PROMOTION OF HEALTHY AND SUSTINABLE DIETS - VALORIZATION OF MILK OF MILK PRODUCTS IN HEALHTY AND SUSTINABLE FOOD MODELS (VALILAT).

One of the major challenges for current food systems is promoting healthy and sustainable diets (SHDs) for the growing global population while limiting the impact on the environment. Prioritizing plant-source foods (PSFs) and reducing the animal-source foods (ASFs) is crucial for human and planetary health, but this dietary transition may cause unintended nutritional consequences if the nutrient contribution of ASFs is not properly considered. Among them, milk consumption is declining in several countries due to environmental, ethical and health-related concerns, as well as misinformation surrounding its consumption, despite being widely recommended in Food Based Dietary Guidelines (FBDGs) worldwide. Conversely, these factors have led to an increase in the consumption of its plant-based analogues (PBAs). The present PhD project aimed to explore the potential role of milk and dairy products within SHDs, while also exploring characteristics of PBAs and impact of their use when replacing milk. This thesis addressed four main tasks: (i) investigating the impact of replacing milk with plant-based drinks (PBDs) on human health; (ii) examining the nutritional quality of milk and dairy products PBAs sold in Italy and the theoretical impact of substituting milk with PBAs on nutrient intake; (iii) optimizing diets that include the portions of milk and yogurt recommended by the Italian FBDGs, considering both nutritional and environmental aspects; (iv) addressing misinformation through the development and validation of a questionnaire on milk and yogurt designed to assess the nutritional knowledge (NK), and the design and implementation of dissemination activities. The first task revealed that available data on the effect of replacing milk with PBDs are scarce and sometimes conflicting. Results from the second task highlighted nutritional variability both among and within the same category of dairy PBAs, emphasizing the lack of important nutrients (e.g., calcium) and/or excessive sodium levels in some products. Furthermore, the use of different categories of PBDs in place of milk resulted in varying changes in nutrient intake, with calcium deficiency being the primary nutritional risk associated with this substitution. Results from the third task emphasized that including recommended portions of milk and yogurt can align with SHDs when considering specific nutrients and carbon footprint. In the fourth task, a specific questionnaire was developed and validated to assess the NK regarding milk and yogurt. Furthermore, dissemination activities were carried out through workshops and social media campaigns to promote behaviors aligned with the Italian FBDGs and to counter misinformation, particularly regarding milk and dairy products. In conclusion, this PhD thesis supports the inclusion of milk and dairy products in SHDs, especially for their role in calcium intake, while recognizing that current dairy PBAs on the Italian market are not substitutes for a nutritional perspective. However, PBAs consumption should be considered considering the increased food variety they offer. Consequently, future research is needed to enhance the nutritional quality of PBAs and to further explore their role, along with that of dairy products, in SHDs. Finally, this project underscores the importance of consumer education to raise awareness about the benefits of making informed dietary choices.