Interviews with an experts

To ensure a diverse and representative perspective on the examined questions, experts were purposefully selected from three countries: Belgium, Greece, and Lithuania. The selection strategy aimed to include experts from various backgrounds, including academia, clinical practice, public health administration, and health communication. This approach enabled a balanced mix of roles, encompassing policy development, education, practical application, and public engagement. In total, 15 experts were interviewed – five in each partner country.

Across Belgium, Lithuania, and Greece, the conceptualization of “vulnerable citizens” in the context of nutrition reflects a multidimensional understanding that moves beyond mere economic status to include social, cultural, psychological, and functional factors.

The experts from all three countries emphasized that vulnerability is not defined by a single criterion (e.g., income), but rather a confluence of factors, including socioeconomic disadvantage, social isolation, cultural marginalization, limited knowledge or skills, life stage or physical/mental conditions.

Our interviewed experts described that vulnerability is often seen as shaped by local systems, including food environments, welfare support, education access, and cultural norms. Experts from different countries sees vulnerability from different perspectives:

• In Belgium, vulnerability is linked to navigating unfamiliar systems (for migrants), mental health, and institutional barriers.
• In Lithuania, emphasis is placed on early-age vulnerabilities, the influence of digital media on adolescents, and limited food autonomy among children.
• In Greece, there is a detailed, life-course approach, highlighting how different stages (infancy, youth, aging) intersect with broader social and cultural dynamics.

Despite that, several groups—such as people with disabilities (Belgium), adolescents (Lithuania), or pregnant and breastfeeding women (Greece)—were described as under-recognized or underserved in current public health strategies. These points to a need for more inclusive definitions and tailored interventions.

Multiple forms of vulnerability often intersect, creating compounded disadvantage. For example: a low-income single mother from a migrant background may face financial, cultural, and informational barriers simultaneously or an older adult with mobility issues and digital illiteracy may struggle both to access food and understand dietary advice.

Our interviewed experts say, that especially in Belgium and Greece, vulnerability is also defined by capacity and support networks. Functional limitations (e.g., chewing, cooking, shopping) can lead to vulnerability, even in the absence of poverty. Lack of social or institutional support (e.g., for meal preparation, accessing services) was highlighted as a key vulnerability factor.

Analyzing the responses of the interviews, we have made key findings related with the uptaking of beneficial tools and apps:

• All three countries face challenges with the underuse of digital tools among vulnerable populations, especially those with low digital or health literacy.
• There is a consistent need for digital tools to be user-friendly, culturally adapted, and easy to navigate.
• Professionals across all countries rely on offline approaches, such as group sessions, brochures, or meal cards, due to their higher effectiveness with vulnerable populations.
• All experts agree that digital tools should complement, not replace, real-life strategies.
• Belgium focuses on the need for tools to support vulnerable groups in real-life settings, while Lithuania highlights barriers like limited device access and resistance to screen-based tools.
• Greece’s primary concern is the lack of digital tools tailored for vulnerable groups, with suggestions focused on integrating simple language, food vouchers, and notifications to increase user engagement.

The insights gathered from experts across Belgium, Greece, and Lithuania reveal that nutritional vulnerability is a multifaceted and context-dependent phenomenon, shaped by a range of systemic and individual factors. Importantly, the findings underscore the critical need for inclusive, adaptable public health strategies that recognize intersecting forms of disadvantage and prioritize accessibility, especially in the digital domain.

As digital tools become increasingly central to public health interventions, ensuring their cultural relevance, simplicity, and integration with offline support systems will be vital to reaching and empowering vulnerable populations in a meaningful and sustainable way.

Multi-country epidemiological study

A recent multi-country epidemiological study conducted across Greece, Belgium, and Lithuania has shed light on the health, food behaviors, and digital readiness of vulnerable European citizens. The research, encompassing 482 participants, provides key insights into how individuals from diverse socio-economic and cultural backgrounds navigate nutrition, food security, and technology in their daily lives.

The study included participants from rural villages to large cities, spanning ages 17 to 65+. While demographic characteristics varied, a common theme emerged: vulnerability—whether economic, social, or digital—impacted daily choices related to food and health. Over half of the participants were parents, and a significant portion lived in medium- to large-sized cities, indicating potential urban food insecurity challenges.

Participants demonstrated a high level of self-awareness regarding personal health, which often motivated healthier behaviors. However, nutrition literacy remained moderate: while most said that they understand basic healthy food principles, many struggled with interpreting food labels and resisting misleading food advertising. Encouragingly, those with higher nutrition literacy showed a greater openness to using digital cooking apps—especially those promoting healthier recipes.

A notable portion of the study population reported mild to severe food insecurity. Common coping mechanisms included reducing food variety or skipping meals — especially concerning for households with children. Interestingly, individuals facing food insecurity were more likely to express interest in using apps that offer budget-friendly, sustainable meal suggestions. This points to a crucial opportunity: digital tools may help vulnerable individuals make informed food choices under financial constraints.

Study participants expressed a clear preference for fresh, unprocessed foods and were wary of additives and highly processed products. However, practicality and affordability often outweighed nutritional or ethical concerns when making food choices. This underscores the importance of cost-effective and accessible nutrition interventions.

While ethical concerns like hunger and the waste of nutritious food were top-of-mind, environmental sustainability received less emphasis. Many participants were unsure how to reduce food waste, signaling the need for targeted food waste literacy tools and resources.

Most participants showed strong food safety practices (e.g., checking expiration dates), yet many lacked skills in meal planning, budgeting, and preparation. Shopping habits were generally intentional, with many relying on lists, reading labels, and bulk-buying to maximize savings — suggesting potential touchpoints for educational support.

Food remained deeply intertwined with cultural identity. There was strong support for local and seasonal produce, driven more by taste and quality than by nationalism or anti-import sentiment. This mild ethnocentrism could be leveraged to promote sustainable, community-based food initiatives.

Digital readiness among participants was moderate, with higher adoption intent seen for health-related apps over sustainability-focused ones. Notably, participants with greater digital and nutrition literacy were more inclined to use recipe apps. Younger participants were especially likely to adopt digital tools for sustainable cooking.

Analyzing the study, we see these highlights to be considered during the DietWise project:

• Nutrition and digital skills are critical enablers for engaging with healthy, sustainable food apps.
• Cost and food security are dominant drivers of food choice and technology uptake.
• Sustainability messaging may be less effective unless paired with economic or health incentives.
• There’s a need for targeted support: practical food waste reduction tips, label-reading education, and digital engagement strategies for vulnerable groups.

These findings highlight the critical need for targeted, inclusive tools that bridge digital, nutritional, and financial literacy. By aligning app development and policy support with the real-world needs of vulnerable citizens, Europe can move closer to a more equitable and health-conscious food future.