Title:Environmental footprints of Mediterranean versus Western Dietary Patterns: Beyond the health benefits of the Mediterranean Diet

Transcription

1 Author's response to reviews Title:Environmental footprints of Mediterranean versus Western Dietary Patterns: Beyond the health benefits of the Mediterranean Diet Authors: Sara Sáez Almendros Biel Obrador Lluis Serra-Majem Anna Bach-Faig Version:4Date:12 December 2013 Author's response to reviews: see over

2 Dear Editor, December 3, Las Palmas de Gran Canaria, Please, find attached our manuscript entitled Environmental footprints of Mediterranean versus Western Dietary Patterns: Beyond the health benefits of the Mediterranean Diet. It has been edited and revised according to the Reviewers reports and checked by a native English speaker. Authors would like to thank the Reviewers for their contribution and work because they have helped to significantly improve our manuscript. Response to the Reviewer's report on: Beyond the health benefits of the Mediterranean Diet: Environmental Sustainability Main changes introduced in the new version: New Title: Environmental footprints of Mediterranean versus Western Dietary Patterns: Beyond the health benefits of the Mediterranean Diet Two annex tables have been added to improve the content of the manuscript. Specific Reviewer Responses: To Reviewer (RV): Roberto Capone Authors answers (AA) - Minor Essential Revisions 1. Materials and Methods: Considering the total Spanish population may be problematic especially given the fact that the Mediterranean Diet Pyramid used refers to servings for the adult population. We agree with the reviewer. Using only adult population would change the absolute footprints but would provide only a partial assessment of the true total footprint. If a dietary composition (servings) for different age groups according to the MDP was available for each dietary pattern a more precise estimate could be calculated, but this is not the case. As this information was not available, we used total rather than a single population and assumed the associated uncertainty. In fact, using only adult population would not

3 change our results substantially in the relative comparison of the environmental footprints between dietary patterns. 2. Materials and Methods: Authors should clearly state why the final consumption stage was, generally, not considered. It has been stated in the manuscript that these three phases were considered key, where information was available. 3. Materials and Methods: Authors should provide a table showing the exact composition of the 4 dietary patterns that was used to calculate their environmental footprints. Composition should be expressed in terms of the main food items/food groups (FBS classification can be used for this purpose). That is particularly important in order to better understand the interpretation of the study results. This is true also in the case of the Mediterranean Dietary Pattern (MDP). In fact, the new Mediterranean diet pyramid is provided with serving frequency but more detailed information about servings sizes are necessary. All data regarding the composition of the different diets can be expressed in Kg/capita/year for easy comparison. A table as annex is attached with this information. - Discretionary Revisions 1. Abstract/abbreviations: I think that MDP should refer to the Mediterranean Dietary Pattern (not Mediterranean Diet). Authors agree and have changed the definition to Mediterranean Dietary Pattern. 2. Abstract: Delete t in the sentence The aim of the study was to analyze the sustainability of the MDP in the context of the Spanish population t in terms of greenhouse gas emissions Authors agree and have deleted this in the manuscript. 3. Abstract: Maybe is better to use the expression environmental footprints as ecological footprints may be confusing.

4 Authors agree and have changed this to environmental footprints throughout the manuscript. 4. Abstract: Delete second, in the sentence The MDP is presented as not only a cultural model but also as a healthy and environmentally-friendly model adherence to which in Spain would have,, a significant contribution. Comma was deleted in the manuscript. 5. Whole manuscript: Check and replace double spaces. Authors revised and made the proper changes on the manuscript. 6. Material and Methods, page 6: Year of reference of FAO food balance sheets data used to estimate the current Spanish dietary pattern (SCP) may be stated. The year of reference has been added to the reference in the manuscript. 7. Material and Methods, page 6: The SCP was estimated from the Household Consumption Surveys based on daily food purchases. Authors may state why they decided to consider food purchases and food consumption as equivalents especially considering food waste that may occur at household level. Authors used the comparison between food consumption and food purchase as a quality control. This information is actually stated in the text. A sentence to make it clear that this is different has been added to the revised manuscript. 8. Material and Methods, page 7: For sure energy is a resource but I wonder if it can be considered as a natural resource. The word natural has been removed from page 7 (Methods section). 9. Material and Methods, page 7/ Annex: Some LCA sources are from abroad (not Spain) and refer to different years. Authors are invited to state why, according to them, the use of some old data (e.g. Agricultural land use dairy products: 1997), data from different

5 countries (e.g. Northern Europe: Denmark, Sweden) belonging to different agro-ecological zones, and foods representing the different food groups do not affect in a significant way the robustness and soundness of results. They may also specify better the assumptions adopted to consider these data valid also for the current Spanish context. This is a major limitation of the study and authors have included an acknowledgment of it in the discussion section. 10. Material and Methods, page 7: Authors may explain in this section what were the main strategies that they adopted to cope with missing and unavailable data. This is important as the aim was to evaluate the environmental footprint of the whole dietary pattern rather than a selection of food items/ groups. In fact, data presented and discussed refer to dietary patterns. A paragraph on these issues has been added to the Methods section. 11. Material and Methods, page 7: It is stated that The three phases analyzed in the food production system were the agricultural production, processing and packaging, transportation and retail. It is better to talk about food system or food chain rather than food production system as, for example, retail can not be included in the production system. Moreover, authors may explain while the final food consumption stage was not considered: unavailability of data, insignificant contribution to the overall footprint keeping in mind that that may change from a food/food group to another and depending on the considered environmental pressure. Food production system has been changed for food system. Reasons for food consumption that were excluded from the text have now been stated in the Methods section. 12. Material and Methods, page 7: Water footprint data used to calculate water consumption (Mekonnen and Hoekstra, 2011) include the green, blue and grey components. Authors may specify which components they considered: only blue water? We used total water consumption (blue+green+grey) because we considered the three main phases of the LCA. 13. Results, page 9: It is stated that The MDP in Spain would substantially reduce GHG emissions (72%), agricultural land use (58%) and energy consumption (52%), and to a lower extent water consumption (33%). Results regarding water consumption may be better further explained in Discussion section with clear reference to the food products/groups that are responsible of this situation.

6 A paragraph has been added to Discussion section regarding this issue. 14. Results, page 10: Clauses such as (data not-shown) may be merely deleted. Clause data not-shown has been deleted from the text. 15. Results, page 11: Authors may add a table (in addition to figure 3) showing the relative contributions of the different food products/food groups to the MDP (in terms of weight as expressing values in terms of dietary energy would be quite difficult) and their relative contributions to the different environmental footprints. That would be quite inspiring and will make easier understanding. We have added this information as a table. 16. Results/Annex: It is not clearly stated if the same data sources were used to estimate also the environmental footprints of the WDP (USA). We have added a sentence to better express this. 17. Discussion: Some methodological limitations may be moved to Material and Methods section as they affect not only comparisons of environmental footprints from different studies but also the robustness and soundness of the present study results. Limitations have been changed to Methods section. 18. Discussion, page 13: Please correct, human consumption not humanconsumption. The phrase has been corrected. 19. Discussion, page 14: Delete second, in Furthermore,, post retailing. The phrase has been corrected. 20. Discussion: Among methodological problems (regarding environmental footprints and environmental accounting in general) there is also that of double counting so authors

7 can explain how they overcome/avoided that especially in the case of land use (cf. land use for crops and animal products, cereals and bread). We did not consider this issue, we agree on the potential effect of this on our calculations. This should, however affect almost exclusively the land use footprint estimates. We have added a sentence to highlight this aspect. 21. Discussion, page 14: Authors may better explain the slight increase in energy consumption due to the adherence of the Spanish population to the MDP. This might correspond to a misunderstanding of our results since such an increase is not shown in fig Discussion, 15: It is stated that In our study, legumes were included in the vegetable group as they have a similar low environmental impact values. This statement is misleading and a bit confusing. In fact, to my knowledge, legumes and vegetables footprints (e.g. water footprint) are neither similar nor low in the Mediterranean area. We have corrected our explanation of why legumes and vegetables were dealt with together. 23. Abbreviations: Life CYcle Assessment (LCA) not Life Cicle Assessment. Abbreviation was changed to Life CYcle Assessment. 24. Authors' contributions: Please provide full names for "SSA and ABF. Full names have been added. 25. References, number 16: European Commission not European Comission. Misspelling has been corrected. 26. Figure 1: The Mediterranean diet pyramid and so also servings are addressed to adult population so authors may state what are the adjustments /assumptions made to get food consumption for the total Spanish population, necessary to estimate the environmental footprints associated to the MDP.

8 A sentence has been added to mention this issue in the article. 27. Figure 3, Legend: The fish group was not considered also in water footprint. Legend was corrected according to Review s suggestion. 28. Table 1: For greenhouse gas emissions, please consider (Gg CO2-eq year-1) instead of (Gg CO2-eq year). Table was corrected according to Reviewers suggestion. 29. Figure 1: In The Mediterranean diet pyramid can be put also data about the dietary composition (so the amount of the different foods and food groups) that were used to calculate the environmental footprints of the MDP. A table has been added to clarify dietary composition. 30. Figure 2: Labels 150 and 200 are too close and do not reflect the adopted scale. For ease of visualization, after the break in the x-axis, the scale was changed. 31. Figure 3: The fact of considering vegetable oils and (animal) fats in one category (cf. vegetal oils and fats) make more difficult having a clear idea about the relative contributions of vegetal-source foods and animal-source foods to different environmental footprints. We agree and a limitation in Material & Methods has been added to state that issue. 32. Figure 3, GHG emissions: There is no legend. 33. Figure 3, Water consumption: Legend is not clear. 34. Figure, Agricultural land use: I think that also in this case values should be expressed per year as these refer to the land surface necessary for producing the food necessary for one individual in one year. All these format issues have been corrected.

9 Specific Reviewer Responses: To Reviewer (RV2): F. Xavier X Medina Authors answers (AA) Reviewer's report: - Major Compulsory Revisions RV2: NO Major Revisions. - Minor Essential Revisions RV2: Even if the writing is very acceptable, it needs a new formal revision regarding details like:..would have,, a significant (in the abstract), and others. A formal revision of the English Language has been made. We have incorporated some improvements in writing with the help of an English native expert - Discretionary Revisions RV2: Even if the article says that MD takes part of the World heritage of the Humanity by UNESCO and the main focus is on consumption and environment, the social aspects of this consumption, changing patterns and its influences on the environment are secondary (even in the references). Maybe a reference on social aspects and food habits should be useful to understand the real framework of this research. A reference on social aspects has been included. Changes introduced in the new version according to the journal style: For the corresponding author, the existing text has been replaced with *Corresponding author placing the * after his/her superscript numbers in the authors' list. In the Abstract, colons have been removed and text has been moved below. The second heading should read Methods and the third and fourth Results and Discussion. In the List of abbreviations we have changed the commas to colons. In the References the issue numbers have been removed and used full page references.

10 Yours sincerely, Lluis Serra Majem Department of Clinical Sciences, University of Las Palmas de Gran Canaria Spain