Predicting the Adoption of a Sustainable Diet in Adults: A Cross-Sectional Study in Italy

Round 1

Reviewer 1 Report

In this research, the authors assessed the predictive value of the intention to adopt and follow a healthy diet such as MD with regard to actual dietary behavior in a representative sample of Italian adults. Also, the authors looked at what factors feed into this intention, such as attitude, and subjective norms. 

Results showed that the studied intention can indeed point to higher adherence to healthy dietary principles. In their conclusions, the authors suggested that initiatives increasing awareness and reducing barriers would be helpful to facilitate these internal motivation drivers.

The sentence in the abstract "By applying..." is grammatically inaccurate and the statistical jargon used obscures a key result that readers would be interested in. I recommend rewriting it in the style of the conclusion section and/or discussion such as in lines 354-358. The authors could also consider bringing in the key concept "attitude-behavior gap" here.

In lines 383-384, "more interested people a stronger motivation" sounds vague. I suggest a rephrase such as: "For people who express explicit interest in adopting a healthy Mediterranean dietary pattern, the facilitation of behavior and removal of barriers strengthens their intention and the subsequent adoption of the diet."

Please remove the repetition "Figure 1".

 

Line 324. I suggest changing "next future". The future is already next by definition. Maybe "near future"/ "foreseeable future".

Author Response

see the attached file

Author Response File: Author Response.pdf

Reviewer 2 Report

 

The manuscript aims to identify behavioral aspects related to the adoption of a sustainable diet in a representative sample of adults in Italy, by applying the theory of planned behavior.

Some points that need to be considered:

1. While the outcome (behavior of interest) is adequately described and measured through a subjective indicator (i.e. degree of adherence to the Mediterranean Diet, considered as a proxy of sustainable food consumption), the description of determinants (exposure) is not clear. 

2. The information provided in the abstract is sometimes technical and does not allow a succinct description of findings. For instance, the sentence " The explained variance for intention, perceived behaviour, adherence to the MD and food consump-19 tion frequencies was 78%, 54%, 13% and 0-8%, respectively" is difficult to interpret in the context of the abstract.   

3. Although authors present the statistical methods used to identify the most relevant indicators of behavioral intention and to predict behavior (e.g., Spearman's rank-order correlations, SEM models), precision estimates have not been determined/indicated.

4. The study sample is relatively small and representativeness is presented in relation to broad categories of age (<45, >45 years) and residential area (3 groupings). This may limit the generalizability of results (external validity) and should be acknowledged among the study’s limitations.

5. Authors should add information on the survey's response rate. Moreover, they should present and comment on the characteristics of non-respondents.

6. Authors should add a description of the co-variates introduced in the models to estimate standardized coefficients. This information needs to be reported in the section on data analysis as well as a footnote of the corresponding tables.

7. The titles of tables 2 and 3 should be rephrased to assist the explanation of relevant findings and enhance the provision of self-standing tables. Please also elaborate on the results presented in tables 2 and 6.

8. Please expand on the finding by Biasini et al [47], indicated in line 210. Additional information on this study sample and design will allow the reader to evaluate comparability with the present findings.

 

Minor editing required

Author Response

see the attached file

Author Response File: Author Response.pdf