Sustainability Perception of Italian Consumers: Is it Possible to Replace Meat, and What Is the Best Alternative?

Abstract

Growing worldwide food demand with its environmental impacts requires a reshaping of food consumption. This study aims to evaluate the degree of Italian consumers’ awareness of sustainability and whether protein alternatives to meat could be accepted. A cross-sectional survey was carried out on a group of 815 respondents, representative of the Italian adult population for geography, gender, and age, using multivariate analysis together with cluster analysis. Lack of awareness of the consequences of food choices on the environment was found in 45% of respondents, and 51% reduced their consumption of meat. Typical foods of the Mediterranean diet (84% legumes 82% eggs, and 77% fish) were selected as the preferred sources of protein to replace meat, while insects and insect-based products were less accepted (67%). The importance of meat is the latent factor that explains more than 50% of the common variance observed in the factor analysis. The cluster analysis confirmed the importance of meat for Italian consumers, emphasizing other aspects of the sustainability of food choices. Cluster 1 (25.6%) considered meat very important. Two out of five clusters (clusters 2 and 3, 38%) considered meat replaceable in the diet, and cluster 4 (31.3%) included meat consumers that were willing to be sustainable. Cluster 5 identifies the “unsustainable consumers” (5.7%). In conclusion, besides the perceived importance of meat, there is room for recommendations for its reduction by proposing alternative foods already present in the Mediterranean diet.

Full text

Citation: Aureli, V.; Nardi, A.;
Palmieri, N.; Peluso, D.; Di Veroli,
J.N.; Scognamiglio, U.; Rossi, L.
Sustainability Perception of Italian
Consumers: Is it Possible to Replace
Meat, and What Is the Best
Alternative? Nutrients 2023,15, 3861.
https://doi.org/10.3390/
nu15183861
Academic Editor: Joerg Koenigstorfer
Received: 20 August 2023
Revised: 29 August 2023
Accepted: 29 August 2023
Published: 5 September 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
nutrients
Article
Sustainability Perception of Italian Consumers: Is it Possible to
Replace Meat, and What Is the Best Alternative?
Vittoria Aureli 1, Alessandra Nardi 2, Nadia Palmieri 3,* , Daniele Peluso 4, Jacopo NiccolòDi Veroli 1,
Umberto Scognamiglio 1and Laura Rossi 1, *
1CREA Council for Agricultural Research and Economics—Research Centre for Food and Nutrition,
00178 Rome, Italy; vittoria.aureli@crea.gov.it (V.A.); jacoponiccolo.diveroli@crea.gov.it (J.N.D.V.);
umberto.scognamiglio@crea.gov.it (U.S.)
2
Department of Mathematics, University of Rome “Tor Vergata”, 00133 Rome, Italy; alenardi@mat.uniroma2.it
3CREA Council for Agricultural Research and Economics—Research Centre for Engineering and Agro-Food
Processing, 00015 Monterotondo, Italy
4Department of Biology, University of Rome “Tor Vergata”, 00133 Rome, Italy; daniele.peluso@gmail.com
*
Correspondence: nadia.palmieri@crea.gov.it (N.P.); laura.rossi@crea.gov.it (L.R.); Tel.: +39-069-067-5219 (N.P.)
Abstract:
Growing worldwide food demand with its environmental impacts requires a reshaping
of food consumption. This study aims to evaluate the degree of Italian consumers’ awareness of
sustainability and whether protein alternatives to meat could be accepted. A cross-sectional survey
was carried out on a group of 815 respondents, representative of the Italian adult population for
geography, gender, and age, using multivariate analysis together with cluster analysis. Lack of
awareness of the consequences of food choices on the environment was found in 45% of respondents,
and 51% reduced their consumption of meat. Typical foods of the Mediterranean diet (84% legumes
82% eggs, and 77% fish) were selected as the preferred sources of protein to replace meat, while
insects and insect-based products were less accepted (67%). The importance of meat is the latent
factor that explains more than 50% of the common variance observed in the factor analysis. The
cluster analysis confirmed the importance of meat for Italian consumers, emphasizing other aspects of
the sustainability of food choices. Cluster 1 (25.6%) considered meat very important. Two out of five
clusters (clusters 2 and 3, 38%) considered meat replaceable in the diet, and cluster 4 (31.3%) included
meat consumers that were willing to be sustainable. Cluster 5 identifies the “unsustainable consumers”
(5.7%). In conclusion, besides the perceived importance of meat, there is room for recommendations
for its reduction by proposing alternative foods already present in the Mediterranean diet.
Keywords:
sustainability; consumers’ behavior; dietary recommendations; meat; meat alternative; Italy
1. Introduction
The increasing world population will inevitably cause an increase in food demand [
1
],
especially in the most developed areas that have an unsustainable food consumption pat-
tern, consuming more food than necessary, mainly based on animal products, processed
foods, and saturated fats that inevitably have an impact on water, land use, and gas produc-
tion [
2
]. It is estimated that 26% of anthropogenic greenhouse gas emissions (GHGE), 70%
of freshwater consumption, the occupation of half the world’s habitable land, and 78% of
global eutrophication of oceans and freshwater is due to agriculture [
3
]. Livestock produc-
tion, in particular beef and lamb, contributes to 14.5% of total global GHGE [
4
], either in
terms of GHGE or land use [
5
] and meat consumption largely exceeds the recommendations
in several countries with an average of 34.5 kg per person per year worldwide and 80 kg
per capita in Italy [
6
]. The food patterns of North and West Europe and the United States
have the highest levels of carbon footprints, being, therefore, primarily responsible for
environmental problems [
7
], but also bringing social, ethical, and economic implications
for future generations [8].
Nutrients 2023,15, 3861. https://doi.org/10.3390/nu15183861 https://www.mdpi.com/journal/nutrients

Nutrients 2023,15, 3861 2 of 18
Environmental protection is included in the framework guidelines of the World Health
Organization (WHO) to be beneficial from a healthy point of view and contribute to achiev-
ing global sustainability goals [
9
]. In Italy too, recommendations for dietary choices that are
protective of the environment and promote a sustainable food system have been included in
dietary guidelines [
10
]. A sustainable diet is defined by the Food and Agriculture Organiza-
tion (FAO) as an eating pattern with minimal environmental impact, which guarantees food
security and health for future generations, which is protective and respectful of biodiversity
and the environment, and is acceptable, accessible, and affordable [8]. In this sense, a diet
with a low quantity of animal products and a high proportion of plant-based foods has
positive effects on human cardio-metabolic health [
11
–
14
] is correlated with a reduction in
overall mortality [
15
–
17
] and will positively impact on the environment with a relevant
decrease of GHGE [
18
]. Cereals and legumes are characteristic vegetable protein elements
of the Mediterranean dietary pattern. Legumes are an excellent source of protein that
could replace the consumption of animal proteins; besides their healthy nutritional profile,
legumes also represent an advantage from an environmental point of view (e.g., fixing the
nitrogen in the soil, facilitating circulation of soil nutrients and water retention [
19
]) despite
the limits of a low level of productivity in Mediterranean areas [20].
In recent years, sources of protein alternatives to meat such as algae, jellyfish, insects,
and insect derivatives, traditionally used in Africa, Asia, and South America [
21
], have
been proposed in addition to the foods traditionally recommended as meat replacements
(e.g., fish, legumes, nuts, eggs, and dairy products). Despite the increasing interest in
these new protein sources, people’s acceptance represents an important barrier to the
consumption of very different foods in European countries [
22
], including Italy. Other
typologies of alternative sources of proteins include lab-grown meat (from cell culture),
and plant-based meat alternatives (with or without GMOs). Lab-grown meat, or
in vitro
meat, means meat produced through tissue engineering technologies without breeding
and killing animals [
23
]. Laboratory production reduces the environmental impact of
livestock and controls the composition and quality of meat [
24
]. However, cultured meat
production is still very expensive [
25
] with the problem of consumer acceptance largely
unexplored in Italy [
26
]. In addition, lab-grown meat needs to be assessed in terms of
safety considering that it is a new product and dangers could occur from the use of specific
materials, additives, ingredients (including potential allergens), and equipment used for
cell-based food production [
27
]. Moreover, it will be necessary to understand whether
the assumed benefits of the greater sustainability of lab-grown meat can be realized and
guaranteed compared to conventionally produced foods [28].
At the moment, the most common meat alternatives on the market are plant-based
meat substitutes, which have seen a significant increase in sales in recent years [
29
]. Substi-
tutes can be found in various formats such as burgers, sausages, and ground beef, which
are remarkably close to the original texture and organoleptic properties of meat [
30
] and
have largely been accepted by consumers.
Despite the ongoing expansion of the meat alternative market, consumers are still
too often unaware of the impact of their food choices on the environment. In fact, human
health and animal welfare are the main motivations for consumers to reduce or even
eliminate meat consumption, while environmental issues are relevant for a minority of the
population [
31
]. According to Hartmann et al. [
32
], it is the lack of awareness of the negative
impact that food production has on the environment that results in non-sustainable food
choices.
This work originates from the idea of having a benchmark for the development of
sustainability recommendations in the framework of dietary guidelines that in Italy were
provided without an evaluation of consumers’ considerations of sustainability [
10
]. To the
best of the authors’ knowledge, no similar assessments have been carried out in Italy on
a representative sample of the population. Hence, the research questions and the gaps
that this study intended to fill in were (i) how much attention do Italian consumers pay
to the environmental consequences of their dietary choices? (ii) To what extent is meat

Nutrients 2023,15, 3861 3 of 18
considered essential or are alternatives acceptable to Italian consumers? (iii) What kind
of policymaking would consumers welcome to increase the sustainability of their eating
behaviors? (iv) Is it possible to identify socio-demographic characteristics related to the
sustainability of food consumption? These data have practical applications related to
the possibility of providing real-life suggestions aimed at improving the sustainability of
consumer food choices.
The objectives of this study were to evaluate the degree of Italian consumers’ aware-
ness of food sustainability and whether alternative proteins to meat could be recommended
in the context of dietary guidelines and nutritional advice, hypothesizing a conservative
attitude of Italian consumers toward new foods that are markedly different to traditional
foods [26,33].
2. Materials and Methods
2.1. Design of the Study
A cross-sectional survey was carried out in Italy on 815 adults (over 18 years), na-
tionally representative for geography, gender, and age. The fieldwork was conducted in
the period between 22 and 28 March 2022 by a specialized market research agency, SWG
Italy
®
. The data were collected through online interviews using the CAWI (Computer
Assisted Web Interviewing) technique on a group of adults residing in Italy, extracted
from a panel that includes over 60,000 individuals, profiled according to the main national
socio-demographic variables. A random selection method to identify the respondents was
used, stratifying area of residence, age group, and gender. To improve representativeness
for education, a Random Iterative Weighting was used. The target distribution was the
most recently available distribution of educational level in Italy (at the time of the survey),
stratified according to the area of residence, age group, and gender, as provided by the
National Institute of Statistics [
34
]. The survey size was defined to guarantee a maximum
margin of error of 3.5% at 95% confidence intervals (CI). Before the start of data collection,
respondents were required to sign a privacy agreement and consent form for personal data
collection and processing in accordance with the Italian data protection law (Legislative
Decree 101/2018), in line with the European Commission’s general data protection regu-
lation (679/2016). Participants were informed about the objective of the research and the
consequent statistical analysis. Participation in the study was fully voluntary and anony-
mous, and subjects could withdraw from the survey at any time and for any reason. The
study was conducted according to the guidelines of the Declaration of Helsinki [
35
], and all
procedures involving research study participants were approved and are in line with the
SWG code of conduct [
36
]. As the assessment did not involve any invasive procedures or
induce any changes in dietary patterns, the study did not require approval from the ethics
committee.
2.2. Assessment Tool
The questionnaire used in the present paper was previously validated on the Italian
population. The questionnaire resulting from the validation process can be found in the
supplementary material of the paper of Aureli et al. [
37
]. No further modifications were
carried out on the assessment tool. The questionnaire was conceived in order to assess
the perception of Italian consumers on the theme of the environmental impact of food
choices. The outcomes of the assessment could be used for the development of tailored
recommendations.
In synthesis, a multi-section questionnaire was administered with an initial part
covering socio-demographic information (gender, age, region of residence, educational
level, and income) and self-reported weight and height. The key elements of the assessment
tool consisted of 12 questions that comprise 71 items from which three sections could
be identified: (i) food sustainability knowledge (4 questions accounting for 30 items);
(ii) sources of proteins alternative to meat (3 questions accounting for 20 items); (iii) eating
behaviors (5 questions accounting for 21 items). Continuous scale questions were mingled

Nutrients 2023,15, 3861 4 of 18
with categorical questions requiring yes/no responses. In the case of continuous scale
questions, answers were provided through a 10-point Likert scale (1 corresponding to
“strongly disagree” to 10 corresponding to “strongly agree”).
2.3. Data Analysis
Absolute frequencies and percentages were used to describe categorical items; contin-
uous items were summarized as mean and standard deviation (SD).
In order to reduce data dimension, Factor Analysis (FA) was performed. The Principal
Component Analysis (PCA) method was used for the extraction of factors. With the
aim of optimizing the loading factor of each item Varimax rotation was applied. For all
the extracted factors, eigenvalues, proportions, and cumulative proportions of explained
common variance were computed. The proportion of explained common variance was
used as a criterion for factor selection, assuming a threshold of 10%. For each of the selected
factors, we derived a corresponding score considering the items whose factor loading was
greater than 0.35. Scores were defined as the weighted average of responses to these items,
assuming factor loadings as weights. Histograms were used to describe their empirical
distributions. Kernel density estimates and normal densities were superimposed.
Based on the defined scores a non-hierarchical cluster analysis was undertaken. The
k-means clustering method was chosen to minimize within-cluster variances. The choice of
cluster number was based on the Pseudo F Statistic and Cubic Clustering Criterion.
Statistical analyses were conducted using SAS (version 9.4) and R (version 4.2).
3. Results and Discussion
3.1. Characteristics of the Survey
Table 1shows that the socio-demographic characteristics of the respondents are in
line with the Italian socio-demographic composition [
34
] as far as gender, age, and area of
residence are concerned, as expected from the sampling procedure. After the weighting of
the data, the educational level distribution, in which the higher levels were overrepresented,
was also found to be in line with Italian official statistics improving the representativeness
of the sample.
Table 1. Population socio-demographic information and body mass index (BMI) with weight.
Gender
Man 407.05 49.94%
Woman 407.95 50.06%
Age
Mean = 43.43 SD = 12.68
Age groups
18–35 197.42 26.07%
35–45 170.09 28.87%
45–55 213.80 26.23%
55–65 218.65 26.83%
Family size
1 85.72 10.52%
2 222.20 27.26%
3 232.41 28.52%
4 210.31 25.80%
5 50.36 6.18%
6 5.66 0.7%
>6 8.33 1.02%

Nutrients 2023,15, 3861 5 of 18
Table 1. Cont.
Presence of children in the family
Age ≤11 years 178.91 21.95%
Age > 11 years 130.45 16.01%
No 505.63 62.04%
Education level
Low
(primary school or lower) 62.73 7.70%
Middle-low
(secondary school) 525.04 64.42%
High-middle
(first university level) 107.42 13.18%
High
(university degree or higher) 119.80 14.7%
Area of origin
Northwest Italy 216.89 26.61%
Northeast Italy 158.86 19.49%
Central Italy 161.71 19.84%
South Italy 188.69 23.16%
Island 88.84 10.9%
Household income
<18,000 EUR 157.23 21.56%
[18,000 EUR, 36,000 EUR] 366.33 50.25%
>36,000 EUR 205.51 28.19%
Body mass index
Underweight 32.10 3.94%
Normal weight 465.89 57.16%
Overweight 221.57 27.19%
Obese 95.43 11.71%
Working activity
Student 66.40 8.15%
Housemaker 85.62 10.51%
Retired 33.61 4.12%
Unemployed or looking for a
first job 57.84 7.09%
Manual worker 101.35 12.44%
Employee 295.60 36.27%
Self-employed 130.03 15.96%
Others 44.54 5.46%
Urban
<100,000 638.03 78.29%
≥100,000 176.96 21.71%
3.2. Consumers’ Perception of Food Sustainability
The results of the assessment of consumers’ awareness of food sustainability were
reported based on the three sections of the questionnaire. Detailed results of all the
questions are reported in Table S1 of the Supplementary Materials.
3.2.1. Food Sustainability Knowledge
What emerges from this section is that consumers have little consideration of the
impact their food consumption has on the environment and that they perceive sustainable
products as too expensive. On the other hand, the reduction of food waste was recognized as
a key element for achieving sustainability. In detail, Q1 shows a general lack of awareness
regarding the negative effects of respondents’ eating habits on the environment (45%,

Nutrients 2023,15, 3861 6 of 18
<4 points on the Likert scale). More than 80% of respondents associate the concept of
“sustainable foods” (Q2) with low environmental impact, local food supply chains, and
healthy foods. The price of sustainable foods (Q3) is perceived as the biggest barrier to
purchase by 79% of respondents, with 61% complaining about the lack of clear nutrition
labeling (Table S1).
The lack of awareness regarding the consequences of consumers’ food choices on the
environment is supported by several other studies [
32
,
38
–
42
] confirming that consumers
underestimate the environmental impacts of animal production [
43
] and health aspects that
are the main determinant for changing consumption habits either in terms of reduction
or elimination of meat in the diet [
44
]. These findings need to be taken into consideration
since the sustainability transition requires a changing of the cultural approach of consumers
towards a dietary pattern that combines health and sustainable aspects and this could be
pursued by public policy united with private-sector proactivity [45].
In Figure 1, the intention of respondents to actively increase the sustainability level
of their dietary pattern is reported. Respondents are found to be willing to act in a more
sustainable way (7 to 10 points on the Likert scale) as regards reducing household food
waste (79%), consuming more seasonal fruits and vegetables (76%), and eating more plant-
based foods (63%). Only 41% of respondents would pay more to buy sustainable food.
Nutrients2023,15,xFORPEERREVIEW6of21


3.2.Consumers’PerceptionofFoodSustainability
Theresultsoftheassessmentofconsumers’awarenessoffoodsustainabilitywere
reportedbasedonthethreesectionsofthequestionnaire.Detailedresultsofalltheques-
tionsarereportedinTa bleS1oftheSupplementaryMaterials.
3.2.1.FoodSustainabilityKnowledge
Whatemergesfromthissectionisthatconsumershavelileconsiderationoftheim-
pacttheirfoodconsumptionhasontheenvironmentandthattheyperceivesustainable
productsastooexpensive.Ontheotherhand,thereductionoffoodwastewasrecognized
asakeyelementforachievingsustainability.Indetail,Q1showsagenerallackofaware-
nessregardingthenegativeeffectsofrespondents’eatinghabitsontheenvironment(45%,
<4pointsontheLikertscale).Morethan80%ofrespondentsassociatetheconceptof“sus-
tainablefoods”(Q2)withlowenvironmentalimpact,localfoodsupplychains,and
healthyfoods.Thepriceofsustainablefoods(Q3)isperceivedasthebiggestbarrierto
purchaseby79%ofrespondents,with61%complainingaboutthelackofclearnutrition
labeling(TableS1).
Thelackofawarenessregardingtheconsequencesofconsumers’foodchoicesonthe
environmentissupportedbyseveralotherstudies[32,38–42]confirmingthatconsumers
underestimatetheenvironmentalimpactsofanimalproduction[43]andhealthaspects
thatarethemaindeterminantforchangingconsumptionhabitseitherintermsofreduc-
tionoreliminationofmeatinthediet[44].Thesefindingsneedtobetakenintoconsider-
ationsincethesustainabilitytransitionrequiresachangingoftheculturalapproachof
consumerstowardsadietarypaernthatcombineshealthandsustainableaspectsand
thiscouldbepursuedbypublicpolicyunitedwithprivate-sectorproactivity[45].
InFigure1,theintentionofrespondentstoactivelyincreasethesustainabilitylevel
oftheirdietarypaernisreported.Respondentsarefoundtobewillingtoactinamore
sustainableway(7to10pointsontheLikertscale)asregardsreducinghouseholdfood
waste(79%),consumingmoreseasonalfruitsandvegetables(76%),andeatingmore
plant-basedfoods(63%).Only41%ofrespondentswouldpaymoretobuysustainable
food.

Figure 1.
Respondents’ intentions to increase the sustainability of food choices (Willingness to
do—WTD) expressed as % values.
3.2.2. Sources of Protein Alternative to Meat
The section of the questionnaire focusing on meat shows that 51% of respondents
(Figure 2, panel A) have reduced their consumption for environmental issues but are still
eating meat (59% among older people and only 45% in younger people. On the other hand,
there is a relevant group of the population (27%) that neither reduced meat consumption
nor intended to do so in the future for environmental reasons. Legumes (84%), eggs (82%),
and fish (77%) were selected as the preferred protein to replace meat (Figure 2, Panel B).
Among novel foods, insects and insect-based products were reported as less accepted
alternative sources of proteins (67%); GMO-free plant-based meat alternatives were the
most accepted (47%) (Figure 2Panel C). People with a high level of education, with a high

Nutrients 2023,15, 3861 7 of 18
annual income (greater than 36,000 EUR), and students showed a greater propensity to try
new foods.
Nutrients2023,15,xFORPEERREVIEW8of21



Figure2.Respondents’aitudestowardsmeatandmeatalternatives:propensityandreasonsfor
meatreduction(Panel(A));preferredoptionstoreplacemeat(Panel(B));meatalternativesaccepta-
bleforItalians(Panel(C));expressedas%values.
3.2.3.EatingBehaviors:TheImportanceofMeatandtheRequestforRules
Respondents(56%,7to10points)inparticularolderagegroups(>55years)consider
meatanddairyproductionlessimpactfulonclimatechangethandeforestation(77%)and
exhaustemissions(73%)(Q12—TableS1).AsreportedinFigure3,Italiansconsidermeat
animportantelementforacomplete(52%,7to10pointsontheLikertscale)andbalanced
diet(36%),and28%ofrespondentsdonotconsidervegetableproteinsavalidalternative
tomeat(7–10points).
Figure 2.
Respondents’ attitudes towards meat and meat alternatives: propensity and reasons for
meat reduction (Panel (
A
)); preferred options to replace meat (Panel (
B
)); meat alternatives acceptable
for Italians (Panel (C)); expressed as % values.
Hence, the alternatives to meat accepted by consumers that could currently be pro-
posed in Italy are the foods typically recommended in the Italian Dietary Guidelines [
10
],
which are legumes, eggs, and fish. Other foods such as insects were strongly rejected by
Italian consumers. This could be related to people’s unfamiliarity with novel food (i.e., pre-
vious experience, taste expectations, and attitude towards new food experiences) playing
an important role in shaping individual inclination [
26
]. Another interpretation of these

Nutrients 2023,15, 3861 8 of 18
findings is the hypothetical nature of the proposed alternative [
28
]; in other words, cultured
meat products and insects are unacceptable to Italian consumers simply because they are
not yet available on the market. This aspect is in line with a further result of the present
study showing that plant-based meat alternatives (e.g., vegetable burgers) are considered a
practicable substitute for meat. These products are well known by consumers and largely
accepted, as demonstrated by the rapidly growing sales trend in Italy, other European
countries [
46
], and the United States, where from November 2018 to November 2020, ex-
penditure for plant-based meat alternatives increased from 4.22% to 6.29% [
47
]. Consumers’
acceptance of plant-based meat alternatives is related to taste, considering an added value
the similarity with meat, habit, convenience, and price; on the other hand, negative aspects
are found in the sense of “highly processed” products manufactured with “unnatural”
methods [
23
]. In general, consumers consider the production of industrial foods with
suspicion, having a strong reliance on what is claimed to be natural—considered de facto
better—and this is also related to the lack of awareness and familiarity with technologies
used in the production of novel foods [48].
3.2.3. Eating Behaviors: The Importance of Meat and the Request for Rules
Respondents (56%, 7 to 10 points) in particular older age groups (>55 years) consider
meat and dairy production less impactful on climate change than deforestation (77%) and
exhaust emissions (73%) (Q12—Table S1). As reported in Figure 3, Italians consider meat
an important element for a complete (52%, 7 to 10 points on the Likert scale) and balanced
diet (36%), and 28% of respondents do not consider vegetable proteins a valid alternative
to meat (7–10 points).
Nutrients2023,15,xFORPEERREVIEW9of21



Figure3.Respondents’aitudestowardstheimportanceofmeatinthediet(MeatImportance—MI)
expressedas%values.
Meatsoundingisnotperceivedasaproblembyrespondentsandonly19%would
prohibitusingtheword“meat”forplant-originproducts(Q10—TableS1).Asreportedin
Figure4,alargemajorityoftherespondents(61%to67%)wouldwelcomerulesforin-
creasingandpromotingthesustainabilityoffoodproductionandfoodchoices.Respond-
entsreportedincentivestofarmers(67%),sustainabilityinformationonlabels(66%),a
proactiveEUsustainablefoodpolicy(66%),andstringentsustainabilitystandardsforpro-
ducers(61%)asrelevantactionstobeputinplacewithregulations.Ontheotherhand,
taxation(48%)andprohibitionofsellingunsustainablefood(45%)werelessfrequently
welcomedaspolicyactions(Figure4).

Figure 3.
Respondents’ attitudes towards the importance of meat in the diet (Meat Importance—MI)
expressed as % values.
Meat sounding is not perceived as a problem by respondents and only 19% would
prohibit using the word “meat” for plant-origin products (Q10—Table S1). As reported in
Figure 4, a large majority of the respondents (61% to 67%) would welcome rules for increas-
ing and promoting the sustainability of food production and food choices. Respondents
reported incentives to farmers (67%), sustainability information on labels (66%), a proactive
EU sustainable food policy (66%), and stringent sustainability standards for producers
(61%) as relevant actions to be put in place with regulations. On the other hand, taxation
(48%) and prohibition of selling unsustainable food (45%) were less frequently welcomed
as policy actions (Figure 4).

Nutrients 2023,15, 3861 9 of 18
Nutrients2023,15,xFORPEERREVIEW10of21




Figure4.Respondents’RulesRequest—RRforincreasingthesustainabilityoffoodproductionex-
pressedas%values.
3.3.MultivariateAnalysis
Factoranalysiswasundertakenforcontinuousvariablesrelatedtoresponsestoques-
tionsQ1,Q4,Q8,Q11,andQ12.Figure5showseigenvalues,proportions,andcumulative
proportionsofcommonvarianceexplainedbythe28factorsresultingfromFA. Assuming
athresholdof0.1fortheexplainedproportionofcommonvariance,thefirstthreefactors
wereselectedtoaccountfor88%ofthecommonvariance.

Figure 4.
Respondents’ Rules Request—RR for increasing the sustainability of food production
expressed as % values.
3.3. Multivariate Analysis
Factor analysis was undertaken for continuous variables related to responses to ques-
tions Q1, Q4, Q8, Q11, and Q12. Figure 5shows eigenvalues, proportions, and cumulative
proportions of common variance explained by the 28 factors resulting from FA. Assuming
a threshold of 0.1 for the explained proportion of common variance, the first three factors
were selected to account for 88% of the common variance.
Nutrients2023,15,xFORPEERREVIEW11of21




Figure5.Eigenvalues,proportions,andcumulativeproportionsofcommonvarianceareexplained
bythe28factorsresultingfromtheFA.
AfterVarimaxrotation,foreachofthethreeselectedfactors,itemswhosefactorload-
ingwasgreaterthan0.35wereidentifiedandreportedinTable2.Basedontheselected
items,scoreswerederivedastheweightedaverageofresponsestotheseitems,assuming
factorloadingsasweights.
Tabl e2.FactorloadingafterVari max rotation,correspondingfactor,andcommonality.
Items
GroupQuestionsFactorLoadingCommunalityFactor
MeatImportance(MI)
Q8.1Eatingmeatisnecessarytohaveacompletediet0.840.7631
Q8.2Ineedmeattohaveenergy 0.880.7811
Q8.3Eatingmeatallowsmetohaveabalanceddiet 0.90.8121
Q8.4Meatisirreplaceableinmydiet 0.860.7761
Q8.5Replacingmeatwithplant-basedproteinsourcesdoesn’tprovide
mewiththesameenergy0.760.5941
RequestforRules(RR)
Q11.1Sustainabilityinformationshouldbecompulsoryonfoodlabels0.590.672
Q11.2Foodthatislesssustainableshouldbetaxedhigher(andbemore
expensive)0.70.6372
Q11.3
Unsustainablefoodproductsshouldberemovedfromshelves
(e.g.,nostrawberriesinwinter,supermarketsshouldsellonly
sourcedsustainablyfish,etc.)
0.630.482
Q11.4
Regulationsshouldforcefarmersandfoodproducerstomeet
morestringentsustainabilitystandards(intermsofgreenhouse
gasemissions,wateruse,biodiversity,etc.)
0.740.72
Q11.5Farmersshouldbegivenincentives(e.g.,throughsubsidies)to
producefoodmoresustainably0.660.6862
Q11.6TheEUshouldnotbemoreproactiveonsustainablefoodpolicies
unlessothercountriessuchasChinaortheUSAdothesame0.720.7022
Q12.1Emissionsfromaircraft,trains,cars,trucksandships0.360.6262
Q12.2Theproductionofmeatanddairyproducts,whichweeatand
drink0.50.4712
Willingnesstodo(WTD)
Figure 5.
Eigenvalues, proportions, and cumulative proportions of common variance are explained
by the 28 factors resulting from the FA.
After Varimax rotation, for each of the three selected factors, items whose factor
loading was greater than 0.35 were identified and reported in Table 2. Based on the selected
items, scores were derived as the weighted average of responses to these items, assuming
factor loadings as weights.

Nutrients 2023,15, 3861 10 of 18
Table 2. Factor loading after Varimax rotation, corresponding factor, and commonality.
Items Group Questions Factor Loading Communality Factor
Meat Importance (MI)
Q8.1 Eating meat is necessary to have a complete diet 0.84 0.763 1
Q8.2 I need meat to have energy 0.88 0.781 1
Q8.3 Eating meat allows me to have a balanced diet 0.9 0.812 1
Q8.4 Meat is irreplaceable in my diet 0.86 0.776 1
Q8.5 Replacing meat with plant-based protein sources doesn’t
provide me with the same energy 0.76 0.594 1
Request for Rules (RR)
Q11.1 Sustainability information should be compulsory on food
labels 0.59 0.67 2
Q11.2 Food that is less sustainable should be taxed higher (and
be more expensive) 0.7 0.637 2
Q11.3
Unsustainable food products should be removed from
shelves (e.g., no strawberries in winter, supermarkets
should sell only sourced sustainably fish, etc.)
0.63 0.48 2
Q11.4
Regulations should force farmers and food producers to
meet more stringent sustainability standards (in terms of
greenhouse gas emissions, water use, biodiversity, etc.)
0.74 0.7 2
Q11.5 Farmers should be given incentives (e.g., through
subsidies) to produce food more sustainably 0.66 0.686 2
Q11.6
The EU should not be more proactive on sustainable food
policies unless other countries such as China or the USA
do the same
0.72 0.702 2
Q12.1 Emissions from aircraft, trains, cars, trucks and ships 0.36 0.626 2
Q12.2 The production of meat and dairy products, which we eat
and drink 0.5 0.471 2
Willingness to do (WTD)
Q4.2 I’m willing to spend more money on sustainable food 0.62 0.586 3
Q4.3 I’m willing to spend more money on food for which I’m
sure farmers get a fair price for in return 0.59 0.512 3
Q4.4 I’m willing to cut down on red meat (beef, lamb and pork) 0.61 0.615 3
Q4.5 I’m willing to cut down on dairy 0.52 0.387 3
Q4.6
I am willing to waste less food at home, implementing
anti-waste measures (e.g., shopping lists, placing foods
that expire first at the front of the refrigerator, etc.
0.38 0.545 3
Q4.7 I’m willing to eat more vegetables/plant-based food, even
if they’re not to my taste 0.66 0.598 3
Q4.8 I’m willing to change my eating habits, even if they are
not environment-friendly 0.68 0.725 3
Q1.4 Sustainability issues influence my food choices 0.38 0.775 3
Factor 1 is the first latent factor that explains more than 53% of the common variability
and is identified by the Q8 block of items concerning the relevance of meat. The correspond-
ing score was labeled “Meat Importance” (MI) and calculated according to the following
formula:
MI =(0.84 ×Q8.1 +0.88 ×Q8.2 +0.90 ×Q8.3 +0.86 ×Q8.4 +0.76 ×Q8.5)
(0.84 +0.88 +0.90 +0.86 +0.76)(1)
Factor 2 represents 23% of the common variability and is identified by the Q11 block
and by two items of Q12. It expresses respondents’ perceived need for intervention from
national and EU institutions to increase and promote the sustainability of food production.
The related score was named “Request for Rules” (RR) and was calculated according to the
following formula:
RR =(0.59 ×Q11.1 +0.70 ×Q11.2 +0.63 ×Q11.3 +0.74 ×Q11.4 +0.66 ×Q11.5 +0.72 ×Q11.6 +0.36 ×Q12.1 +0.50 ×Q12.2)
(0.59 +0.70 +0.63 +0.74 +0.66 +0.72 +0.36 +0.50)(2)
Factor 3 shows 12% of the common variability and is defined by the Q4 block. It
represents the declared willingness to adopt a more sustainable behavior. It was labeled as
“Willingness to do” (WTD) and was calculated according to the following formula:
WTD =(0.62 ×Q4.2 +0.59 ×Q4.3 +0.61 ×Q4.4 +0.52 ×Q4.5 +0.38 ×Q4.6 +0.66 ×Q4.7 +0.68 ×Q4.8 +0.38 ×Q1.4)
(0.62 +0.59 +0.61 +0.52 +0.38 +0.66 +0.68 +0.38)(3)

Nutrients 2023,15, 3861 11 of 18
Empirical distributions of the scores are reported in Figure 6. The MI score resulted in
the lowest mean value (Mean 5.7; SD 2.2), with a spread distribution of responses and an
interesting peak in the areas of very low scores (0.3–1) (Figure 6, panel A). Hence, among
the group of Italian consumers who are convinced of the importance of meat, there is a
small number for whom meat is not crucial for a healthy and balanced diet. Very relevant
in Italy is the request for rules demonstrated by the RR empirical distribution that shifts
towards high values (Mean 6.9; SD 1.8). A similar shape of the empirical distribution is
observed for WTD (Mean 6.6; SD 1.7) with an even lower mean value compared to the RR
distribution.
Nutrients2023,15,xFORPEERREVIEW13of21



Figure 6.
Empirical distributions of the three scores: MI (Panel (
A
)), RR (Panel (
B
)), and WTD
(Panel (C)).

Nutrients 2023,15, 3861 12 of 18
3.4. Cluster Analysis and Socio-Demographic Characteristics of the Resulting Clusters
Based on the proposed scores, a cluster analysis was undertaken. As a result, five
clusters with specific characteristics of respondents were identified. Table 3shows the
number of observations per cluster and the clusters’ centroids. The plots resulting from the
cluster analysis are reported in Figure 7.
Table 3. Cluster results: centroids and number of observations.
Cluster Weighted Obs
(%)
Cluster Centroids
Means (SD)
MI RR WTD
1—Average sustainable consumer 208.9
(25.6%)
6.28
(1.04)
6.07
(0.98)
5.28
(0.96)
2—Strongly sustainable consumer 268.9
(33%)
3.45
(1.53)
7.92
(1.39)
7.79
(1.19)
3—No change in consumers 35.5
(4.4%)
3.51
(1.24)
3.96
(1.32)
4.13
(1.49)
4—Meat consumers willing to be sustainable
254.8
(31.3%)
7.40
(1.14)
7.68
(1.08)
7.37
(0.97)
5—Unsustainable consumers 46.9
(5.7%)
8.02
(1.64)
3.53
(1.38)
4.09
(1.46)
Nutrients2023,15,xFORPEERREVIEW15of21



Figure7.Theplotsresultingfromtheclusteranalysis:(Panel(A))—theintersectionbetweenfactors
MIandRR;(Panel(B))—thecrossbetweenfactorsMIandWTD;(Panel(C))—thecrossbetween
factorsRRandWTD.
TheclusteranalysisconfirmedtheimportanceofmeatforItalianconsumersempha-
sizingotheraspectsoftheconsumer’sapproachtomeatandthesustainabilityoffood
choices.Almostone-fourthofrespondents,identifiedbyCluster1—Averagesustainable
consumer,considermeatveryimportant.However,theseconsumersarealsoopento
changeandwelcomerulesfrompolicymakerstoincreasesustainablefoodchoices.Inad-
dition,twooutoffiveClusters(i.e.,Clusters2and3,coveringabout38%ofthetotal)
consideredmeatreplaceableinthediet,andmorethanhalfofrespondentsstatedthey
hadreducedbutnoteliminatedmeatforenvironmentalreasons.Aspointedoutinseveral
recentstudies[49–51],meathasacquiredanegativeimagemainlybecauseofitsassocia-
tionwithenvironmentalissues[50],aswellasreligious,ethical,andmoralconcerns
[49,52].Whereasthenegativeaitudetowardsmeatisnotnecessarilyassociatedwitha
reductionofmeatconsumption[53].Themajorityofrespondents(61%ofrespondents,
correspondingtoclusters2and4)haveastrongmotivationforsustainability(highWTD
andRR);however,thetwoclustersaredifferentiatedbytheirconsiderationofmeat:not
veryrelevantforCluster2(Stronglysustainableconsumer—correspondingto33%ofre-
spondents),veryimportantforCluster4(meatconsumerwillingtobesustainable—cor-
respondingto31.3%ofrespondents).The‘No-changeconsumers’group(i.e.,Cluster3)
andthe‘Unsustainableconsumers’(i.e.,Cluster5)coverthe10%ofthepopulation
Figure 7.
The plots resulting from the cluster analysis: (Panel (
A
))—the intersection between factors
MI and RR; (Panel (
B
))—the cross between factors MI and WTD; (Panel (
C
))—the cross between
factors RR and WTD.

Nutrients 2023,15, 3861 13 of 18
Cluster 1 identifies “Average sustainable consumers” (25.6% of the weighted total);
the respondents in this group consider meat important for the diet (MI = 6.3), require rules
(RR = 6.1), and report willingness to do (WTD = 5.3) to increase sustainability. However,
the attitude of consumers in cluster 1 does not correspond to extreme positions, as seen by
the average cluster centroids. In Cluster 1 people over 55 years and with a high level of
education appear under-represented (16.1% and 8.1%, respectively) (Table S2).
Cluster 2 identifies “Strongly sustainable consumers” (33% of the weighted total).
Meat is not considered very important for this group of people (MI = 3.5), but there is a
strong demand for rules (RR = 7.9) and Cluster 2 respondents have a solid motivation to
actively increase the sustainability of food behaviors (WTD = 7.8). Cluster 2 is characterized
by the presence of older consumers (36.5% of 55–65-year-olds) and families without children
(72%) (Table S2).
Cluster 3 includes “No change consumers” (4.4% of the weighted total). These con-
sumers generally have a low score on all factors: they do not consider meat consumption
relevant (MI = 3.5), do not require rules (RR = 4.0), and are unwilling to be proactive
for sustainability (WTD = 4.1). Men (76.4%), families with children of less than 11 years
(61.7%), and homemakers (44.8%) are more distributed in this cluster, living mainly in the
northwest or center of Italy (44.4% and 30.5% respectively). Low and high levels of income
are under-represented (4.9% and 7.3%) (Table S2).
Cluster 4 identifies “Meat consumers willing to become sustainable” (31.3% of the
weighted total). This group considers meat very important for the diet (MI = 7.4), strongly
welcomes rules (RR = 7.7), and wants to change and become more sustainable (WTD = 7.4).
Compared with total respondents, this cluster is characterized by a relevant percentage of
families with children (44.3%) and high levels of income (32.2%) (Table S2).
Cluster 5 corresponds to the “Unsustainable consumers” (5.7% of the weighted total).
People in this group consider meat essential for the diet (MI = 8.0), do not welcome rules
(RR = 3.5), and are unwilling to act for sustainability (WTD = 4.1). Respondents are mainly
men (66%), living in the northern regions of Italy (61.3%), 17% have a low educational level
and 37.9% have an annual income above 36,000 Euros (Table S2).
The cluster analysis confirmed the importance of meat for Italian consumers empha-
sizing other aspects of the consumer’s approach to meat and the sustainability of food
choices. Almost one-fourth of respondents, identified by Cluster 1—Average sustainable
consumer, consider meat very important. However, these consumers are also open to
change and welcome rules from policymakers to increase sustainable food choices. In
addition, two out of five Clusters (i.e., Clusters 2 and 3, covering about 38% of the total)
considered meat replaceable in the diet, and more than half of respondents stated they
had reduced but not eliminated meat for environmental reasons. As pointed out in several
recent studies [
49
–
51
], meat has acquired a negative image mainly because of its association
with environmental issues [
50
], as well as religious, ethical, and moral concerns [
49
,
52
].
Whereas the negative attitude towards meat is not necessarily associated with a reduction
of meat consumption [
53
]. The majority of respondents (61% of respondents, corresponding
to clusters 2 and 4) have a strong motivation for sustainability (high WTD and RR); however,
the two clusters are differentiated by their consideration of meat: not very relevant for
Cluster 2 (Strongly sustainable consumer—corresponding to 33% of respondents), very
important for Cluster 4 (meat consumer willing to be sustainable—corresponding to 31.3%
of respondents). The ‘No-change consumers’ group (i.e., Cluster 3) and the ‘Unsustainable
consumers’ (i.e., Cluster 5) cover the 10% of the population characterized by a general lack
of interest in the issue of sustainability. One of the research questions of this work was re-
lated to the identification of consumers’ policy supports that could be helpful in increasing
the sustainability of food choices. This study shows that Italian consumers would welcome
rules for more information on products (e.g., clear labels). Taxation and other forms of
prohibition have been flagged as less acceptable, probably due to fears of rising prices
that have been recognized as a barrier to the selection of sustainable foods (perceived as
expensive). At the same time, the large majority (90%) of respondents requests rules by

Nutrients 2023,15, 3861 14 of 18
policymakers and recognize individual responsibility (WTD) to improve the sustainability
of dietary choices (Clusters 1, 2, and 4). Similar results emerged from Whittall et al. [
54
]
when reporting that consumers are willing to adopt sustainability despite uncertainty about
what action should be taken.
The socio-demographic characteristics of respondents influence the sustainability of
food choices, confirming current literature on the topic [
55
–
57
]. In particular, according to
Verain and Dagevos [
57
], men have a greater propensity to consume meat than women, in
line with the present study in which men are most commonly found in the clusters that
consider meat important (76.4% of respondents in Cluster 3 and 66% of respondents in
Cluster 5 vs. 50% of the total population). Besides the specific aspect of meat preference and
importance, several studies [
55
–
57
] reported women as more interested in sustainability
than men. In terms of age, in the present study, the oldest group (55–65 years) showed
more attention to sustainability and did not perceive meat as an important element of the
diet.
The presence of children in the household is a determining factor for meat consumption
and represents a barrier to the replacement of meat with other foods. Families with young
children (under 11 years) were most reluctant to be sustainable, being more frequent
in Cluster 3 “Consumer against change” and in Cluster 4 characterized by consumers
that consider meat important. To complete the picture, it should be pointed out that the
two clusters corresponding to consumers with a general lack of interest in sustainability
(Cluster 3—the no-change consumers’ group and Cluster 5—the unsustainable consumers)
mainly include men, from northern regions, aged over 55 years, with low educational levels
and a medium income. These findings are confirmed by Neuhofer & Lusk [
47
] reporting
that the buyers of plant-based meat alternatives that could be considered an element
of a sustainable attitude, tend to be young, single, female, highly educated, employed,
and with a higher income. The socio-demographic profiling that emerged in the cluster
characterization of the present work has several similarities with the results reported by
Gutiérrez-Villar et al. [
58
] in Spanish households in which sustainable dietary habits are
frequently found in high-income groups, families without children, and people living in
small cities.
4. Conclusions
The main result of this paper is related to the role of meat in the diet as the key
aspect characterizing the respondents and marking the differences between population
groups. Almost half (45%) of respondents have a general lack of awareness regarding
the consequences of their food choices on the environment and consider meat an impor-
tant element of the diet often claimed as not replaceable. Meat consumption represents a
challenge to human health and the environment, and its reduction is a positive and achiev-
able goal [
59
–
66
]. Recently, IPCC [
63
] has reinforced the concept previously expressed by
the EAT-Lancet Commission [
61
] underlining how a plant-based diet represents the best
choice for people and the environment. Dietary patterns are directly related to overall
food demand, thus diets can be an important entry point for action and best practices to
be put in place both individually and collectively to improve the sustainability of food
systems [
64
,
65
]. However, the substitution of meat is a complex behavioral change as it is
related to the sensory experience of eating meat, the taste, and subjective concerns about
the risk of protein deficiency [
66
]. The most relevant novelty of this assessment is that
besides clarifying Italian consumers’ view of the importance of meat, there is room for
recommendations for reducing the consumption of this food item. However, it should be
considered that the motivation for the reduction of meat consumption is more related to
health factors than environmental reasons. A key point of consumers’ attitude towards
meat is related to the possible alternatives, meaning legumes, eggs, dairy products, and
fish that should be considered in terms of practical applicable recommendations. In view
of the importance of increasing the vegetable sources of proteins for human health and the
environment [
67
], the use of plant-based meat alternatives could be a way to increase the

Nutrients 2023,15, 3861 15 of 18
choices of legumes in forms acceptable to consumers thus increasing the variety of food
choices. The future development of dietary guidelines should consider these environmental
and societal impacts, as well as issues related to health [
68
]. However, further studies are
necessary to provide a more detailed understanding of people’s preferences towards new
sustainable foods, for example, proposing experimentation with novel foods (e.g., insects)
in terms of sensory experience. However, changing consumer preferences and introducing
new foods requires time without any assurance of success. An important finding of this
study is related to the fact that consumers declared a high interest in rules from policy-
makers and this aspect needs to be considered in the framework of policy strategies and
approaches.
This study has strengths and limitations. The most important strength of the work
is the use, for the assessment, of a proven questionnaire adapted to the local (Italian)
context [
37
]. This is particularly relevant given the fact that the sustainability of diet is an
emerging topic only recently addressed in the framework of nutritional recommendations
and dietary guidelines [
10
]. The added value of this approach is that the assessment of
consumers’ perceptions of the various aspects of food sustainability was preceded by a
validation process reinforcing the value of the present assessment. Another strength of the
present work is linked to the sampling procedure that allowed for a group of respondents
as far as possible representative of the Italian population as regards area of residence, age
groups, gender, and educational level (after the weighting procedure). This is an important
point since the results of this work could be capitalized on through recommendations
that combine nutritional and sustainability considerations increasing the applicability of
the findings. However, the sampling procedure also represents a limitation since the
representativeness for a well-defined set of variables is not guaranteed for other variables
not included in the selection process such as income, family size, household composition,
etc. In this sense, the decision to include people with the ability to use online tools
excluded the elderly, who are therefore not represented in the assessment. Perhaps the most
important limitation of the work is the fact that the evaluation is based on self-declared
behaviors and intentions of change that might not fully reflect reality [69].
Supplementary Materials:
The following supporting information can be downloaded at: https:
//www.mdpi.com/article/10.3390/nu15183861/s1, Table S1: Answers to all the questions (%); Table
S2: Socio-demographic characteristics of the 5 clusters (number of weighted observations).
Author Contributions:
The research questions, conceptualization, and design of the study were
carried out by V.A., N.P., U.S. and L.R.; the methodology was revised by A.N. and D.P.; database
compilation and data analysis were carried out by D.P., J.N.D.V. and A.N.; the paper writing and
original draft preparation were carried out by V.A., N.P. and L.R.; review and editing were done
by V.A., N.P., A.N., D.P. and L.R. All authors have read and agreed to the published version of the
manuscript.
Funding:
This research was funded by the project FAOWASTE: “Food waste in Italy: International
policies and measurements” (Nos. 23278-27 and 12.2019) granted by the Italian Ministry of Envi-
ronment and Energy Security (MASE) and partially supported by the MIUR Excellence Department
Project MatMod@TOV awarded to the Department of Mathematics, the University of Rome “Tor
Vergata”. The funding source had no role in the design of this study and will not have any role during
its execution, analyses, interpretation of the data, or decision to submit results.
Institutional Review Board Statement:
Before starting the data collection, participants were in-
formed about the objective of the research and the consequent statistical analysis. Participation
in the study was fully voluntary and anonymous and subjects could withdraw from the survey
at any time and for any reason. Respondents were required to sign a policy privacy and consent
form for collecting and processing personal data in advance, according to the Italian Data Protection
Law (Legislative Decree 101/2018) in line with the European Commission General Data Protection
Regulation (679/2016). The investigation was carried out following the rules of the 1975 Declaration
of Helsinki [
35
], revised in 2013. All procedures involving research study participants were approved
and are in line with the SWG Code of Conduct [
36
]. Ethical review and approval were waived for

Nutrients 2023,15, 3861 16 of 18
this study because it did not involve any invasive procedure (e.g., fecal samples, voided urine, etc.),
laboratory assessment, induce lifestyle changes, or impose dietary modifications.
Informed Consent Statement:
Informed consent was obtained from all subjects involved in the
study.
Acknowledgments:
Authors thank Rado Fonda and Giovanni Borghesan (SWG S.p.A.) for support in
data collection and for granting access to the comprehensive datasets and allowing their elaboration
for the present manuscript.
Conflicts of Interest: The authors declare no conflict of interest.
Abbreviations
GHGE Greenhouse Gas Emissions
WHO World Health Organization
FAO Food and Agriculture Organization
GMO Genetically Modified Organisms
MD Mediterranean Diet
CAWI Computer Assisted Web Interviewing
ISTAT National Institute of Statistics
SD Standard Deviation
FA Factor Analysis
PCA Principal Component Analysis
CI Confidence Interval
MI Meat Importance
RR Request for Rules
WTD Willing to do
References
1.
United Nations. World Population Prospects 2022: Summary of Results; Statistical Papers—United Nations (Ser. A); Population and
Vital Statistics Report; United Nations: New York, NY, USA, 2022; ISBN 978-92-1-001438-0.
2.
Poore, J.; Nemecek, T. Reducing Food’s Environmental Impacts through Producers and Consumers. Science
2018
,360, 987–992.
[CrossRef] [PubMed]
3.
Ritchie, H.; Roser, M. Environmental Impacts of Food Production. Available online: https://ourworldindata.org/environmental-
impacts-of-food#citation (accessed on 9 April 2023).
4.
Tackling Climate Change through Livestock: A Global Assessment of Emissions and Mitigation Opportunities; Gerber, P.J.; FAO (Eds.)
Food and Agriculture Organization of the United Nations: Rome, Italy, 2013; ISBN 978-92-5-107920-1.
5.
Nelson, M.E.; Hamm, M.W.; Hu, F.B.; Abrams, S.A.; Griffin, T.S. Alignment of Healthy Dietary Patterns and Environmental
Sustainability: A Systematic Review. Adv. Nutr. 2016,7, 1005–1025. [CrossRef] [PubMed]
6.
Pratesi, I.; Alessi, E. Dalle Pandemie Alla Perdita di Biodiversità: Dove ci sta Portando il Consumo di Carne; WWF Italy: Rome, Italy,
2021; 42p.
7. González-García, S.; Esteve-Llorens, X.; Moreira, M.T.; Feijoo, G. Carbon Footprint and Nutritional Quality of Different Human
Dietary Choices. Sci. Total Environ. 2018,644, 77–94. [CrossRef] [PubMed]
8.
FAO. WHO Sustainable Healthy Diets: Guiding Principles. Available online: http://www.fao.org/3/ca6640en/ca6640en.pdf
(accessed on 31 May 2022).
9. UN. The Sustainable Development Agenda. Available online: https://sdgs.un.org/goals (accessed on 8 August 2022).
10.
Rossi, L.; Berni Canani, S.; Censi, L.; Gennaro, L.; Leclercq, C.; Scognamiglio, U.; Sette, S.; Ghiselli, A. The 2018 Revision of
Italian Dietary Guidelines: Development Process, Novelties, Main Recommendations, and Policy Implications. Front. Nutr.
2022
,
9, 861526. [CrossRef] [PubMed]
11.
Wang, F.; Zheng, J.; Yang, B.; Jiang, J.; Fu, Y.; Li, D. Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and
Meta-Analysis of Randomized Controlled Trials. JAHA 2015,4, e002408. [CrossRef]
12.
Sutliffe, J.T.; Fuhrman, J.H.; Carnot, M.J.; Beetham, R.M.; Peddy, M.S. Nutrient-Dense, Plant-Rich Dietary Intervention Effective at
Reducing Cardiovascular Disease Risk Factors for Worksites: A Pilot Study. Altern. Ther. Health Med. 2016,22, 32.
13. Satija, A.; Hu, F.B. Plant-Based Diets and Cardiovascular Health. Trends Cardiovasc. Med. 2018,28, 437–441. [CrossRef]
14. Kahleova, H.; Levin, S.; Barnard, N. Cardio-Metabolic Benefits of Plant-Based Diets. Nutrients 2017,9, 848. [CrossRef]
15.
Naghshi, S.; Sadeghi, O.; Willett, W.C.; Esmaillzadeh, A. Dietary Intake of Total, Animal, and Plant Proteins and Risk of All Cause,
Cardiovascular, and Cancer Mortality: Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. BMJ
2020,370, m2412. [CrossRef]

Nutrients 2023,15, 3861 17 of 18
16.
Huang, J.; Liao, L.; Weinstein, S.; Sinha, R.; Graubard, B.; Albanes, D. Association Between Plant and Animal Protein Intake and
Overall and Cause-Specific Mortality. JAMA Intern. Med. 2020,180, 1173–1184. [CrossRef]
17.
Xiang-Xiu, Q. Associations of Dietary Protein Intake with All-Cause, Cardiovascular Disease, and Cancer Mortality: A Systematic
Review and Meta-Analysis of Cohort Studies. Nutr. Metab. Cardiovasc. Dis. 2020,30, 1094–1105.
18.
Springmann, M.; Godfray, H.C.J.; Rayner, M.; Scarborough, P. Analysis and Valuation of the Health and Climate Change
Cobenefits of Dietary Change. Proc. Natl. Acad. Sci. USA 2016,113, 4146–4151. [CrossRef] [PubMed]
19.
Stagnari, F.; Maggio, A.; Galieni, A.; Pisante, M. Multiple Benefits of Legumes for Agriculture Sustainability: An Overview. Chem.
Biol. Technol. Agric. 2017,4, 2. [CrossRef]
20.
Guiguitant, J.; Vile, D.; Ghanem, M.E.; Wery, J.; Marrou, H. Evaluation of Pulse Crops’ Functional Diversity Supporting Food
Production. Sci. Rep. 2020,10, 3416. [CrossRef] [PubMed]
21.
Rumpold, B.A.; Schlüter, O. Insect-Based Protein Sources and Their Potential for Human Consumption: Nutritional Composition
and Processing. Anim. Front. 2015,5, 5.
22.
van Huis, A.; Oonincx, D.G.A.B. The Environmental Sustainability of Insects as Food and Feed. A Review. Agron. Sustain. Dev.
2017,37, 43. [CrossRef]
23.
Rubio, N.R.; Xiang, N.; Kaplan, D.L. Plant-Based and Cell-Based Approaches to Meat Production. Nat. Commun.
2020
,11, 6276.
[CrossRef]
24.
Bhat, Z.F.; Kumar, S.; Bhat, H.F. In Vitro Meat: A Future Animal-Free Harvest. Crit. Rev. Food Sci. Nutr.
2017
,57, 782–789.
[CrossRef]
25.
Basile, A.; Ferranti, P. Synthetic Meat: Acceptance. Encycl. Food Secur. Sustain.
2019
,1, 285–288, Reference Module in Food Science.
[CrossRef]
26.
Palmieri, N.; Perito, M.; Lupi, C. Consumer Acceptance of Cultured Meat: Some Hints from Italy. Br. Food J.
2020
,123, 109–123.
[CrossRef]
27.
WHO. Food Safety Aspects of Cell-Based Food. Available online: http://www.fao.org/documents/card/en/c/cc4855en
(accessed on 27 April 2023).
28.
Post, M.J.; Levenberg, S.; Kaplan, D.L.; Genovese, N.; Fu, J.; Bryant, C.J.; Negowetti, N.; Verzijden, K.; Moutsatsou, P. Scientific,
Sustainability and Regulatory Challenges of Cultured Meat. Nat. Food 2020,1, 403–415. [CrossRef]
29.
McClements, D.J.; Grossmann, L. A Brief Review of the Science behind the Design of Healthy and Sustainable Plant-Based Foods.
NPJ Sci. Food 2021,5, 17. [CrossRef] [PubMed]
30.
Kumar, P.; Chatli, M.K.; Mehta, N.; Singh, P.; Malav, O.P.; Verma, A.K. Meat Analogues: Health Promising Sustainable Meat
Substitutes. Crit. Rev. Food Sci. Nutr. 2017,57, 923–932. [CrossRef] [PubMed]
31.
Roselli, L.; Stasi, A.; Seccia, A. Atteggiamento dei consumatori nei confronti dell’evoluzione del sistema agro-alimentare:
L’introduzione di alimenti geneticamente modificati. Econ. Agro-Aliment. 2006,1, 1000–1024.
32.
Hartmann, C.; Siegrist, M. Consumer Perception and Behaviour Regarding Sustainable Protein Consumption: A Systematic
Review. Trends Food Sci. Technol. 2017,61, 11–25. [CrossRef]
33.
Coderoni, S.; Perito, M.A.; Cardillo, C. Consumer Behaviour in Italy. Who Spends More to Buy a Mediterranean Diet? New Medit
2017,16, 38–46.
34.
ISTAT. ISTAT—Popolazione 15 Anni e Oltre per Titolo di Studio—Regolamento Precedente (Fino al 2020). Available online:
http://dati.istat.it/Index.aspx?DataSetCode=DCCV_POPTIT1_UNT2020 (accessed on 4 April 2023).
35.
World Medical Association. Wma Declaration of Helsinki—Ethical Principles for Medical Research Involving Human Subjects.
Available online: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-
involving-human-subjects/ (accessed on 15 March 2023).
36. SWG. Modello Di Organizzazione Gestione e Controllo 2021; SWG: Rome, Italy, 2021.
37.
Aureli, V.; Nardi, A.; Peluso, D.; Scognamiglio, U.; Rossi, L. Consumers’ Attitude towards Sustainability in Italy: Process of
Validation of a Duly Designed Questionnaire. Foods 2022,11, 2629. [CrossRef]
38.
Dornhoff, M.; Hörnschemeyer, A.; Fiebelkorn, F. Students’ Conceptions of Sustainable Nutrition. Sustainability
2020
,12, 5242.
[CrossRef]
39.
Hoek, A.C.; Pearson, D.; James, S.W.; Lawrence, M.A.; Friel, S. Shrinking the Food-Print: A Qualitative Study into Consumer
Perceptions, Experiences and Attitudes towards Healthy and Environmentally Friendly Food Behaviours. Appetite
2017
,108,
117–131. [CrossRef]
40.
Lea, E.; Worsley, A. Australian Consumers’ Food-Related Environmental Beliefs and Behaviours. Appetite
2008
,50, 207–214.
[CrossRef]
41.
Macdiarmid, J.I.; Douglas, F.; Campbell, J. Eating like There’s No Tomorrow: Public Awareness of the Environmental Impact of
Food and Reluctance to Eat Less Meat as Part of a Sustainable Diet. Appetite 2016,96, 487–493. [CrossRef] [PubMed]
42.
Mann, D.; Thornton, L.; Crawford, D.; Ball, K. Australian Consumers’ Views towards an Environmentally Sustainable Eating
Pattern. Public Health Nutr. 2018,21, 2714–2722. [CrossRef]
43.
Vanhonacker, F.; Van Loo, E.J.; Gellynck, X.; Verbeke, W. Flemish Consumer Attitudes towards More Sustainable Food Choices.
Appetite 2013,62, 7–16. [CrossRef] [PubMed]
44.
Latvala, T.; Niva, M.; Mäkelä, J.; Pouta, E.; Heikkilä, J.; Kotro, J.; Forsman-Hugg, S. Diversifying Meat Consumption Patterns:
Consumers’ Self-Reported Past Behaviour and Intentions for Change. Meat Sci. 2012,92, 71–77. [CrossRef] [PubMed]

Nutrients 2023,15, 3861 18 of 18
45.
Moberg, E.; Allison, E.; Harl, H.; Arbow, T.; Almaraz, M.; Dixon, J.; Scarborough, C.; Skinner, T.; Rasmussen, L.; Salter, A.; et al.
Combined Innovations in Public Policy, the Private Sector and Culture Can Drive Sustainability Transitions in Food Systems. Nat.
Food 2021,2, 282–290. [CrossRef] [PubMed]
46.
GFI. Europe Plant-Based Food Retailer Market Insights 2020–2022. Available online: https://gfieurope.org/wp-content/uploads/
2023/03/2020-2022-Europe-retail-market- insights.pdf (accessed on 27 April 2023).
47.
Neuhofer, Z.T.; Lusk, J.L. Most Plant-Based Meat Alternative Buyers Also Buy Meat: An Analysis of Household Demographics,
Habit Formation, and Buying Behavior among Meat Alternative Buyers. Sci. Rep. 2022,12, 13062. [CrossRef]
48. Siegrist, M.; Hartmann, C. Consumer Acceptance of Novel Food Technologies. Nat. Food 2020,1, 343–350. [CrossRef]
49.
Berndsen, M.; van der Pligt, J. Risks of Meat: The Relative Impact of Cognitive, Affective and Moral Concerns. Appetite
2005
,44,
195–205. [CrossRef]
50.
Povey, R.; Wellens, B.; Conner, M. Attitudes towards Following Meat, Vegetarian and Vegan Diets: An Examination of the Role of
Ambivalence. Appetite 2001,37, 15–26. [CrossRef]
51.
Font-i-Furnols, M.; Guerrero, L. Consumer Preference, Behavior and Perception about Meat and Meat Products: An Overview.
Meat Sci. 2014,98, 361–371. [CrossRef]
52.
Troy, D.J.; Kerry, J.P. Consumer Perception and the Role of Science in the Meat Industry. Meat Sci.
2010
,86, 214–226. [CrossRef]
[PubMed]
53.
Holm, L.; Møhl, M. The Role of Meat in Everyday Food Culture: An Analysis of an Interview Study in Copenhagen. Appetite
2000,34, 277–283. [CrossRef] [PubMed]
54.
Whittall, B.; Warwick, S.M.; Guy, D.J.; Appleton, K.M. Public Understanding of Sustainable Diets and Changes towards
Sustainability: A Qualitative Study in a UK Population Sample. Appetite 2023,181, 106388. [CrossRef] [PubMed]
55.
Clonan, A.; Wilson, P.; Swift, J.A.; Leibovici, D.G.; Holdsworth, M. Red and Processed Meat Consumption and Purchasing
Behaviours and Attitudes: Impacts for Human Health, Animal Welfare and Environmental Sustainability. Public Health Nutr.
2015,18, 2446–2456. [CrossRef] [PubMed]
56.
Tobler, C.; Visschers, V.H.M.; Siegrist, M. Eating Green. Consumers’ Willingness to Adopt Ecological Food Consumption
Behaviors. Appetite 2011,57, 674–682. [CrossRef]
57.
Verain, M.C.D.; Dagevos, H. Comparing Meat Abstainers with Avid Meat Eaters and Committed Meat Reducers. Front. Nutr.
2022,9, 1016858. [CrossRef]
58.
Gutiérrez-Villar, B.; Melero-Bolaños, R.; Montero-Simo, M.J.; Araque-Padilla, R.A. Profiling Consumers with an Environmentally
Sustainable and Healthy Diet: The Case of Spanish Households. Front. Nutr. 2022,9, 1035142. [CrossRef]
59.
Perignon, M.; Vieux, F.; Soler, L.-G.; Masset, G.; Darmon, N. Improving Diet Sustainability through Evolution of Food Choices:
Review of Epidemiological Studies on the Environmental Impact of Diets. Nutr. Rev. 2017,75, 2–17. [CrossRef]
60.
Steenson, S.; Buttriss, J.L. Healthier and More Sustainable Diets: What Changes Are Needed in High-Income Countries? Nutr.
Bull. 2021,46, 279–309. [CrossRef]
61.
Willett, W.; Rockström, J.; Loken, B.; Springmann, M.; Lang, T.; Vermeulen, S.; Garnett, T.; Tilman, D.; DeClerck, F.; Wood, A.; et al.
Food in the Anthropocene: The EAT—Lancet Commission on Healthy Diets from Sustainable Food Systems. Lancet
2019
,393,
447–492. [CrossRef]
62.
Tiberius, V.; Borning, J.; Seeler, S. Setting the Table for Meat Consumers: An International Delphi Study on in Vitro Meat. NPJ Sci.
Food 2019,3, 10. [CrossRef] [PubMed]
63.
IPCC. Climate Change and Land—Summary for Policymakers. Available online: https://www.ipcc.ch/site/assets/uploads/
sites/4/2019/12/02_Summary-for-Policymakers_SPM.pdf (accessed on 6 April 2023).
64. Meybeck, A.; Gitz, V. Sustainable Diets within Sustainable Food Systems. Proc. Nutr. Soc. 2017,76, 1–11. [CrossRef] [PubMed]
65.
Sun, Z.; Scherer, L.; Tukker, A.; Spawn-Lee, S.A.; Bruckner, M.; Gibbs, H.K.; Behrens, P. Dietary Change in High-Income Nations
Alone Can Lead to Substantial Double Climate Dividend. Nat. Food 2022,3, 29–37. [CrossRef] [PubMed]
66.
Humpenöder, F.; Bodirsky, B.L.; Weindl, I.; Lotze-Campen, H.; Linder, T.; Popp, A. Projected Environmental Benefits of Replacing
Beef with Microbial Protein. Nature 2022,605, 90–96. [CrossRef] [PubMed]
67.
Ferrari, L.; Panaite, S.-A.; Bertazzo, A.; Visioli, F. Animal- and Plant-Based Protein Sources: A Scoping Review of Human Health
Outcomes and Environmental Impact. Nutrients 2022,14, 5115. [CrossRef] [PubMed]
68.
Tong, T.Y.N.; Papier, K.; Key, T.J. Meat, Vegetables and Healt—Interpreting the Evidence. Nat. Med.
2022
,28, 2001–2002. [CrossRef]
69.
Wright, K.B. Researching Internet-Based Populations: Advantages and Disadvantages of Online Survey Research, Online
Questionnaire Authoring Software Packages, and Web Survey Services. J. Comput.-Mediat. Commun.
2005
,10, JCMC1034.
[CrossRef]
Disclaimer/Publisher’s Note:
The statements, opinions and data contained in all publications are solely those of the individual
author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to
people or property resulting from any ideas, methods, instructions or products referred to in the content.