Abstract

Background: There is increasing interest in dietary patterns that support both human and planetary health. Plant-forward dietary patterns commonly promoted within sustainability frameworks frequently include nuts. Despite concerns regarding resource use, particularly water demands, nuts may contribute to improved diet quality and sustainable dietary behaviors.

Objectives: To examine whether diets characterized by higher nut intake are associated with dietary quality, adherence to sustainable dietary patterns, and food-related sustainability behaviors among free-living adults.

Methods: Cross-sectional analyses were conducted using data from an online validated semi-quantitative food frequency questionnaire integrated with sustainability-related survey items. Energy-adjusted nut intake was categorized into quintiles. Dietary quality was assessed using the Healthy Eating Index-2020 (HEI-2020), and sustainable dietary patterns were assessed using the EAT-Lancet Index. Food-related sustainability behaviors, including packaging preferences, food waste, and use of single-use tableware, were assessed using descriptive and ordinal survey measures. Associations were evaluated using multivariable regression and descriptive analyses.

Results: Higher nut intake was associated with greater adherence to both the Dietary Guidelines for Americans and EAT-Lancet dietary patterns. Participants with higher nut intake also reported lower red meat intake and less frequent use of certain single-use products and bottled beverages. These associations remained significant after adjustment for relevant covariates.

Conclusions: Greater nut intake was associated with higher dietary quality, greater adherence to sustainable dietary patterns, and several sustainability-related consumer behaviors among free-living adults. These findings suggest that nut intake may serve as a marker of broader sustainability-oriented dietary and lifestyle patterns.

LLU Discipline

Nutrition

Department

Nutrition

School

School of Public Health

First Advisor

Joan Sabaté

Second Advisor

Gina Segovia-Siapco

Third Advisor

Rawiwan Sirirat

Degree Name

Doctor of Philosophy (PhD)

Degree Level

Ph.D.

Year Degree Awarded

2026

Date (Title Page)

6-2026

Language

English

Library of Congress/MESH Subject Headings

Sustainable agriculture; Nutrition--Environmental aspects; Nuts--Health aspects; Diet--Quality; Sustainable living; Food waste--Environmental aspects

Type

Dissertation

Page Count

xvi, 202 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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