J. Armando Perez-Cueto Eulert Associate Professor Christian Ritz SUBMITTED ON: 08 august 2019 ABSTRACT Introduction There is a proved association of mal nutrition in all its forms (obesity, undernutrition and other dietary risks) and climate change (Patterson et al., 2019). In the last report of the Lancet Commissions this concept is defined as “Syndemic” due to the synergy that these three main issues have to each other, and this is a global concern. One of the recommendations to fight this situation is move to a plant based diet (Boer, Schösler, & Boersema, 2013). The awareness in the develop countries is growing and some of them have included environmental sustainability in their dietary guidelines, however on Latin American countries, this evidence seems not to be enough to make real and consistent changes in laws and recommendations to fight this syndemic issue. This thesis was divided in two parts, first a systematic review with the aim of analyse the literature available published on Latin American countries regarding plant-based diet related to climate change and sustainable diet, and secondly a quantitative consumer survey distributed among selected Latin American countries to determine the readiness of the consumer to move towards a plant-based diet. Material and methods A quantitative consumer survey was carried out through online program surveyXact and distributed among selected Latin American countries, the questionnaire was developed in Spanish and the distribution was made with help of some collaborators in each country. The sampling methods was a non- probability snowball sampling. The inclusion criteria were defined by people from 15 to 99 years old, residents of the selected countries. The results from the survey were analysed using R and Rstudio® software, applying a fully adjustment model and descriptive statistics. i Results, discussion and conclusion The sample was composed by 827 respondents from three Latin American countries (BL N=245; BR N=260; CL N=322) with a mean age of 30.21 years old, most of the respondents were females and the majority of them have completed higher education. The sample was mostly composed by omnivorous and flexitarians (over 80% in all three countries). The subjects were asked if they intended to change their diet to a plant- based diet on a scale of Likert from 1 to 7, and the results show responses with a greater tendency to change, over 5 points in most of the sample. Although most of the respondents were omnivorous and flexitarians, a tendency to have a willingness to change was observed, either to improve health or due to the knowledge of global warming. This indicates that a structural change can be made in the public policies of the countries to generate a real change. The willingness to change diet was positively affected by the higher consumption of fruits and vegetables and negatively affected by the higher consumption of red meat, this finding can be due to the deep-rooted customs of consuming meat in Latin American countries as a main course, consumers have a limitation of conceiving food without products of animal origin as the center of the main dish. Knowledge also affected the will, the more knowledge regarding global warming and association with diet, the more will to change (BR. p 0.0002).and lastly the more awareness of the benefits of a Mediterranean type of diet increased significantly the will of change (CL. p 0.0004). The association of knowledge, awareness and willingness to change has been seen in other cultures and gives us hope to make changes in education from childhood, awareness campaigns for the population and educate health professionals to have a more educated and awareness countries, to achieve true changes, not only at the health level of individuals, but also globally to fight the damage that the industry generates in the environment. ii PREFACE This report presents the work of a master thesis that acts as the final paper in the conclusion of the Master of Science degree in Food Innovation and Health at the faculty of science at the University of Copenhagen. The first part of the report systematically reviews the literature published on global warming in Latin American countries, diet, and health, and the second part refers to an online survey among selected Latin American countries to determine the readiness to move toward a plant-based diet. Associate Professor Federico Jose Armando Perez-Cueto Eulert from the Section of Food Design and Consumer Behaviour, University of Copenhagen, and Associate Professor Christian Ritz from the Department of Nutrition, Exercise, and Sports, Pediatric and International Nutrition, University of Copenhagen, supervised the thesis. The theoretical part of the thesis was conducted at the Department of Food Science, Section of Food Design and Consumer Behaviour at the University of Copenhagen from February to August 2019. iii INDEX ABSTRACT i PREFACE iii INDEX iv LIST OF FIGURES AND TABLES vii LIST OF ABBREVIATIONS ix BACKGROUND Definitions 1 Background 2 SECTION 1 8 Systematic review Introduction 9 Aim 10 Research question 10 Methodology 11 Results 12 Diet and global warming 16 Plant based diet and health 16 Implication and social motivation of vegetarianism and 17 veganism Undergraduate thesis 20 Discussion 22 Conclusion 24 iv SECTION 2 25 Online survey and analysis to determine readiness to move towards a plant-based diet in Latin American countries Introduction 26 Research question 28 Study design Data collection 28 Questionnaire 29 Data analysis 30 Results Sociodemographic description of the sample 31 Willingness to move towards a PBD 32 Frequency of consumption 33 Willingness to move towards a PBD influenced by frequency of 34 consumption Willingness to move towards a PBD influenced by knowledge 35 Willingness to move towards a PBD influenced by awareness 37 regarding GW and PBD Barriers and facilitators 38 Intention to change diet influence by barriers and facilitator 39 Willingness to change diet influence by barriers and facilitator 42 Barriers and facilitators influence by diet 44 Intention to change diet and motives 47 Intention to change diet and motives for parents 50 v Discussion The sample 53 Willingness to Move Toward a Plant-based Diet 54 Frequency of Consumption 55 Willingness to Move Toward a PBD Influenced by Knowledge 55 and Awareness Regarding GW and PBD Barriers and Facilitators 56 Intention to Change Diet and Motives 57 Limitations and strength 58 Conclusion 59 REFERENCES 60 APPENDICES 67 Appendix Nº1 survey 67 Appendix Nº2 commands for Rstudio 72 vi LIST OF FIGURES AND TABLES Tables Table 1: Methodology 11 Figure 1: Screening of articles 12 Table 2: Analysis of articles 13 Table 3: Analysis of included theses 19 Table 4: Socio demographic characteristics of the sample 31 Figure 2: Willingness to move towards a plant based diet 32 Table 5: Frequency of consumption descriptive 33 Table 6: Willingness to move towards a PBD influenced by frequency 34 of consumption of certain groups of food Table 7: Willingness to move towards a PBD influenced by knowledge 36 of specific statements Table 8: Willingness to move towards a PBD influenced by awareness 37 regarding GW and PBD Table 9: Barriers and facilitators descriptive analysis 39 Table 10: Intention to change diet influence by barriers and facilitator 41 Table 11: Willingness to change diet influence by barriers and 43 facilitator Table 12: Barriers and facilitators influenced by diet (part 1) 45 Table 12: Barriers and facilitators influenced by diet (part 2) 46 Figure 3: Intention to change to a PBD 47 Figure 4: Motives to change to a PBD 48 Figure 5: Motives to NOT change to a PBD 49 vii Figure 6: Intention to change to a PBD for parents 50 Figure 7: Motives to change to a PBD for parents 51 Figure 8: Motives to NOT change to a PBD for parents 52 viii LIST OF ABBREVIATIONS • W: Willing. • GW: global warming. • PBD: plant-based diet. • WTC: willingness to change. • A: Agreement. • OCDE: organization for cooperation and economic develop (by their Spanish initials). • UK: United Kingdom. • FAO: Food and agriculture organization of the united nations. • EEUU: United states of America. • LATAM: Latin American countries (by their Spanish initials). • BL: Bolivia. • BR: Brazll. • CL: Chile. • FBDG: food based dietary guidelines. ix BACKGROUND Definitions Before starting, it is important to set some definitions for better understanding of this document. The association of U.K. dietitians defines a plant-based diet as a diet based on foods derived from plants that include a few or no animal products (Garton & Hood, 2017). However, there is still no consensus about the definition of a plant-based diet. Authors define this as minimally processed food, which includes fruits, vegetables, legumes whole grain, nuts and seed and excludes all animal products (Ostfeld, 2017). For this dichotomy, it is important to not only define the concept of a plant-based diet but also the different types of plant-based diets found in the literature. In this document, a plant-based diet is defined as follows: “A diet based on foods derived from plants, such as fruits, vegetables, legumes, whole grains, nuts, and seed, and with few or no animal product include.” The definition of a plant-based diet comprises many diets, which have been defined as follows: Veganism: this form of diet excludes all types of animal-derived products from its daily plan (Melina, Craig, & Levin, 2016). Vegetarianism: this form of diet excludes all types of flesh foods, such as meat, poultry, and seafood (Baroni, Goggi, & Battino, 2018). Pescetarianism: this form of diet contains fish or seafood, but no meat (Dagnelie & Mariotti, 2017b).